When "Learning" Means Forgetting Everything We Know About Healthcare

Photo by Pars Sahin on Unsplash

Well, folks, I've just finished reading what might be the most spectacular example of someone learning all the wrong lessons from their clinical experience. Dr. Dwight Panozzo, a PhD and LCSW who should definitely know better, has written "From Respect to Understanding," where they want us to believe they've had some grand awakening about gender identity[1]. What they've actually done is trade their clinical training for a crash course in conspiracy thinking.

Meet Our "Journey-Taker"

Dr. Panozzo wants you to know they have 30+ years of experience. That's three decades of practice, folks. You'd think after all that time, they'd have developed some humility about the complexity of human experience. Instead, they've decided that their work with "dozens" of trans youth over several years has given them insights that somehow escaped every major medical organization.

Let me put that in perspective: "dozens" over "several years." I've probably seen more trans youth at a single Pride event. But apparently this limited experience is enough for Panozzo to overturn decades of research and clinical guidelines. Makes perfect sense if you don't think about it too hard.

Panozzo is now affiliated with Therapy First and Beyond Trans. Let's talk about those affiliations for a moment.

Therapy First operates under the charming assumption that if you just talk to kids long enough about their trauma or their autism or their family dynamics, they'll realize they're not really trans. It's conversion therapy with extra steps and better PR.

Beyond Trans, meanwhile, specializes in what they call "gender-questioning" support, which translates to "we won't affirm your gender identity." These organizations are part of a larger network promoting approaches that major medical organizations have rejected as harmful[2].

These organizations are part of a larger network including Genspect (who's promoting this essay), the Society for Evidence-Based Gender Medicine (SEGM), and various "parent groups" that offer about as much support as a paper umbrella in a hurricane. What unites them? They all promote approaches that major medical organizations have rejected as harmful[2]. They dress up their transmisia in concerned language about "protecting children" while advocating for exactly the kinds of delays and barriers that increase suicidality in trans youth.

But Panozzo has found their people! After decades of practice, they've discovered a community that validates their newfound skepticism about trans identities. It's heartwarming, really. Like watching someone find their tribe at a flat earth convention.

Let me walk you through Panozzo's journey, because boy howdy, it's a doozy.

The "I Used to Be Cool" Opening

Panozzo starts by telling us they once supported transgender rights but now sees the light. They frame their past support as "missteps" and "speaking without sufficient knowledge." You know what this reminds me of? Every "I used to be a Democrat until..." story that ends with someone explaining why they now think the moon landing was faked.

Here's the thing: supporting human rights isn't a misstep. It's basic decency. What Panozzo calls "insufficient knowledge" was probably just following established clinical guidelines from every major mental health organization[3]. But I guess when you decide science is a religion (more on that wild claim in a minute), actual clinical knowledge becomes optional.

The real tell here is the false humility. Panozzo positions themselves as someone who's grown wiser through experience, but what they're actually doing is a classic authority fallacy—"trust me, I've been on both sides." Except being wrong before doesn't make you right now. It just means you've been wrong twice. And when a licensed clinical social worker decides to abandon evidence-based practice, that's not growth—it's professional regression.

The Great Religion Comparison of 2025

Now here's where things get properly unhinged. Panozzo claims gender identity is an "unfalsifiable belief" like religion, writing that "core aspects rest on beliefs that cannot be proven or measured by empirical means."

Let me get this straight. A PhD-holding mental health professional is comparing the documented neurological basis of gender identity[4], the measurable psychological distress of gender dysphoria[5], and the observable positive outcomes of affirming care[6] to... what? Faith-based beliefs about the afterlife?

This is particularly rich coming from someone with LCSW credentials. Social workers are trained to understand that human experience includes subjective elements that are nonetheless real and treatable. Pain, trauma, anxiety—none of these can be "proven" in the way Panozzo seems to demand, yet we don't dismiss them as religious beliefs. By Panozzo's logic, their entire field of practice is basically a church.

The intellectual dishonesty here is staggering. Panozzo knows—or should know, given their training—that subjective experiences can be studied systematically. We have diagnostic criteria, assessment tools, and outcome measures. The fact that gender identity involves self-knowledge doesn't make it unfalsifiable any more than depression or PTSD are unfalsifiable. This isn't philosophy class; it's healthcare, and Panozzo should know the difference.

The "Trans as Religion" Playbook: A Coordinated Strategy

Before we move on from Panozzo's religion comparison, we need to talk about the elephant in the room. This isn't just one confused clinician's bad take—it's part of a deliberate political and media strategy that's been gaining steam over the past few years.

From state legislatures to op-ed pages, we're seeing the same talking point repeated ad nauseam: "gender ideology is a religion," "trans identity is based on faith not facts," "we're being forced to participate in someone else's religious beliefs." This isn't coincidence; it's coordination.

Why this particular comparison? Well, it's strategically brilliant if your goal is to undermine trans rights. In the U.S., we have strong protections for religious freedom, but we also have separation of church and state. By framing trans identity as a religion, opponents can argue that:

• Schools shouldn't "teach" gender identity (separation of church and state)

• Healthcare providers can refuse to participate (religious exemption)

• Inclusive policies violate others' religious freedom

• Insurance shouldn't cover "religious" treatments

• The government shouldn't fund "faith-based" healthcare

See the trick? They're weaponizing religious freedom against trans people by falsely categorizing gender identity as a religious belief. It's the same playbook used against marriage equality—remember "participating in gay weddings violates my religion"? Now it's "using pronouns violates my religion because I'm being forced to affirm someone else's faith."

But here's why this comparison falls apart faster than a dollar store umbrella:

Religion is about metaphysical beliefs. It deals with the supernatural, the afterlife, divine beings, and ultimate meaning. Gender identity is about lived experience in the material world. When a trans woman says she's a woman, she's not making a claim about the nature of the universe or the existence of souls. She's describing her persistent internal sense of self—something psychologists can study, measure, and work with clinically[7].

Religious beliefs are typically taught. You learn about Christianity, Islam, or Buddhism from external sources. Gender identity emerges internally, often despite external teaching to the contrary. No one's conducting gender identity catechism classes. Trans kids often know their gender before they even have words for it[8].

Medical conditions have diagnostic criteria. Gender dysphoria appears in the DSM-5 with specific diagnostic criteria[9]. There's no "Christianity dysphoria" or "Buddhism disorder" because religions aren't medical conditions. The distress that can accompany gender incongruence is measurable, treatable, and responds to evidence-based interventions[10].

Trans identity exists across all religions. There are trans Christians, Muslims, Jews, Buddhists, atheists, and everything in between. If gender identity were itself a religion, how could trans people simultaneously hold other religious beliefs? That's like being simultaneously Catholic and Protestant—it doesn't track.

The really insidious part is how this rhetoric works to dehumanize trans people while sounding superficially reasonable. "I respect your beliefs" sounds nicer than "I deny your existence," but functionally, they're the same thing. When someone says trans identity is a religious belief, they're saying it's optional, changeable, and not grounded in material reality.

Weaponizing "Religious Freedom" Against Trans Rights

Here's where Panozzo's argument reveals its true purpose. This isn't just philosophical navel-gazing—it's a calculated strategy to strip trans people of civil rights protections.

Think about it: If being trans is a "religion," then suddenly bathroom access becomes a "religious accommodation" that can be denied. Medical care transforms from healthcare to "religious practice." Anti-discrimination laws no longer apply in the same way. School policies can exclude trans kids as "religious exemptions."

Panozzo isn't naive. They know exactly what they're doing. By reframing trans identity as a "New Religious Movement," they're trying to invoke the same limitations we place on religious practice. The message becomes: "Sure, you can believe you're trans—that's your religious freedom! But your beliefs stop at the bathroom door."

This strategy also allows them to demand "religious exemptions" from treating trans patients, argue that teaching about gender identity violates church-state separation, claim that insurance covering trans healthcare is "establishing a religion," and frame trans-inclusive policies as government-imposed theology.

Notice how Panozzo specifically mentions the Establishment Clause? That's not accidental. They're laying groundwork to argue that any government recognition of trans people is unconstitutional. It's the same playbook used against marriage equality—"We're not discriminating, we just can't let government establish the 'religion' of gay marriage!"

The delicious irony? Many actual religions support trans people. There are trans clergy, inclusive theology, and faith communities that fully embrace gender diversity[11]. But Panozzo wants to create a fake religion to deny rights that real religions often support. This isn't philosophy—it's a legal strategy dressed up as academic concern.

The "Regret" Card

They mention providing letters for hormones to patients who "experienced negative outcomes" including some who "have now detransitioned and feel harmed." Notice how vague that is? No numbers, no context, no acknowledgment that regret rates for gender-affirming care are incredibly low—under 1% in most studies[12].

This is pure selection bias served with a side of emotional manipulation. A trained clinician like Panozzo knows better than to generalize from a handful of cases. It's like opposing antidepressants because some patients experience side effects. Yeah, no treatment is perfect, but we don't usually throw out entire treatment modalities because of rare adverse outcomes.

What's particularly troubling is that Panozzo, as a mental health professional, should understand the complexity of detransition. Research shows that most detransition is driven by external factors like discrimination, not "realizing" they're not trans[13]. But acknowledging that would require Panozzo to consider systemic issues rather than blaming gender-affirming care itself.

The Biohazard Protocol

This is my favorite part, and by favorite I mean most horrifying. Panozzo suggests we should treat "unfalsifiable concepts like GI with caution, akin to handling bio pathogens" to "protect those vulnerable to adopting inaccurate self perceptions."

I'm sorry, what? A licensed clinical social worker is comparing their clients' identities to infectious diseases? Should mental health professionals wear hazmat suits during gender therapy sessions? Set up decontamination chambers outside their offices?

This isn't just bad practice; it's a fundamental violation of social work ethics. The NASW Code of Ethics emphasizes respect for client self-determination and dignity[14]. Comparing aspects of client identity to pathogens is about as far from ethical practice as you can get. How does someone with Panozzo's credentials write this without their professional conscience screaming?

The pathogen metaphor is particularly insidious because it frames trans identity as something that spreads, that infects, that needs to be contained. This is recycled homophobia with a modern coat of paint, and Panozzo should be ashamed to be recycling it.

The Money Shot

And here we get to the real agenda: "medicalization of gender dysphoria should be at the expense of the GI practitioner, not the public."

Ah yes, because nothing says "ethical clinical practice" like creating financial barriers to healthcare. A social worker—someone supposedly committed to social justice and removing barriers to care—is literally advocating for making healthcare less accessible. The NASW Code of Ethics specifically calls for social workers to advocate for client access to needed resources[15]. Guess Panozzo skipped that part in grad school.

But here's what really gets me: treating gender dysphoria actually saves money in the long run. Untreated gender dysphoria leads to depression, anxiety, substance abuse, and suicide attempts[16]—all of which are way more expensive to treat than hormone therapy. As someone with a PhD, Panozzo should be able to read the cost-benefit analyses. This isn't about fiscal responsibility; it's about creating barriers to care for people they've decided don't deserve it.

What Real Intellectual Humility Looks Like

Panozzo ends by preaching about intellectual humility and continuous learning. They write about the importance of "critically reevaluating our positions" and remaining "willing to acknowledge when we may have been wrong."

But here's what actual intellectual humility looks like for a mental health professional: listening to your clients about their own experiences. Following the evidence base even when it challenges your personal beliefs. Consulting with colleagues who specialize in gender-affirming care. Recognizing when your discomfort is interfering with your clinical judgment.

What it doesn't look like? Abandoning established best practices because you've bought into the idea that they're too much like religion. A PhD should understand the difference between challenging orthodoxy and throwing out evidence-based practice entirely. This isn't intellectual humility; it's professional arrogance dressed up as wisdom.

The Bottom Line: What We've Learned and What's Coming

Panozzo's "journey" from respect to understanding is actually a journey from evidence to ideology, from helping clients to harming them, from professional ethics to political agenda. But this essay isn't just about one clinician's fall from grace. It's a preview of coming attractions in the anti-trans playbook.

Let's recap what we've debunked here:

The claim that gender identity is "unfalsifiable" ignores diagnostic criteria, measurable outcomes, and decades of research. We've shown how gender dysphoria meets every standard for a legitimate medical condition. It's observable, treatable, and responds predictably to intervention. The "unfalsifiable" argument is a philosophical shell game designed to make you ignore actual evidence.

The religion comparison falls apart on every level. Trans identity has neurological correlates, exists across all faiths, emerges without teaching, and appears in medical diagnostic manuals. Calling it a religion is like calling depression a philosophy. It fundamentally misunderstands what medical conditions are.

But here's why this matters beyond Panozzo: We are already seeing this "trans as religion" argument cropping up with me alarming frequency, and I expect we will see it everywhere in 2025 and beyond, until it loses its edge. It's already spreading through the Genspect/SEGM/Anti-trans organizations pipelines and even some headlines/public figures are beginning to repeat this. I expect we will see it more in legislatures, school boards, and in headlines to come. So here's your field guide for spotting and countering it:

When they say: "Gender identity is (unfalsifiable) like religion"
You respond: "So is pain, anxiety, and depression. Should we stop treating those too? Medical conditions don't need to be visible under a microscope to be real. We have diagnostic criteria, treatment protocols, and measurable outcomes."

When they say: "Schools are teaching gender ideology"
You respond: "Schools teach about human diversity, including that trans people exist. That's not ideology, it's reality. Acknowledging gay people exist isn't teaching 'gay ideology,' and acknowledging trans people exist isn't teaching 'trans ideology.'"

When they say: "Affirming trans identity violates my religious freedom"
You respond: "Your religious freedom doesn't include denying other people's medical care or basic dignity. You can believe whatever you want, but you can't impose those beliefs on others' healthcare decisions."

When they say: "Trans identity spreads like a social contagion"
You respond: "Visibility isn't contagion. Left-handedness 'increased' when we stopped forcing kids to use their right hands. ADHD diagnoses 'increased' when we learned to recognize it. Trans people have always existed; we're just letting them live openly now."

The tragedy is that real trans youth will suffer because of clinicians like Panozzo. Kids who need support will instead get endless "exploratory therapy" designed to make them doubt themselves. Families looking for guidance will find professionals who view their children's identities as contagions to contain.

But here's the good news: This argument is so flimsy that it collapses under the slightest scrutiny. Once you see the pattern of falsely labeling medical care as religion to deny rights and access, you can't unsee it. And once you can name it, you can fight it.

When the history books are written about this moral panic, Panozzo's essay will be Exhibit A in how medical professionals abandoned their ethics to join a political crusade. But it will also be Exhibit A in how transparent their arguments were, how easily debunked their claims, and how desperately they had to distort reality to justify their prejudice.

The "trans as religion" narrative isn't going away soon. But neither are we. And now you've got the tools to fight back. Because at the end of the day, no amount of philosophical hand-wringing can change the fact that trans people exist, deserve healthcare, and have the right to live without their identities being treated like biohazards.

Stay vigilant, friends. The next time someone tries to sell you the "gender identity is a religion" line, you'll be ready. And remember: when they have to compare your existence to a pathogen to make their point, they've already lost the argument.

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[1] Panozzo, D. (2024). From respect to understanding: One clinician's journey of learning in the era of gender identitarianism. Genspect.

[2] Ashley, F. (2022). Interrogating gender-exploratory therapy. Perspectives on Psychological Science, 17(5), 1340-1347.

[3] American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832-864.

[4] Guillamon, A., Junque, C., & Gómez-Gil, E. (2016). A review of the status of brain structure research in transsexualism. Archives of Sexual Behavior, 45(7), 1615-1648.

[5] American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

[6] Ristori, J., & Steensma, T. D. (2016). Gender dysphoria in childhood. International Review of Psychiatry, 28(1), 13-20.

[7] Steensma, T. D., Kreukels, B. P., de Vries, A. L., & Cohen-Kettenis, P. T. (2013). Gender identity development in adolescence. Hormones and Behavior, 64(2), 288-297.

[8] Olson, K. R., Key, A. C., & Eaton, N. R. (2015). Gender cognition in transgender children. Psychological Science, 26(4), 467-474.

[9] See [5] above.

[10] See [6] above.

[11] Tanis, J. (2018). Trans-gendered: Theology, ministry, and communities of faith. Pilgrim Press.

[12] Bustos, V. P., Bustos, S. S., Mascaro, A., Del Corral, G., Forte, A. J., Ciudad, P., ... & Manrique, O. J. (2021). Regret after gender-affirmation surgery: A systematic review and meta-analysis of prevalence. Plastic and Reconstructive Surgery Global Open, 9(3), e3477.

[13] Turban, J. L., Loo, S. S., Almazan, A. N., & Keuroghlian, A. S. (2021). Factors leading to "detransition" among transgender and gender diverse people in the United States: A mixed-methods analysis. LGBT Health, 8(4), 273-280.

[14] National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers. NASW Press.

[15] Ibid.

[16] Bauer, G. R., Scheim, A. I., Pyne, J., Travers, R., & Hammond, R. (2015). Intervenable factors associated with suicide risk in transgender persons: A respondent driven sampling study in Ontario, Canada. BMC Public Health, 15(1), 1-15.