Washington Wednesday: Pausing harm

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LINDSAY MAST, HOST: It’s Wednesday, December 24th. Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Lindsay Mast.

NICK EICHER, HOST: And I’m Nick Eicher. Time now for Washington Wednesday!

The Department of Health and Human Services last week unveiled steps it’s taking to act on the president’s order to roll back Biden-era policies on transgenderism, and put medical providers on notice.

What makes this moment different is not just a policy reversal—but a direct challenge to who gets to define “medical consensus” in Washington.

HHS Secretary Robert F. Kennedy Jr.

RFK JR.: …Sex-rejecting procedures impose medical dangers and lasting harm on children who receive these interventions.

HHS did its own review of the data available, and published its findings last month.

OZ: We don't provide health care to every child, but at 53% we've got most. And we're not going to let taxpayer money go to hurt these children. And those children will no longer be hurt by this ideology.

MAST: Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services.

He said the agency is working on rules to prohibit doctors in the Medicare system from offering procedures to minors to attempt sex-change. CMS would also block Medicaid dollars to pay for them. That would be a sharp break from the last decade, when federal reimbursement rules reinforced these treatments as standard care.

Another policy would reverse efforts to add gender dysphoria to the definition of disability. HHS Deputy Director Jim O’Neill:

O’NEILL: At the root of the evils we face, such as the blurring of the lines between sexes and radical social agendas, is a hatred for nature as God designed it, and for life as it was meant to be lived.

EICHER: Many in attendance have been active in challenging the medical ideology of the transgender movement, and told WORLD they are encouraged to see progress.

Dr. Katherine Welch is a pediatrician from Indiana.

WELCH: Nothing terribly surprising, but it's all a step in the right direction.

Dr. Welch works with detransitioners through the Resilience Health Network.

WELCH: The problem is, is that doctors are looking to either their Academy and their Association guidelines. Doctors are really busy. They don't have time to read a lot of science, and they're just following what their respective academies are doing. And so that's not going to be talked about.

MAST: In other words, even skeptical doctors are constrained—not by law, but by professional gatekeepers.

Right now, America’s leading medical associations in fields from pediatrics to urology still say so-called gender affirming care is safe and effective. Only the American Society of Plastic Surgeons, has its doubts. Dr. Scot Glasberg, past president of the ASPS, says studies don’t back up the claims.

GLASBERG: Our statement is in that in gender affirming care for minors is the evidence is of low certainty. So our surgeon should be cautious in even considering these types of surgeries.

Dr. Glasberg told WORLD he supports steps the Administration has taken to protect minors, but he’s concerned about the decision to cut funding for research.

GLASBERG: I think that one thing that's clear as day amongst all of these surgeries, even even for adults, is that we need more evidence. We need more data.

EICHER: But that raises a deeper question: if the evidence is still thin, what kind of research would be required to improve it—and is it ethical to conduct that research at all?

Joining us to talk about it now is political scientist Hunter Baker. Good morning Hunter!

HUNTER BAKER: Good morning!

MAST: Hunter, this feels like more than a policy tweak—it’s a challenge to the medical establishment itself. Is this a durable political shift, or a moment that collapses if power changes hands?

BAKER: I think that what I would say is that I'm grateful for the pause. I'm grateful for the momentum to kind of come to a halt while there's time to reconsider. It seemed like we were on a rocket ship there for a while, with this idea of gender suddenly becoming fluid, and a willingness to do some pretty radical things with drugs and surgical interventions. Now there's time to kind of stop and breathe and think, and I think that this is the kind of thing we're talking about, radical changes to a person's body, and in particular, we're talking about radical changes to a developing person's body, a person who is still maturing and who is likely to think about things differently within a period of years, that we can be grateful that the 2024 election basically bought time. But. Basically arrested the momentum, and we're going to see what happens when the political winds next change.

EICHER: Yeah, when, not if. Well, Hunter, I do want to return to something that we raised at the end of the setup there, namely, that even supporters of the rollback say we need more evidence and we shouldn't be cutting research funding. But I'm curious about this research. What if the reason the evidence is thin is that rigorous studies would require experimenting on children, which in any other context we wouldn't allow that? Are we missing something really important here?

BAKER: I think that what has happened is we have really moved beyond the medical into the social and the political. Just speaking as somebody who is married to a physician, I can tell you that I have 30 years of looking at medical journals that come to my house, and I can tell you there's an awful lot more politics and social activism in those journals than there were 30 years ago. So we're not just talking about improving someone's health or making changes in the body that are sort of consonant with what that body needs. Instead, we're in a realm. Just to make a comparison, I think that the kinds of things we're talking about with sex changes are sort of like if a person really felt that they needed to amputate their left arm in order to be a whole functioning person, you know, if they if they just had an impulse that they needed to make that change or that they needed to have a prosthetic leg instead of the leg they have. And so really, we're getting into the psychological and the political and what kind of rights people have. And so this is way beyond questions like, can we cure a particular disease? And it gets down to what it means to be human, and the degree to which physicians should empower people, regardless of what their personal vision might be.

MAST: One other Washington development worth noting—we reported this yesterday on the program. The Heritage Foundation is losing more than a dozen staff members who’ve departed amid internal turmoil over leadership and mission.

At the same time, Advancing American Freedom, the think tank founded by former Vice President Mike Pence, has been hiring several former Heritage staffers.

So it appears less like random turnover—and more like a sorting. Interpret this for us, Hunter: when you see staff leaving Heritage and re-forming around Pence’s group, what does that tell you about where conservative institutional energy is moving right now?

BAKER: In the short term, this is an immediate reaction to the controversy over Tucker Carlson and his relationship to Kevin Roberts, who is the current president of the institution, but there's a bigger picture, and that is Donald Trump in 2016 really disrupted the conservative movement and the way it understands itself. For a long time, there was a Reagan identity for the Republican Party, and Donald Trump is a different kind of a figure with a similarly large effect, and the party has kind of been remaking itself around Trump, but there remains that kind of previous Reagan sort of identity, and so there's kind of a tension there, and working it out. And this is not unusual. It's happened before. Reagan was himself a disruptor of the conservative movement in the United States. You had, at one time, somebody like Governor Rockefeller in New York who was far more moderate relative to Reagan, or even a Richard Nixon who was actually quite moderate in various ways. And so you have had different sorts of changes in the conservative movement in American politics, and we're watching that unfold right now. So is the future of the Republican Party and or the conservative movement? Is it going to be a Trump movement going forward? Or is Trump going to reach the end of his term and then things kind of revert to the mean? That's what we're watching unfold as we see these sort of dramas, as with the Heritage Foundation and advancing American freedom

EICHER: Hunter, you mentioned different kinds of Republicans. I want to pursue this based on different kinds of Democrats, because when we talk about Ronald Reagan, you can't talk about Ronald Reagan without referring to the phenomenon known as Reagan Democrats. And there are Trump Democrats that are certainly part of this Maga coalition. Nation, but I think you had different kinds of Democrats during the Reagan years versus the kind of Democrats that have signed up with Trump. So I wonder if that's not part of this dynamic as well?

BAKER: I think that's part of the picture too. I think that there are Trump Democrats. I have no doubt in my mind that there are people who voted for Bill Clinton or even who voted for Barack Obama, who have now voted for Donald Trump and so and at the same time as the Republican Party has sort of oriented itself around Trump, you have some Republicans, not a lot, but some who have begun to take on more of a kind of a left wing identity out of their sort of revulsion or opposition to Donald Trump. So, yeah, the whole picture is is pretty fluid right now.

EICHER: Well, one final Washington note, and this one is very sad. Former senator and university president Ben Sasse announced this week that he has been diagnosed with stage-four pancreatic cancer. In a long and candid message posted on the social media site X, Sasse writes openly about death, faith, family, and hope—especially fitting for the season of Advent.

We’ve posted the full statement in today’s program transcript. There's a link, and you can go read it for yourself. It is absolutely well worth reading.

But as a senator, Ben Sasse was known for framing political debates in moral terms and not simply partisan terms, during a Washington Wednesday conversation several years back, back in 2019 he put it this way. Listen to this.

SASSE: I believe in the long term that the pro-life movement is going to be successful, because we’re pro-baby, we’re pro-compassion, we’re pro-mom, and we’re pro-science. And the reason the pro-life movement is growing is because there’s more and more imaging technology available in the world and younger people are becoming more pro-life because they’re seeing more images of what happens in-utero.

Well, Hunter hearing that now alongside the message that he has just written, what stands out to you about the consistency of the way that Ben Sasse has thought about human dignity, both in public life and now as he faces death?

BAKER: He absolutely was a champion for life, a strong Christian. I remember him coming to speak at in my previous university, Union University, and he, he pulled out his phone and referred to it as an idol factory as he as he addressed that large audience at graduation. But I just have to reflect on him more broadly as well. He is a politician who had the opportunity to be around through the ERLC Baptist organization. And I was just so deeply impressed with this man, a true intellectual, a tremendous influence for the Christian faith in the U.S. Senate. I was sad to see him leave the Senate, and I greatly regretted him leaving the University of Florida, where he had served as president. This is a person who had tremendous gifts, and I think was faithful in the use of them. I'm sad to see him go. I know that many people will be and I pray that that God will bring others in his place who are similarly gifted.

EICHER: Hunter Baker is provost at North Greenville University. Thank you, Hunter, and Merry Christmas.

BAKER: Merry Christmas.

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