In this episode of The Right Idea, TPPF's Brian Phillips and Derek Cohen break down how political activism has seeped into Texas healthcare — influencing diagnoses, treatments, and public policy.They’re joined by Dr. Lisa Ehrlich, internal medicine physician and former TMA trustee, and Joseph Figliolia, Manhattan Institute policy analyst and author of a major report on the TMA’s drift into ideological advocacy.Together, they examine:* How the TMA embraced gender-affirming care despite weak evidence* Why many physicians feel silenced* How institutional capture happens inside medical organizations* The impact on children, parents, lawmakers, and the practice of medicine* What reforms are needed to bring medicine back to evidence-based practice00:30 – Thanksgiving politics & family discussions03:40 – Today’s topic: Gender ideology in healthcare05:18 – Guest introductions: Dr. Ehrlich & Joseph Figliolia05:42 – Why Joseph investigated the TMA07:23 – Is the TMA doubling down despite national pushback?09:07 – Evidence problems & reversals in Europe10:25 – Dr. Ehrlich: What clinicians saw on the ground11:38 – Social contagion & the rise of gender questioning13:12 – Vulnerable populations & patterns emerging14:58 – Why endocrinology led the shift16:02 – “Science by consensus” and activist medicine17:36 – The problem with WPATH & activist guidelines18:33 – How TMA was captured: institutional mechanics19:23 – Why doctors stay silent20:57 – Fear of being labeled discriminatory22:08 – Dr. Ehrlich: Intimidation inside the TMA23:56 – Identity sections and cultural politicization25:05 – Personal attacks vs scientific debate26:31 – Medicine requiring ideological pre-commitments?27:55 – Historical parallels (e.g., lobotomies)28:58 – Pandemic mandates & ethical shifts31:09 – Three separate issues: dysphoria, treatment, ideology32:57 – Suicide risk, treatment failures, evidence gaps34:18 – Is someone funding this movement?36:01 – TMA’s definitions avoid “gender dysphoria” entirely37:44 – The financial incentives behind affirming care38:39 – Do associations influence medical boards?41:15 – How TMA influences Texas policy42:07 – Is Texas protecting kids effectively?43:30 – Evidence-based standards being ignored44:56 – CME problems: outdated, debunked studies45:14 – Can the TMA be fixed?47:34 – Structural governance problems49:24 – What shoe drops next?51:07 – The comprehensive HHS gender dysphoria review51:35 – Dr. Ehrlich’s advice for physicians afraid to speak up

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