Thread by @benryanwriter

⚧️The WPATH Files⚧️
A damning new report from Environmental Progress, based on leaked internal documents from the World Professional Association for Transgender Health, asserts:

WPATH is “neither scientific nor advocating for ethical medical care.”

For the details see the 🧵⬇️

The #WPATHFiles quote WPATH members saying:
⚧️Gender-transition treatment is given to those with at best a limited capacity to consent
⚧️Treatment can have serious side effects
⚧️Minors often don’t understand the long-term risks
⚧️Detransitioning is conceived of as trivial

Largely U.S. based, @WPATH is an “interdisciplinary professional and educational organization” that produces influential guidelines for treating gender dysphoria. It’s not a standard medical society like the AMA. Many members are neither physicians nor mental-health providers.

The #WPATHFiles quote physicians discussing serious adverse events in patients after gender-transition treatment and surgeries, including:
⚧️Liver masses and cancer
⚧️Erections “feeling like broken glass”
⚧️Pelvic inflammatory disease
⚧️Pain with orgasm
⚧️Bleeding after sex

The #WPATHFiles report finds that WPATH members express public confidence about gender-transition treatment for minors while in private they express uncertainty and concern—such as regarding the ability of children, and sometimes even parents, to understand the serious risks.

The WPATH Files quote internal messages from Thomas Satterwhite, a California surgeon, who describes surgeries he’s conducted to create bodies with no natural equivalent, including:
⚧️Mastectomies without nipples
⚧️Vaginoplasties that leave the penis
⚧️Genital nullification

One WPATH surgeon sought advice on whether to perform a vaginoplasty on a 14-year-old patient. Dr. Christine N. McGinn said she’d performed about 20 such surgeries on minors in two decades and battled her hospital to do more where she deemed it “sound medical practice.”

These @WPATH leaders suggest that minors often can’t understand the implications of medical transition:
⚧️Daniel Metzger, endocrinologist
⚧️Dianne Berg, child psychologist, coauthor of the @WPATH Standards of Care 8 child chapter
⚧️Christine McGinn, plastic surgeon

Dianne Berg, child psychologist and co-author of WPATH's child guidelines, said minors can't consent to gender care, and said: “But what really disturbs me is when the parents can’t tell me what they need to know about a medical intervention that apparently they signed off for.”

The #WPATHFiles report asserts that WPATH follows “an unethical approach to consent among adults,” and sees as able to consent to gender-transition treatment those with:
⚧️Dissociative identity disorder
⚧️Other severe mental health diagnoses
⚧️Major psych diagnoses + homelessness

The Environmental Progress’ report excoriates WPATH, saying:

“The WPATH Files reveal that WPATH is neither a medical organization nor a scientific organization. The group is engaging in an unregulated experiment on some of the most vulnerable individuals in society.”

WPATH, the WPATH Files report says, “advocates for a transition-on demand style of care, valuing patient autonomy over avoidance of harm.” And, it says, “notably absent...is any consideration of the ethical concerns surrounding surgeries that destroy healthy reproductive organs.”

At least one @WPATH member leaked a trove of communications from an internal message forum to Michael @Shellenberger in 2023. For Environmental Progress, Mia Hughes @_CryMiaRiver led a 216-page report.

Access it here: environmentalprogress.org/big-news/wpath…

Dr. Marci Bowers, president of @WPATH, said on an internal message board that “acknowledgement that de-transition exists even to a minor extent is considered off-limits for many” in the trans community.

One researcher sought to reframe detransitioning as a non-negative outcome.

Jamison Green is a trans-rights activist, former WPATH president and a coauthor of a 2020 WPATH statement saying that in general, mental health and medical professionals evaluate gender dysphoric youths before OK’ing gender transition treatment. In private, he contradicted this:

WPATH leader Dianne Berg said that she is “stumped” about how to communicate the risks of fertility loss to a gender dysphoric 9 year old.

Daniel Metzger said gender-transition treatment is “to a degree robbing these kids of that sort of early-to-mid pubertal sexual stuff.”

The authors of the #WPATHFiles report call for “a national inquiry to investigate how activists with little respect for the Hippocratic Oath could have risen to such prominence as to set the Standards of Care for an entire field of medicine, leading [to] medical abuse.”

The #WPATHFiles report argues @WPATH members are “improvising, experimenting without a structured framework” on trans-identified youths.

WPATH president Marci Bower said in a 2022 forum, speaking about puberty blockers’ impacts, that the “fertility question has no research.”

A gynecologist told WPATH colleagues of a patient who after receiving a vaginoplasty, had prostate secretions leaking via the urethra. There’s no remedy for this. A nursing lecturer said to tell the patient to “enjoy the ride,” as it’s a sign of orgasm and “What's not to like?”

Surgeons often won’t perform elective surgeries on high-BMI patients given the associated risks. WPATH members scoffed at such a barrier in their private forum, lambasting it as “systemic fat phobia.” WPATH member Dr. Scott Mosser, however, operates on people with a BMI up to 65.

The authors of the WPATH Files report could find only 1 instance in the leaked WPATH internal messages in which members expressed concern about the potential dangers and adverse effects of gender-transition treatment: about a trans female who wanted to lactate but had no infant.

“WPATH is held up as the source of all knowledge about gender-affirming care, but the scientific basis for their recommendations is exceptionally weak,” the #WPATHFiles states. “The group exists solely to shield doctors from legal liability...and to ensure insurance coverage.”

The authors of the WPATH Files report claim @WPATH values “patient autonomy over risk aversion.” The organization, the authors claim, “conceptualizes harm, as in ‘do no harm,’ as unfulfilled consumer desire.” The authors conclude: “This is a violation of medical ethics.”

“WPATH has broken the chain of trust in gender medicine,” the report asserts. It “presents itself as scientific but is, as the files reveal, an advocacy group promoting risky, experimental, and cosmetic procedures in the guise of well-researched and ‘medically necessary’ care.”

The #WPATHFiles report includes the names of quoted people who are in WPATH leadership but redacts those of others and only generally describes their professional position and location.

eg: An activist and law professor with no medical training at the University of Alberta:

The author of the #WPATHFiles report, Mia Hughes @_CryMiaRiver, contacted each named @WPATH member who is quoted in the report, seeking comment. Only one WPATH member responded, and with legal threats. None claimed the internal messages were inauthentic.

In one WPATH message-board exchange, a Canadian nurse practitioner said she was struggling over whether a severely mentally ill patient should start hormones. Dr. Dan Karasic of @UCSF, lead author of WPATH’s Standards of Care 8 mental health chapter, scoffed at her hesitancy.

The #WPATHFiles feature the following internal message from Dr. Daniel Metzger, a Canadian endocrinologist. He portrays young people as naive about foreclosing on their ability to have biological children through gender-transition treatment.

Endocrinologist Daniel Metzger acknowledges to his @WPATH colleagues in internal messages that suppressing the puberty of gender dysphoric natal boys at the onset of puberty prevents them from learning to masturbate and from thus producing a sperm sample to preserve.

The WPATH Files report authors say that health care providers should reject @WPATH’s guidance and instead follow the systematic literature reviews from Sweden, Finland, England and Florida that found the evidence backing youth gender transition “insufficient and inconclusive.”

WPATH members, the report shows, repeat the common claim that prescribing puberty blockers or cross-sex hormones to gender dysphoric youths is life saving. Finnish researchers published a study last month that found no evidence to back this claim:

I covered the #WPATHFiles in my S****tack. This is essentially my Twitter thread on the subject distilled into an article form: benryan.substack.com/p/the-wpath-fi…