What should count as a mental disorder—and who gets to decide? In this week’s deep dive, Jamie Reed, Lauren Leggieri, and Cori Cohn examine how the DSM (Diagnostic and Statistical Manual of Mental Disorders) became one of the most politicized documents in modern medicine. From the pathologizing of homosexuality to today’s debates over “gender dysphoria,” the hosts explore how psychiatric labels have shaped medicine, culture, and identity itself.

Recorded in the wake of the 2025 SEGM Conference in Berlin and the Genspect Conference in Albuquerque, this conversation looks at competing proposals for a new diagnosis—or whether “gender-related distress” belongs in the DSM at all.

Jamie and Lauren join from the road while traveling through the Pacific Northwest on their speaking tour.

Drawing on insights from leading critics of psychiatry, including Dr. Paul McHugh and Dr. James Davies, the hosts trace how clinical consensus replaced scientific rigor—and how ideology continues to define what counts as care.

They also discuss what “bad therapy” really looks like and why the cell phone generation faces unique psychological challenges that psychiatry has yet to understand.

Links for Show Notes:

SEGM

SEGM 2025 Conference, BerlinSept. 11-14th, 2025https://segm.org/Berlin-2025

Dr. Paul McHugh

The Psychiatrist Who Shut Down America’s First Gender Clinic Speaks OutInterview of Dr. Paul McHugh, University Distinguished Service Professor of Psychiatry at Johns Hopkins University School of MedicineBeyond Gender podcastJul 17, 2025

“Psychiatry is a discipline that’s not come of age.” - Dr. Paul McHugh

(48:46 )

Notable fact: Dr. McHugh (1931–) co-founded the U.S.-based FMSF in 1992 to support families accused of abuse via “recovered memories,” often critiquing psychotherapy techniques for inducing false memories. The FMSF dissolved in 2019, after completing its contributions to the 1990s “memory wars” in therapy and legal contexts.

Dr James Davies

AD4E Festival - Dr James Davies - The Making of DSM.ADisorder4Everyone YouTube ChannelSep 25, 2020Dr. James Davies, accredited U.K. psychotherapist and professor of Social Anthropology and Mental Health at the University of Roehampton, London, presents at the ‘A Disorder For Everyone’ online festival, held September 18, 2020. The making of DSM. Dr. Davies is co-founder of CEP (The Council for Evidence-based Psychiatry).

CEP (The Council for Evidence-based Psychiatry)

Diagnostic system lacks validity

Statement: “Psychiatric diagnostic manuals such as the DSM and ICD (chapter 5) are not works of objective science, but rather works of culture since they have largely been developed through clinical consensus and voting. Their validity and clinical utility is therefore highly questionable, yet their influence has contributed to an expansive medicalisation of human experience.”https://cepuk.org/unrecognised-facts/diagnostic-system-lacks-validity/

Psychiatry & Big Pharma: Exposed - Dr James Davies, PhDThe Weekend University

“by reclassifying painful normality as psychiatric abnormality we have created the illusion of a psychiatric epidemic” -- Dr. James Davies

(3:07 )

Regarding Dr. Robert Spitzer & DSM 3, 4, 5

Stella O’Malley and Mia Hughes Recount Robert Spitzer-Led Updates to the DSMBeyond Gender Podcast, Clip from Episode #18https://x.com/stellaomalley3/status/1937598587157852616

During his presentation at the A Disorder 4 Everyone! (AD4E) Festival, Dr. Davies recounts his interview with Dr. Robert Spitzer (chairperson of DSM-III) regarding the lack of biological basis and reliance on consensus for DSM disorders:

(14:06 )

An Orchestrated Consensus becomes “Clinical Consensus”

“we took over because we had the power” - Robert Spitzer

(30:00 )

Mia Huges at Genspect

“The Upstream Battle: Challenging the False Belief Fueling Medical Harm” Mia HughesPresentation at the 2025 Genspect The Bigger Picture Conference, Albuquerque, NM

Cori Cohn at Genspect

The recording of his speech has not yet been released. As soon as it is we will include the link in a future episode.

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