Advocates of gender-affirming care say it’s evidence-based.
But now, newly released internal files from the World Professional Association for Transgender Health (WPATH) prove that the practice of transgender medicine is neither scientific nor medical.
American Medical Association, The Endocrine Society, the American Academy of Pediatrics, and thousands of doctors worldwide rely on WPATH. It is considered the leading global authority on gender medicine.
And yet WPATH’s internal files, which include written discussions and a video, reveal that its members know they are creating victims and not getting “informed consent.”
Victims include a 10-year-old girl, a 13-year-old developmentally delayed adolescent, and individuals suffering from schizophrenia and other serious mental illnesses.
The injuries described in the WPATH Files include sterilization, loss of sexual function, liver tumors, and death.
WPATH members indicate repeatedly that they know that many children and their parents don’t understand the effects that puberty blockers, hormones, and surgeries will have on their bodies. And yet, they continue to perform and advocate for gender medicine.
The WPATH Files prove that gender medicine is comprised of unregulated and pseudoscientific experiments on children, adolescents, and vulnerable adults. It will go down as one of the worst medical scandals in history.
Why I Am Publishing WPATH Files And How I Got Them
The written WPATH Files come from WPATH’s member discussion forum, which runs on software provided by DocMatter.
Ninety seconds of the 82-minute video was made public last year. We are making the full video available for the first time.
One or more people gave me the WPATH Files, and my colleagues and I attempted to summarize them as a series of articles. We quickly realized the topic was too sensitive, complex, and large to be dealt with as a work of journalism, and we moved the project to the research institute I founded seven years ago, Environmental Progress (EP).
The Files are authentic. We redacted most names and left only those individuals who are leading gender medicine practitioners to whom we sent “right-of-reply” emails. We know WPATH members discussed our emails internally. No WPATH leader or member has denied that the Files are anything other than what they appear to be.
EP is publishing a 70-page report to provide context for the 170 pages of WPATH Files. Mia Hughes is the author of the report. It and accompanying summary materials can be downloaded at the link below. That link also provides a link to the full WPATH video.
What follows are simply a few highlights. People with a serious interest in the topic should read the report and all the files:
“We're explaining things to people who haven't even had biology in high school…”
“I think the thing you have to remember about kids is that we're often explaining these sorts of things to people who haven't even had biology in high school yet,” says Dan Metzger, an endocrinologist.
“The 14-year-olds, you just... It's like talking [about] diabetic complications with a 14-year-old. They don't care. They're not going to die. They're going to live forever, right? So I think when we're doing informed consent, that's still a big lacuna.”
“14 year old trans female who started transition since she was 4… wants to have Gender Affirming Surgery”
“I’ve recently received questions from an [‘Assigned Female At Birth’] pre-menarche 10 y/o patient about whether blockers will ‘stunt’ his growth…”
“It is very difficult to ask that they wait until age 16...”
A “16 y/o patient…found to have two liver masses… the likely offending agents were the hormones…”
The problem is that drugs can cause tumors, even, apparently, in people as young as 16 years old.
“To what degree… providers discuss actual rates of surgical complications… (e.g., pain…additional surgeries, necrotic tissue, infection, hematomas…”
Many young patients experiencing gender distress do not appear to understand that they may suffer serious consequences from long-term hormone use and genital surgery.
“I feel the best time for surgery in the U.S. is the summer before their last year of high school.”
Despite the widespread and growing expression of concern within the WPATH Files over the negative side effects of gender medicine, WPATH members urge that irreversible surgeries take place when adolescents are just 16 or 17 years old.
“Most of the kids are nowhere in any kind of brain space to really talk about it seriously.”
One WPATH member says, “It's out of their developmental range sometimes to understand the extent to which some of these medical interventions are impacting them.”
“We try to talk about it, but most of the kids are nowhere in any kind of a brain space to really, really, really talk about it seriously.”
Many Parents Don’t Understand What Will Happen To Their Children
“I try to kind of do whatever I can to help them understand best they, best I can,” says a therapist. “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."
“In a developmentally delayed 13yo… what is the ethical approach?”
The situation of obtaining informed consent is complicated further when the adolescents are also developmentally delayed and, in the case below, “may not reach the emotional and cognitive developmental bar set” by WPATH’s already very low standards of care.
“Oh, the dog isn’t doing it for you?”
Many gender medicine victims are filled with regret that they were sterilized. Nobody knows this more than the doctors who mistreated them. At times, their response to such regret appears callous.
“I follow a lot of kids into their mid twenties, I'm always like, ‘Oh, the dog isn't doing it for you, right?’ They're like, ‘No, I just found this wonderful partner and now we want kids. So you know, it doesn't surprise me.”
“I’m unaware of an individual claiming ability to orgasm when they were blocked at Tanner 2.”
Many gender medicine patients lose sexual function, including experiencing orgasm. As such, they are not only deprived of sexual pleasure, they are significantly undermining their ability to form long-lasting romantic relationships.
It’s clear from the Files that even many people within gender medicine do not understand this.
On January 14, 2022, the surgeon and President of WPATH, Marci Bowers, explained this reality in a low-key way.
Seven days later, a WPATH member asked Bowers to clarify.
“After 8-10 years of [testosterone, they] developed hepatocarcinomas… died a couple of months after.”
For some gender medicine patients, there are fates worse than both sterility and loss of sexual function.
Part II: Mental Illness
“A Patient Who Became Dangerous”
On an unknown date, a San Francisco-based surgeon named Thomas Satterwhite posted an urgent new message to WPATH’s internal message board.
“I had a patient who became dangerous/threatening to our care team post-op,” he wrote, “which ultimately ended in a restraining order.”
Satterwhite explained that “This patient had undiagnosed mood disorders that did not surface until post-op, after which, she travelled around the country to find other surgeons to provide care.”
It’s a chilling story, and one that raises many questions about the ethics and legality of gender-affirming medicine.
At the top of that list is how did Satterwhite and his colleagues miss the fact that the person they operated upon had a serious psychiatric condition?
But Satterwhite was focused on a more prosaic question: What was the best “medicolegal” way that he could warn other doctors and health care providers that his former patient was “potentially dangerous”?
There is no evidence in the WPATH Files, nor elsewhere, that the experience shook Satterwhite enough to question whether gender-affirming care is, in reality, committed to the maxim, “First, do no harm.”
Our Awful History Of Mistreating Mental Illness
Nations have struggled to care properly for people with mental illness and psychiatric disorders for centuries.
After every past scandal, we pledge to do better next time, relying more on science than ideology.
Readers of the WPATH Files may walk away with the sense that we have learned nothing.
Repeatedly throughout the WPATH Files, we see gender medicine practitioners waive away evidence that mental illnesses and psychiatric disorders have been misdiagnosed as gender dysphoria.
The WPATH Files are a picture of people single-mindedly committed to the hammer of gender medicine and thus seeing every patient who comes to them as a nail.
“Disordered eating,” “purposeful malnutrition,” and a “high prevalence of eating disorders”
A therapist raises concerns in a message about the age of a patient.
“I have an incoming 13yo (soon to be 14 yo)... I was under the impression that is more the exception to start for kids under 16, not the norm…”
But the person has another piece of troubling information.
“A possible complication,” the therapist warns, is that it “sounds like there is some purposeful malnutrition and restrictive eating for ‘a more non-binary appearance.’”
The chief medical officer of a health center in Texas chimed in that the therapist had best hurry the 13-year-old teenager along the gender-affirming path because “waiting appears to increase the rate of suicide,” which is one of several pseudoscientific myths repeated within the WPATH Files.
“Something is off… I am wondering if they might have schizoaffective disorder or schizophrenia”
“...I was surprised to find that several of my clients met criteria for dissociative disorders...”
“Someone can have schizophrenia and be ready for surgery…”
“...I have noted a high incidence of dissociative disorders...”
“I have operated on three DID [Dissociative Identity Disorder] patients... All three did okay out to the six month mark....”
“In the last 15 years, I had to regrettably decline writing only one letter, mainly b/c the person evaluated was in active psychosis and hallucinated during the assessment session...”
“They had alters who were both male and female gender and it was imperative to get all alters who would be effected by [Hormone Replacement Therapy] to be aware and consent to the changes."
Part III: Ethics
“I’m not aware of any other medical procedure that requires the approval of a therapist.”
Frequently, WPATH members push back against “gatekeeping,” including the requirement for sound mental health before undergoing a lifelong regime of drugs and surgery.
“If an individual patient feels that they made a mistake… be careful with that not letting that change the way others receive care.”
At times, WPATH members speak of the growing number of “detransitioners” who regret gender medicine.
Some gender medicine practitioners express less concern for the detransitioners than for the threat they may pose to gender medicine.
“Patients need to own and take active responsibility for medical decisions, especially those that have potentially permanent effects."
There is evidence within the WPATH Files of WPATH members, as well as its president, Marci Bowers, blaming their victims.
“Those conversations can be ongoing even after the intervention has occurred.”
Readers of the WPATH Files may be struck, as we were, by how flexible WPATH members were in rationalizing their mistreatments.
Faced with rising amounts of regret and detransition, WPATH members describe what’s happening as a “gender journey” not a single “transition.”
And faced with their own failure to achieve informed consent, WPATH members re-frame it as a “process,” and an “on-going conversation.”
“...informed consent [is a]... process... not one conversation at one point in time ... those conversations don't have to stop once the Medicaid and intervention has been started. Those conversations can be ongoing even after the intervention has occurred.”
“What has been currently happening is, frankly, not what we need to be doing, ethically.”
As we saw above, many WPATH members waive away the evidence of medical mistreatment.
But others appear genuinely concerned by the lack of informed consent.
A therapist describes talking to parents after they meet with a medical doctor.
“I would go in, and say, ‘Okay, so tell me what you learned.’ They would be like, ‘We have no idea what they were talking about.’
“Part of it is that they feel less deferential to the kind of doctor I am than the kind of doctor the medical doctor is.
"And because they really are seeking the care, they're just going to say they know when they really aren't picking up on what's happening.
“And so I think the more we can normalize that it is okay to not get this right away, that it is okay to have questions, is, you know, the more we're going to actually do a real informed consent process than what I think has been currently happening and that I think is, frankly, not what we need to be doing ethically.”
You can tell that her comment had an impact from the long and awkward pause that followed.
Within minutes of Texas floods killing dozens of girls, the media said it was because of Trump budget cuts and climate change. In truth, the deaths occurred in “one of the highest flood-prone regions in the entire state,” warnings were issued, and the underlying cause was the failure to install flood warning sirens. Climate journalists are cultists.
Trump cuts to the National Weather Service, and climate change, are to blame for the Texas flood deaths, said the media yesterday. Today, most admit NWS did its job. The real problem was the lack of a flood warning system. Those who blame the climate are trapped in a weird cult.
Per capita flooding deaths in Texas declined dramatically:
"As the population of Texas increased from ~9.2 million in 1958 to ~28.6 million in 2018, overall flood deaths remained fairly constant, meaning that the fatality rate dropped by about two-thirds." @RogerPielkeJr
More Pielke: "The flooding was certainly extreme but it should not have been historically unexpected. The documented record of extreme flooding in “flash flood alley” goes back several centuries, with paleoclimatology records extending that record thousands of years into the past.
"Consider the figure above, from a classic 1940 historical text on U.S. floods, which shows that the same region of Texas that experienced this week’s floods has long been known to be a bullseye for flash flooding. In fact, almost a century before Hoyt and Langbein, Texas experienced one of the greatest losses of life in U.S. history related to extreme weather.
"In 1846, in the months after Texas became a U.S. state, massive flooding compounded the many problems facing thousands of recent immigrants from Germany who had been settled in New Braunfels, Texas, which was significantly impacted by this week’s floods.
"According to a contemporaneous 1846 account, cited in a fantastic 2006 PhD dissertation on flooding in Texas by William Keith Guthrie, at the University of Kansas, 'The Guadalupe [River] would often rise fifteen feet above its normal stand after these heavy rains, carrying with it in its swift torrent a number of large trees, uprooted farther up the hills. Smaller brooks, ordinarily not containing flowing water, became raging torrents which could be crossed only by swimming.'"
The website of NYC mayoral frontrunner says he'll "shift the tax burden" to "whiter neighborhoods." When asked about his openly racist agenda, @ZohranKMamdani insists it's not a proposal at all but rather "a description of what we see right now." That's next-level gaslighting.😬
This guy's ability to lie so calmly while smiling should send chills up the spines of every New Yorker.
He could have taken it down and said, "You know, I regret that the website said that and so I deleted it, because it doesn't express what I believe."
Instead, he's just asked millions of New Yorkers to believe his own obviously flagrant lie rather than their own eyes. That's creepy and wrong.
Everyone can see for themselves that he used a gratuitous racial reference regarding a tax proposal. We don't tax people on race. So why use it? Because he and his campaign wanted to introduce race.
And it's not the first time. @ZohranKMamdani should delete his flagrantly racist tweets and web site language, apologize, and promise to never invoke racism in these ways again.
The audacity of @ZohranKMamdani to cite Dr. Martin Luther King should make your skin crawl. King adamantly rejected anti-white racism.
Mamdani’s call for higher taxes on white neighborhoods should shock New Yorkers. If they elect him as Mayor then they will have no excuses. He’s made clear that he will advance a racist agenda and then demand that people believe his lies.
The idea that former Intelligence Community officials are working with European leaders to censor the Internet sounds like a conspiracy theory, but over the last two days, Obama’s CIA Director plotted with UK, EU, and Irish officials in Dublin to do precisely that.
These people are a direct and imminent threat to free speech and democracy worldwide. They are dangerous and out of control:
Former CIA Director John Brennan helped initiate the Trump-Russia collusion hoax. He used foreign spies to help trigger the FBI investigation of of the Trump campaign. And he manipulated the January 2017 Intelligence Community Assessment to falsely claim the Russians favored Trump over Clinton.
Niamh Hodnett, Ireland’s “Online Safety Commissioner,” leads Ireland’s censorship regime under the Online Safety and Media Regulation Act, which mirrors EU and U.S.-backed models shaped by intelligence-linked NGOs.
Aine Kerr, a Former Facebook Policy Manager, helped manage Facebook’s public policy as it partnered with U.S. intelligence agencies post-2016, then co-founded Kinzen, which received support from EU and transatlantic institutions focused on content surveillance. Her work connects platform moderation with state-funded narrative monitoring.
Nóirín O’Sullivan, a Former Garda (Irish police) Commissioner and EUROPOL Official, who went from leading Ireland’s national police to a senior role at EUROPOL, which works closely with intelligence and security services across Europe. She advocates for integrating security principles into online content governance.
Claire Loftus, Ireland’s Former Director of Public Prosecutions, oversaw prosecutions during a period of expanding legal efforts to criminalize online expression and misinformation. Her presence signals an effort to align the judiciary with state-backed censorship.
Robyn Simcox, the UK Commissioner for Countering Extremism,
operates within the UK Home Office, a department with direct ties to MI5 and GCHQ. She frames conspiracy theories and misinformation as forms of radicalization and demands surveillance and preemptive regulation. Her office channels intelligence priorities into speech policing under the banner of counter-extremism.
Brazil has been banning and censoring journalists and politicians for years. But now it is taking steps to ban X entirely. It’s time for @SecRubio to block President Lula, Justice Moraes, and their criminal accomplices from entering the US.
President Trump and Secretary Rubio must not let these tin pot dictators censor speech and ban the world’s most important social media company.