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Mar 4, 2024 31 tweets 16 min read Read on X
THE WPATH FILES

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.

environmentalprogress.org/big-news/wpath…Image
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:

environmentalprogress.org/big-news/wpath…
Part I: Children and Adolescents

“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”Image
“I’ve recently received questions from an [‘Assigned Female At Birth’] pre-menarche 10 y/o patient about whether blockers will ‘stunt’ his growth…”Image
“It is very difficult to ask that they wait until age 16...”Image
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.Image
“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.Image
“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.Image
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“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.Image
“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.Image
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“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.Image
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.”Image
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.

environmentalprogress.org/big-news/wpath…
“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.Image
“Something is off… I am wondering if they might have schizoaffective disorder or schizophrenia”Image
“...I was surprised to find that several of my clients met criteria for dissociative disorders...”Image
“Someone can have schizophrenia and be ready for surgery…”Image
“...I have noted a high incidence of dissociative disorders...”Image
“I have operated on three DID [Dissociative Identity Disorder] patients... All three did okay out to the six month mark....”Image
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“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...”Image
“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."Image
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.Image
Image
“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.Image
“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.Image
Image
“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.

/END

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More from @shellenberger

Apr 1
One FBI employee involved in the cover-up of the Hunter Biden laptop was Bradley Benavides (ctr-intel div). Weeks earlier he played key role in an apparent FBI scheme to smear @SenRonJohnson & @ChuckGrassley — who were investigating Hunter — as tools of Putin. Sinister.Image
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According to @SenRonJohnson & @ChuckGrassley , Benavides and a colleague on August 6, 2020 provided "an unnecessary briefing on behalf of the FBI and Intelligence Community on matters purportedly related to the senators’ investigation into Hunter Biden."

ronjohnson.senate.gov/2022/8/sens-jo…
Why would Benavides & FBI give an unnecessary briefing? Probably so they could then leak information about the briefing to The Washington Post.

Keep in mind this was 2.5 months before NY Post story.

This appears to be a key part of the FBI's disinformation operation.Image
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Read 17 tweets
Apr 1
The FBI said it didn't interfere in the 2020 election, but it did. It tricked Twitter & Facebook into censoring the Hunter Biden laptop story. Now, newly released chat messages show the FBI issued a "gag order" after an employee accidentally confirmed the laptop's authenticity. Image
This is a CatherineHerridgeReports @C__Herridge / Public Investigation

In 2024, an FBI official admitted to House investigators that an FBI employee had inadvertently confirmed the authenticity of Hunter Biden’s laptop to Twitter on a conference call the morning of October 14, 2020, the day the New York Post published a story about it.

“I recall that when the question came up, an intelligence analyst assigned to the Criminal Investigative Division said something to the effect of, ‘Yes, the laptop is real’,” testified the then-Russia Unit Chief of the FBI’s Foreign Influence Task Force in a closed door transcribed interview.

“I believe it was an (Office of General Counsel) attorney assigned to the (Foreign Influence Task Force) stepped in and said, ‘We will not comment further on this topic.’”

For the first time, and with a change of administration, the FBI has now turned over to GOP House investigators the internal chat messages that show Bureau leadership actively silenced its employees.

The FBI, which had a special task force to counter foreign election interference, could have set the record straight by confirming the laptop was real and the subject of an ongoing criminal probe. Instead, FBI leadership allowed the false narrative about the laptop to gain momentum.

The FBI provided the chat messages to congressional investigators with heavy redactions.

Some of the redactions on the chats are marked “OGC AGC,” which appears to mean that they were made by the FBI’s Office of General Counsel and Associate General Counsel.

An individual whose name is blacked out, tells Elvis M. Chan, the San Francisco-based FBI special agent tasked with interacting with social media companies, there was a “gag order” on discussion of Hunter Biden’s laptop. In a separate exchange, Chan is told “official response no commen(t).”
In the chat, the FBI officials showed awareness that the laptop may have contained evidence of criminal activity.

Asked Chan, “actually what kind of case is the laptop thing? corruption? campaign financing?”

Another FBI employee responds, “CLOSE HOLD —” after which the response is redacted.

To which Chan responds, “oh crap” appearing to underscore the serious nature of the probe, which included felony tax charges. Chan adds, “ok. It ends here”.

In the same conversation, Chan is asked if “Anyone discussing that NYPost article on the Biden’s?” Chan responds, “yes we are. c d confirmed an active investigation. No further comment.” “C D” is likely shorthand for the FBI’s Criminal Division.

Said another FBI employee, whose name was redacted by the Bureau, “please do not discuss biden matter.”
We asked for a response from the bureau and the FBI employees identified in the chat messages. An FBI spokesman declined to comment.

According to the IRS whistleblowers, DOJ prosecutors blocked standard investigative protocols that might have led to Joe Biden ahead of the presidential campaign.

“There were a lot of overt investigative steps that we were not allowed to take because we had an upcoming election,” said Joseph Ziegler, the IRS case agent on the Hunter Biden probe.. “And it related to the president's son. So not even the candidate.”

The FBI chat is cryptic and the heavy redactions make it difficult to discern context. For example, an employee says to Chan that “[redacted] has a gag order from [redacted]... got checked by [redacted] had to backtrack - sorry!”
Another cryptic exchange came from Laura Dehmlow, the FBI employee who told House investigators that an FBI employee had accidentally confirmed that the laptop was real. “WTF(redacted) No COMMENT.”

An employee whose name is also withheld wrote, “nope, just a domestic hit job, yay” to which Dehmlow responded, “Yup.”

The exchange may be referring to the FBI’s knowledge that the laptop was authentic and not a foreign “hack and leak” or “Russian information operation,” as 51 former senior intelligence officials alleged at the time.

The IRS whistleblowers said there was no basis for the statement from the former intelligence officials....
Please subscribe now to support Public's award-winning reporting and to read the rest of this article!

x.com/shellenberger/…Image
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The Twitter Files revealed that the FBI ran a sophisticated info operation aimed at convincing journalists and social media companies that the Hunter Biden laptop, which it had possessed since 2019, was the result of a Russian "hack and leak" operation.

Read 5 tweets
Mar 31
The Right is a threat to democracy, the media says. But it isn’t. It’s winning elections and respecting constituitons. It’s the Left that is undermining democracy. It tried to jail Trump, is about to jail Bolsonaro, and just sentenced Le Pen to prison. This is a five alarm fire. Image
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And when the Left can’t incarcerate a presidential candidate, it simply prevents them from running, for no good reason, and in flagrant violation of the law, as the totalitarian creeps just did in Romania. Image
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Read 6 tweets
Mar 20
Free Speech Diplomacy, R.I.P.

March 3, 2025 - March 19, 2025
“We must stop censorship and suppression of information.” @SecRubio 💯🎯

I miss that guy
Read 10 tweets
Mar 18
Every single Trump advisor, including and especially @StephenM, knows perfectly well that what they did is unconstitutional.
It's up to the courts not the Administration to determine whether it is non-justiciable. The administration must comply with the order until a higher court reverses it or sets it aside. That's how our system works.
If the Trump administration continues with these obviously unconstitutional actions, then it will lose the legitimacy, public support, and power it needs to pursue free speech diplomacy, which would be a very disappointing outcome @SecRubio @marcorubio

Read 6 tweets
Mar 17
There's no proof of major waste, fraud, or abuse in govt spending, say the media. But there is. And now Public has obtained invoices revealing that a major contractor overcharged the Ed. Dept, paid its CEO $2M/year, and promoted debunked research as student performance declined. Image
US Education Department Contractor Overcharged Taxpayers While Spending Millions On Executive Salaries

As student math and reading scores declined, the American Institute of Research charged 50% in indirect costs and paid its CEO over $2 million

by @galexybrane and @shellenberger

Over the last few weeks, the media and Democrats have been lambasting President Donald Trump for cutting the Department of Education’s research budget. In particular, the media criticized the Trump administration for cutting a contractor’s research into support services for students with disabilities who are nearing graduation.

But it’s not clear that the research was necessary or successful, and there is already both state and federal funding aimed at helping students with disabilities to develop life skills and plans for the future.

And now Public has obtained invoices showing that the Department’s contractor for the research in question, American Institute for Research (AIR), had significantly overcharged the Department in so-called indirect costs.

The invoice is from November 18, 2024, and shows AIR billing the Department $411,961.35 for the month of October 2024. Of that money, $214,952.74 was in “total indirects.” AIR charged an additional $26,950.74 as a 7% fee.

The invoice shows that the cumulative amount that AIR had billed the Department of Education was $10,957,275.73, of which $4,993,376.12 was total indirects and $716,831.18 was total additional fees.

A second invoice is from January 15, 2025, and shows AIR billing the Department $60,913.72 for the month of December 2024. Of that money, $29,685.23 was in total indirects. AIR charged an additional $3,985.01 as a 7% fee.

The invoice shows that the cumulative amount that AIR had billed the Department of Education was $11,076,493.79, of which $5,028,446.77 was total indirects and $724,630.48 was total additional fees.

In response to questions from Public, an AIR spokesperson said, “AIR’s indirect rates are similar to those of other social and behavioral research organizations and we have always abided by our approved rates. For government contractors, indirect costs include such costs as information technology, data security, and compliance and reporting.”

However, 50% in indirect fees is widely considered excessive. The National Institutes of Health recently required that its contractors lower indirect costs to 15% to reduce widespread overcharging.

Indeed, when asked about the invoice, a spokesperson for the Department of Education condemned the high fees. “Contracts with indirect rates over 50% take gross advantage of taxpayer dollars, perverting the reason the contracts exist — our students,” said Department spokesperson Madison Biedermann. “Incoming leadership will no longer allow these unacceptable terms.”

According to AIR’s IRS 990 form, the total compensation of AIR’s chief executive, David Myers, in the most recent year available, 2023, was $2,241,374.

“At the end of 2023, David Myers finished a 14-year tenure as AIR’s President and Chief Executive Officer,” said the AIR spokesperson. “His compensation for his final year included a retention payment. The salary for our current President and CEO is lower and in line with what other non-profit organizations of our size and type pay their chief executives.”

However, AIR’s tax forms showed that Myers earned $2,294,637 in 2022 and $1,145,400 in 2021.

Jessica Heppen is the current president and CEO. In 2023, she earned $685,060 as president. Neither Heppen nor Myers responded to Public’s request for comment.

AIR’s 990 form shows other high salaries for staff and fees for board members. AIR’s Executive Vice President and Chief People Officer, earned $931,610 in 2023, and its CFO earned $1,145,400 in 2022. A member of the AIR Board, Robert Boruch, a professor at the University of Pennsylvania, received $80,250 in 2023 for just 2 hours of work per week, which is $772 per hour.

While nonprofit board members typically donate their time, 14 of AIR’s board members received hundreds of dollars per hour for their service. None responded to requests by Public for comment.

AIR’s fees should be considered in the broader context of declining student performance and AIR’s role to provide research that improves student performance.

Today, only 31% of fourth graders and only 30% of eighth graders are reading at or above proficiency levels, according to the National Assessment of Educational Progress (NAEP). In eighth grade reading, 33% of students scored “below basic,” the highest percentage recorded in the NAEP’s history.

Congress established the Education Department in 1979 “to promote student achievement and preparation for global competitiveness by fostering educational excellence and ensuring equal access.”

Student performance has declined across the board over the last 10 years. While Covid school closures significantly worsened them, math and reading scores declined for fourth- and eighth-graders nationwide from 2014 to 2024.

AIR appears to be partly responsible. It gave a favorable evaluation to Lucy Calkins’ Units of Study curriculum, which used elements of the now-debunked “whole language” approach to reading instead of systematic phonics instruction.

Under the whole language approach, teachers taught children to memorize whole words and use guessing strategies instead of sounding out individual sounds in unfamiliar words.

The failure of the whole language approach was precisely why the Department of Education hires groups like AIR. The goal of research is to discover which teaching methods work and which don’t before schools adopt them. That didn’t happen. In fact, the opposite did. The result was a whole generation of children robbed of fundamental literacy.

“It is absolutely inaccurate to say we ‘gave a favorable evaluation’ to Units of Study,” said AIR.

But the evaluation was clearly positive. Implementation of the curriculum, AIR’s report stated, “is associated with improvements in ELA [English Language Arts] achievement starting in the second year of implementation, and in schools that opt to continue with the approach long term, the magnitude of the effects grow larger over time.”

And even AIR noted, in its email to Public, “We found no positive effect in the first year of implementation, then saw positive effects in subsequent years for some schools.”

Other Department contractors had much lower indirect rates. Why was AIR able to charge so much?

If you're not already a subscriber, please subscribe now to support Public's award-winning investigative reporting, read the rest of the article, and watch the full video!

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