Tactical Surrender: World Professional Association for Transgender Health

"WPATH [World Professional Association for Transgender Health] now agrees that pediatric transgender medicine is marked by 'medical and scientific uncertainty."

"Yet for years, WPATH presented its guidelines as an  unquestionable medical standard of care."

"The social and scientific costs of questioning their recommendations were steep and could be career-ending."

"For 10+ years doctors have been told WPATH's is the only way." 

Society for Evidence-Based Gender Medicine (SEGM) 

 

"SEGM's characterization of WPATH's legal position is a clear misrepresentation of an established legal distinction by the courts."

"[Our dedication to our mission and the served patient population] remains unwavering."

"[We are a nonprofit] dedicated to promoting science-based medical care, education, research and public policy in transgender health." 

"[Our Standards of Care] articulate a professional consensus about the psychiatric, psychological, medical and surgical management of transgender people."

"That transgender health care is an area of intense medical debate does not entitle Plaintiffs to prevent individuals and organizations like WPATH from free speech aimed at contributing to that debate."

"Many governments and organizations, including New Zealand, Canada, and some U.S. States and the American Academy of Pediatrics, agree that the evidence supports SOC-8 [Standards of Care-8 updated by WPATH]." 

World Professional Association for Transgender Health

 

"Parents have been told that the WPATH approach is not optional, but medically necessary and lifesaving."

"[WPATH] has aggressively promoted that approach, including by suppressing and stigmatizing alternatives. I think it's disingenuous at best for WPATH to now frame its recommendations as merely one opinion in a legitimate debate."

Leor Sapir senior fellow, Manhattan Institute for Policy Research 

 

 

Within the throes of a legal battle with the Trump administration, the U.S. transgender health organization appears to have made a shift of significance in its guidelines; the very guidelines that platform gender-care policies in North America. According to a new legal filing, the World Professional Association for Transgender Health now claims that its guidance to doctors represents one area in a matter of "intense medical debate". 

 

The organization has brought forward a dismissal of lawsuit motion that the U.S. Federal Trade Commission brought against WPATH, by now claiming that its Standards of Care that have been so influential up to the present are not in fact presented as "assertions of fact, but rather opinions" ,that have been based on cited scientific studies.

 

WPATH claims its opinions are "non-actionable", protected by the First Amendment; that it is doctors who have based their decision-making on WPATH's guidelines who are in point of fact the bearers of "independent responsibility for their own advice", according to the legal filing by WPATH. In response, the organization's critics regard these arguments as a "remarkable humbling in attitude". 

 

They are, in essence, shrugging off their own responsibility in presenting their guidelines as the final word in response to gender dysphoria. Their having framed those guidelines as a matter of dire necessity to respect the confused gender choices made by underage children meriting instant responses of pediatric decision making in hormone-arresting maturation of pre-puberty adolescents and even 'corrective' surgeries now rests on the consciences of the doctors responding to the authority of their original guidelines. 

"[WPATH] went to great lengths to convince insurance companies, doctors and parents that its standard of care was the 'settled science'."

"And now it's claiming that the standard of care is worth no more than a student essay in a high school newspaper."

Andrew Ferguson, chair, U.S. Federal Trade Commission  

The initial development of WPATH's guidelines in its Standards of Care date from 1979. A recent 2022 update was signed off by over 100 co-authors. Guidelines for gender-affirming care in Canada have been driven in alignment with WPATH recommendations. In its position statement in support of an affirming approach to care, the Canadian Paediatric Society refers to the recommendations within SOC-8. Those are recommendations described as internationally accepted standards of care. A chapter dedicated to adolescents states the "medical necessity of treatment and care is clearly recognized for the many people who experience dissonance between their sex assigned at birth and their gender identity". 

WPATH describes itself as a non-profit "dedicated to promoting science-based medical care, education, research and public policy in transgender health." Photo by Adobe Stock

In the original document WPATH offers “suggested minimum ages” for a number of irreversible surgical procedures for minors, such as: 

 14+ years old for cross-sex hormones 

 15+ years old for double mastectomies 

 16+ years old for breast implants, facial feminisation surgery 

 17+ years old for metoidioplasty, orchiectomy, vaginoplasty, hysterectomy, fronto-orbital     remodelling  

18+ years old for phalloplasty.  

The decision to remove all age requirements (apart from the phalloplasty) was taken despite there being no new evidence to support that recommendation. 

Genspect 

 

Britain's National Health Service took the initiative to question its own earlier position that the effects of puberty blockers are wholly reversible. Doctors, SOC-8 adherents are now advised, may decide to depart from WPATH's guidance in reflection of a patient's "unique anatomic, social or psychological situation", led by a research study  or other reasons. "These departures should be recognized as such, explained to the patient and documented for quality patient care and legal protection."

 

The Federal Trade Commission's lawsuit (along with Alaska, Iowa, Nebraska and Texas) claims that WPATH made "false, misleading or unsubstantiated" statements regarding the necessity, effectiveness and safety of puberty blockers, hormones, and sex-change surgeries. WPATH asserts, in seeking to squash the complaint that the "core deceptive statements" have no  presence in SOC-8 and thus were paraphrased from other quotes based on citations by the group quoted in published research.

 

According to WPATH, the deceptive statements are "non-actionable opinions about subjects and scientific uncertainty", reads the WPATH motion, in that the plaintiffs "fail to allege a single deceptive statement by WPATH, much less a statement to consumers". "SOC-8 does not tell doctors what to say, much less how to mislead". "Plaintiffs", they go on, "seek to brand one side of scientific debate as 'deceptive' without even considering the science". 

 

The evidence is of such low certainty, it is impossible to determine whether the use of puberty blockers and cross-sex hormones in children and teens help or harm, according to Canadian researchers who last year published two major reviews. For its part, WPATH claims the Federal Trade Commission and other plaintiffs are "attempting to insert themselves in the middle of this medical debate and silence those with whom they disagree".  

"All clinical guideline recommendations are evidence informed, but opinion based."

"The guidelines for hypertension, for diabetes, for Crohn's disease. Pick a disease, pick a clinical scenario, pick a preventative health issue."

"An 'opinion' in this context does not imply ill-considered loose thoughts or brain droppings, but specifically refers to a genuinely subjective judgement that cannot be proven true or false and thus cannot be sanctioned merely because he government disagrees with it."

"[However, a legitimate debate is to be had over whether WPATH's opinions are supported by the evidence]."

Dr. Laura Targownik, professor of medicine, University of Toronto