Thread by @benryanwriter

🚨BREAKING: Unsealed documents in suit over Alabama pediatric gender-transition treatment ban reveal inner workings of @WPATH
One exhibit is an export report by Canadian sex researcher @JamesCantorPhD, who has served as a paid expert testifying in favor of state bans.
See: 🧵

Cantor provided redacted internal @WPATH communications that portray the trans medical-activist group as bending the science to suit the narrative when drafting the Standards of Care 8 (SoC8), and in particular to aid in lawsuits and battles against unwanted state legislation.

"WPATH views evidence-based medicine as an obstacle to its policy goals, rather than as an important tool to beneficent health care for patients," @JamesCantorPhD writes.
WPATH members acknowledge that in developing the SoC8 guidelines for trans care:
▶️They didn't use the GRADE system to evaluate the quality of evidence.
▶️They are "painfully aware of the gaps in the literature."
▶️They acknowledge that the "policy changes" in Europe, Australia and New Zealand (restricting access to pediatric gender-transition treatment) pose a "threat to our assertion that the WPATH SOC are the Gold Standard used around the world."
▶️Chair of the SoC8 Steering Committee Dr. Eli Coleman sees as adversaries skeptical academics and scientists who pressure "health care to provide evidence-based care." This suggests, Cantor asserts, that Dr. Coleman sees evidence-based medicine itself as a threat, and thus does not see SoC-8 as evidence based.

Jesse Singal reports about Rachel Levine's efforts to get @WPATH to remove minimum age restrictions on pediatric gender-transition treatment and surgeries, as revealed in @JamesCantorPhD's expert report, just unsealed:

In the wake of an Oct 2021 @TheFP article by @AbigailShrier that quoted then-head of USPATH Erica Anderson saying that some gender care providers were providing "sloppy" care of minors, some @WPATH members acknowledged the veracity of her claim, per internal communications:

This is the @AbigailShrier article in @TheFP in question: thefp.com/p/top-trans-do…

James Cantor quotes internal @WPATH communications indicating members' concern about a lack of evidence backing their Standards of Care 8 guidelines for trans care. They expressed concern about responding to critics such as @SEGM_EBM. They also don't have evidence for what type of psychosocial assessments are helpful, which is in keeping with @Jack_Turban's suggestion in his new book, Free to Be, that such assessments should be done away with for accessing puberty blockers.

Internal @WPATH communications suggest that "a global consensus" on the use of puberty blockers to treat gender dysphoria in adolescents "does not exist."

James Cantor writes about @WPATH internal communications: "Members of the Guideline Development Group expressed the view the SoC8 was endorsing a 'lax approach' to approval of [gender-transition] surgery that represented 'bad medicine."

These are quotes from WPATH members:

The Social Contagion Debate:
James Cantor writes: "Members of the [@WPATH] Guideline Development Group agree with me that adolescents may mistakenly come to believe that they are transgender due to 'social factors' and immature 'decision making'." Below are WPATH internal comms:

WPATH members' comments on social contagion, cont:

"Members of the [@WPATH] Guideline Development Group were sharply critical of the @AmerAcadPeds and positions it pressed WPATH to adopt in SoC8," writes @JamesCantorPhD.
▶️Criticizing the 2018 AAP policy statement on the gender-affirming care method as the work of "a few friends."
▶️The AAP guidelines (they're actually not guidelines, it's just a policy statement) "have a very weak methodology."

As @JesseSingal reported, the @AmerAcadPeds put pressure on @WPATH during the drafting processes for the 2022 Standards of Care 8:

"@WPATH documents reveal that the SoC8 development process was extensively influenced by factors other than medical science, including political pressure, litigation and legislative advocacy strategy, and the financial self-interest of WPATH members," @JamesCantorPhD writes.

At one point, a @WPATH member appears to suggest that during debates over the drafting of the Standards of Care 8 (SoC8) on transgender care, they sought to aid the efforts of @ChaseStrangio, who heads the trans litigation team at the @ACLU:

"Members of the @WPATH Guideline Development Group went so far as to explicitly advocate that SoC8 be written to maximize impact on litigation and policy even at the expense of scientific accuracy," @JamesCantorPhD writes.

"@WPATH made changes to the SoC8 for the explicit purpose of minimizing members' risk of malpractice liability," @JamesCantorPhD writes.

"After @WPATH removed age minimums after finalization and publication of SoC8 and without scientific justification, it fabricated a false explanation for public consumption," @JamesCantorPhD writes.

The @AmerAcadPeds issued an ultimatum to @WPATH: Delete the minimum age requirements for gender-transition treatment of minors or the AAP would both withhold endorsement of the Standards of Care 8 and also publicly oppose the SoC8, per internal WPATH communications:

How, @JamesCantorPhD asserts based on internal communications, @WPATH went about fabricating an explanation for why it removed all minimum age requirements for pediatric gender-transition treatment in the SoC8:

"WPATH did not even alert Soc8 committee members about, nor ask questions that would identify, direct financial conflicts of interest, or intellectual conflicts of interest," @JamesCantorPhD asserts, based on internal @WPATH communications.

One WPATH member wrote on his conflicts disclosure form: "Everyone involved in SOC process has a non-financial interest," meaning an intellectual conflict of interest. "Yet," @JamesCantorPhD writes, "WPATH assured the public that no conflicts of interest existed."

How sex researcher James Cantor produced his damming report on @WPATH's inner workings:
▶️The Alabama attorney general, in the dispute in the federal court system over the state's pediatric gender-transition ban, subpoenaed internal WPATH communications on the development of its Standards of Care 8 (SoC8) guidelines on trans care, published in 2022. They reportedly received millions of pages of documents from WPATH in response.
▶️@JamesCantorPhD, who has been a paid expert witness in multiple states testifying in support of state bans on pediatric gender-transition treatment, received documents generated by this subpoena, which otherwise remained under seal, on Sept. 7, 2023.
▶️Cantor wrote a report on those documents and submitted it on Feb. 2, 2024. He told me: "I wrote it for the court, on behalf of the legal team representing the state, acting in the public’s best interests."
▶️Cantor's report, catalogued in this tweet thread (see the tweets above), was unsealed on June 25. I obtained it from the AG's office.
▶️The original source material remains under seal, but according to the AG's office more documents from the subpoena will be unsealed soon; so it could become available.