James Esses Profile picture
Sep 16 15 tweets 3 min read
THREAD WARNING - The World Professional Association for Transgender Health (WPATH) Standards of Care.

I have just read Version 8 of these standards, released last week. It is one of the most shocking indictments of ideology infecting medicine that I have ever come across:
(1/13)
The guidelines are filled with ideological language. Irreversible medication and surgery is “gender-affirming health care”. Terms like “cisgender” and the factually inaccurate “sex assigned at birth” are used. Clinics are told to implement “gender neutral toilets”.
(2/13)
Safeguarding of children is no more. Age limits for puberty blockers, hormones or surgery are removed, as long as a child has reached ‘Tanner Stage 2’ (which can be as young as 9). There’s no requirement for a child to have taken hormones prior to surgery “if not desired”.
(3/13)
Extremely concerning is that “chest masculinization surgery” (i.e. double mastectomy) “can be considered in minors”.

WPATH state that “vaginoplasty” may be considered for under 18 year olds.

Hormone treatment is recommended even though it can cause “infertility”.
(4/13)
Doctors are told to provide education to children on “chest binding” and “genital tucking” to provide “comfort” and “lower rates of misgendering”.

This is even though the former can cause pain, infection and fracture and the latter can cause decreased sperm concentration. (5/13)
Parents are alienated. Healthcare professionals are advised to “challenge” parents unsupportive of medical transition.

They are recommended to prescribe hormone treatment for children without parental involvement, if such involvement would be “harmful or unnecessary”.
(6/13)
There is what looks like a shopping list of surgery recommended for ‘trans’ people, including:

-Body contouring
-Voice surgery
-Hair transplant
-Jaw augmentation
-Liposuction
-Brow lift
-Lip shortening
-Calf implant
-Mastectomy, Hysterectomy, Vaginoplasty, Phalloplasty.
(7/13)
Mental health care is abandoned. It is recommended that therapy or counselling is “never mandatory” before undertaking medication or surgery, including for children.

Therapists are told to not impose narratives or preconceptions, yet they must be “gender affirming”.
(8/13)
Mental illness is deemed of lesser importance. Clinicians are advised that not all mental illness “can or should be resolved” prior to medication or surgery.

We are told there is no basis to withhold hormones simply because a child has a neurodevelopmental condition.
(9/13)
There is an entire chapter on ‘Eunuchs’ who are “assigned male at birth and wish to eliminate masculine physical features or genitals”.

These individuals who seek “castration” are deemed to fall under the “gender diverse umbrella”.
(10/13)
WPATH recommends that staff who provide care to people resident in prisons or psychiatric hospitals should support them with “gender-affirming surgical treatment…when sought by the individual, without undue delay”.
(11/13)
Irreversible medication and surgery are recommended, even though “the number of studies is still low”, “there are few outcome studies that follow youth into adulthood” and “no clinical studies have reported on profiles of adolescents who regret their initial decision”
(12/13)
Ideology has infected medicine and the safeguarding of our most vulnerable children.

We must speak out about this. The stakes are far too high.

Link to the full document is here - tandfonline.com/doi/pdf/10.108…
(13/13)
I am told that Susie Green from Mermaids is on the group responsible for revisions to the Standards of Care.
To note - up until yesterday (when an online correction was posted), there were minimal ages recommended:

Hormones - 14
Mastectomy - 15
Vaginoplasty - 17

Still far too young but better than nothing.

Why were these ages completely thrown out the window?
tandfonline.com/doi/full/10.10…

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More from @JamesEsses

May 23
Thread Warning - Westminster Hall Debate on Non-Binary Gender - ‘The Good and The Bad’.

For those unable to watch today’s proceedings, there were some welcoming statements from MPs but also some extremely concerning statements.

I set out ‘The Good and The Bad below:
(1/10)
The Good:

Nick Fletcher MP (Tory) stated that it’s not safe to erode same-sex spaces.

He spoke of contagion of gender dysphoria and irreversible decisions children are making.

He emphasised government should not bend to whims of lobby groups with questionable motives.
(2/10)
The Bad:

Kirsten Oswald (SNP) argued recognising non-binary gender has no impact on anyone else and simply adds a “drop-down box” on a computer.

The fact that she ignores and minimises the impact on children’s welfare, women’s rights and fairness in sports is telling.
(3/10)
Read 10 tweets
Apr 10
THREAD: Conversion Therapy Letter in Sunday Times

It’s not often that you get a letter to the government that is co-signed by representatives from:

-Labour
-Conservatives
-Lib Dems
-Greens
-Reclaim
-Reform/Brexit
-Social Democrats
-Alba

Today, we got that letter. (1/6)
The fact that politicians from across the spectrum signed this letter, demonstrates the importance of this issue.

Alongside these politicians are clinicians, lawyers, commentators, social workers, activists, parents, detransitioners. (2/6)
thetimes.co.uk/article/ef7d7f…
This well-intentioned but misguided and unnecessary piece of legislation could have the unintended consequences of criminalising exploratory therapy and leave vulnerable children on a one-way path to irreversible medical interventions that they may regret forever. (3/6)
Read 6 tweets
Mar 31
THREAD - Conversion Therapy Ban:

Inflammatory rhetoric emerging that the government has launched a “war” against trans people with a decision not to move forward with legislation in this space.

However, the following are the significant risks and concerns of such legislation:
1. The term conversion ‘therapy’ is a misnomer. The government themselves have admitted that it is “highly misleading”. The vast majority of practices occur in religious/family settings. Yet, they continue to use this term, which paints an incorrect picture about therapy.
2. We cannot even agree on basic definitions of ‘man’, ‘woman’, ‘sex’ or ‘gender’ in civic or political society. Poorly worded legislation risks criminalising ethical therapeutic practises that vulnerable children desperately need.
Read 11 tweets
Feb 22
Thread Warning - Concerns over Ofsted and their treatment of ‘gender reassignment’ under the Equality Act.

I have had sight of a briefing document which has investigated Ofsted and the way they are rating schools regarding this topic. See below. (1/8)
There is evidence suggesting Ofsted are incorrectly interpreting the Equality Act. They are marking schools, including primary schools, down if they fail to teach students about gender reassignment, even though the Equality Act does not apply to curriculum. (2/8)
There is evidence of inspectors going beyond Department for Education guidance - for example, marking schools down for not teaching all students LGBT content, regardless of how young the students are. This has led to schools being downgraded inappropriately. (3/8)
Read 8 tweets
Jan 7
THREAD WARNING - 10 facts about the risks of transitioning for children and benefits of explorative therapy (references in link below):

1. Counselling has been shown to be highly effective when it comes to treating gender dysphoria.
2. Studies demonstrate that upwards of 80% of children who express a discordant gender identity will come to identify with their bodily sex if natural development is allowed to proceed.
3. Studies on children’s brains have shown that if a child begins to ‘live’ as the other gender for a period of time, it can actually cause changes to their brain making it far less likely that they will become comfortable with their biological sex.
Read 11 tweets
Dec 21, 2021
THREAD WARNING - Key concerns with the Women and Equalities Committee Report:

1. The Report uses language that is misleading and factually inaccurate, such as “sex assigned at birth”. This suggests a partisan approach on the part of its authors.
2. The Report references “de-medicalising” gender recognition. On one hand, we are told we should never pathologise being ‘trans’. On the other hand, we are told we must make medication and surgery available to enable people to transition. This is fundamentally inconsistent.
3. The Report refers to “modernisation”. This topic transcends modernity. Biological sex and our understanding of male/female genes and chromosomes are enshrined in science and form the evolutionary backdrop to our species. It’s not something one can or should simply ‘modernise’.
Read 11 tweets

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