Paul Garcia-Ryan identified as a woman from age 15 to age 30, then chose to detransition. Today he is a licensed clinical social worker and the president of Therapy First, and he argues that the debate over gender and young people has a lot less to do with sides than the culture war makes it look.

Paul joins Ryan Vet to share his story in his own words: an early childhood sense that he was different, his medical, social, and legal transition, and his training as a psychotherapist at a leading gender clinic in New York City. He explains what changed once younger patients began arriving in his own practice, and how that led him to rethink gender dysphoria and his own history.

Paul now works with young people and their families, and with trans adults, and leads Therapy First, a nonprofit focused on raising the standard of care in youth mental health. He and Ryan talk about how the field has shifted from a mental health model toward a medical model, why therapists often talk past each other because they use the same terms with different definitions, and how a generation raised on algorithms and social media forms its identity differently than the one before it.

For parents, Paul's advice is to stay curious about what your child is experiencing, however frightening it feels, and to avoid locking horns, because a family in conflict is a family under strain. For clinicians, he describes therapy first as the established standard of care, and says every therapist should hold a young person's identity with an open palm. His closing call: this is an all-hands-on-deck moment for the mental health profession, and it needs leaders to step up.

This episode reflects one person's lived experience and professional views. It is not medical or mental health advice. If you or someone you love needs support, please reach out to a licensed professional.

IN THIS EPISODE

• Paul's personal story, in his own words, and why he decided to detransition
• What he saw in his practice when the young people arriving at gender clinics changed
• How the field moved from a mental health model toward a medical model
• Why therapists talk past each other, and why he says there is an illusion of sides
• How algorithms and social media shape identity formation in adolescence
• What he tells parents: stay curious, and avoid locking horns with your child
• What therapy first means as a standard of care, and why leaders in the field need to step up

CONNECT WITH THERAPY FIRST

• Website: therapyfirst.org

GO DEEPER WITH COLLIDE

Ryan writes about generational shifts in leadership, work, and culture every week in his COLLIDE newsletter. Read it free: ryanvet.com/collide

ABOUT THE RYAN VET SHOW

The Ryan Vet Show is a podcast about generations, culture, leadership, and the future. Host Ryan Vet is a USA Today bestselling author, generational futurist, and keynote speaker with more than 1,000 live in-person presentations.

COMING UP

Thursday, October 15: a new COLLIDE essay episode.

Send us Fan Mail

Ryan Vet is a USA TODAY bestselling author, futurist, and international keynote speaker whose insights on generations, culture, and the future of work have been featured in Forbes, Financial Times, ABC, NBC, and CBS. His research helps leaders understand emerging generational patterns and anticipate societal shifts before they fully unfold.

If you want deeper research and behind-the-scenes insights on generations and the future of culture and society, join Ryan’s weekly newsletter:
👉 https://ryanvet.com/collide