Benjamin Ryan Profile picture
Jun 25, 2024 23 tweets 9 min read Read on X
🚨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: 🧵Image
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.Image
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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: Image
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.Image
Internal @WPATH communications suggest that "a global consensus" on the use of puberty blockers to treat gender dysphoria in adolescents "does not exist." Image
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: Image
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:Image
WPATH members' comments on social contagion, cont: Image
"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."Image
As @JesseSingal reported, the @AmerAcadPeds put pressure on @WPATH during the drafting processes for the 2022 Standards of Care 8: Image
"@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. Image
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: Image
"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. Image
"@WPATH made changes to the SoC8 for the explicit purpose of minimizing members' risk of malpractice liability," @JamesCantorPhD writes. Image
"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.
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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: Image
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: Image
"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. Image
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." Image
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.

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More from @benryanwriter

Jan 9
I’ve been reporting a story for a major outlet about a group that’s desperate to draw attention to a particular cause in hopes that the Biden admin will attend to it by Jan 20. But all but one of the advocates refused to speak to me because of my trans reporting. They prioritized blacklisting me—and not being associated with me—over their cause. I question their priorities and who they think they’re helping vs hurting by giving me the silent treatment.
This is a very common phenomenon when I’m covering public health stories that overlap with activism and advocacy work. Not one of these people has ever confronted me directly to tell me why they have a problem with my reporting or what they want me to do differently. It’s all passive aggression. I wind up hearing confirmation of why they won’t speak to me through the grapevine.
For one story I did, I was providing very rare major national coverage of a group’s pet public health cause. Because they were all on the same listserv, they were able to coordinate to all refuse to talk to me—scores of them. Two of them broke ranks and talked to me off the record. One of them explained to me that even if any of them wanted to talk to me and didn’t have a problem with my trans reporting or didn’t think their qualms should override their desire to get press for their cause, if they went against the group, they’d be excommunicated from it. In other words, maintaining ideological purity in public takes priority in these dynamics. This is also known as groupthink.
Read 7 tweets
Jan 9
In its response to Meta’s new polities GLAAD claims that the word “homosexuality” is an “outdated and a pathologizing way of referring to LGBTQ people.”

Several things:
1. No it is not.
2. How in the world did GLAAD come up with this ridiculous notion?
3. Homosexuality refers to the state of being gay, not to being transgender or queer, or even to being bisexual. Please stop conflating the letters of LGBTQ when it makes no sense to do so.
4. What exactly are we expected to say when we refer to the state of being gay, @GLAAD?Image
We need nouns to get through life, people. The world would fall apart without them.
Are they confusing “homosexuality” with “homosexual”? That would make more sense. Even so, is “homosexual” pejorative or just sort of dusty?
Read 8 tweets
Jan 6
NEWS: 1 in 1,000 Privately Insured 17-Year-Olds Were Taking Cross-Sex Hormones Prior to State Bans
I report, link in 🧵👇: The authors of a new study analyzing 2018 to 2022 insurance claims data characterized such prescriptions as rare and said this rarity undermined arguments for bans of these interventions.Image
LINK: 1 in 1,000 Privately Insured 17-Year-Olds Were Taking Cross-Sex Hormones Prior to State Bans

The authors of a new study analyzing 2018 to 2022 insurance claims data characterized such prescriptions as rare and said this rarity undermined arguments for bans of these interventions.benryan.substack.com/p/1-in-1000-pr…Image
🧵By age 17, about 1 in 1,000 privately insured minors were receiving gender-transition hormones between 2018 and 2022. This broke down to about 140 per 100,000 natal girls taking testosterone and 82 per 100,000 natal boys taking estrogen by this final year before teens hit the age of majority.
benryan.substack.com/p/1-in-1000-pr…
Compared with cross-sex hormones, puberty blockers were prescribed to adolescents with a transgender-related diagnosis at a much lower overall rate during this five-year period.

The authors of a new study reaching these findings characterized the prescription of gender-transition medications to adolescents under age 18—at an overall rate below 0.1%—as rare. Seeking to leverage their findings to score an advocacy win for the besieged field of pediatric gender medicine, they have argued that this rarity undermines arguments supporting state bans of such interventions for minors.Image
Read 19 tweets
Dec 29, 2024
ACLU Deputy With $543,500 Salary Issues Many False Or Misleading Claims About Pediatric Gender Medicine

🧵⬇️I report: The 4th highest paid staffer, AJ Hikes was the ACLU's 1st DEI chief and is at the center of an NLRB case against the ACLU that found it illegally fired an employee on claims she used racist language.Image
LINK: ACLU Deputy With $543,500 Salary Issues Many False Or Misleading Claims About Pediatric Gender Medicine
benryan.substack.com/p/aclu-deputy-…
The 4th highest paid staffer at over $500,000 per year, AJ Hikes was the ACLU's 1st DEI chief and is at the center of an NLRB case against the ACLU that found it illegally fired an employee on claims she used racist language.Image
The ACLU’s fourth highest paid staffer, who is at the center of a National Labor Relations Board case against the legal nonprofit that it lost in August, made a series of false or misleading claims about pediatric gender medicine in a recent interview.

@AJ_Hikes, who identifies as nonbinary, uses they/them pronouns and describes themselves in their ACLU bio as “a social justice advocate, community organizer, TED Talk Speaker, and unapologetically queer and Black,” holds a powerful position at the liberal legal juggernaut as the deputy executive director for strategy and culture.
benryan.substack.com/p/aclu-deputy-…Image
Read 12 tweets
Dec 28, 2024
More reporting from @JesseSingal on the case of the young detransitioner who is suing top pediatric gender medicine doctor Johanna Olson-Kennedy. Singal zeroes in on the therapy (or lack thereof) provided by another defendant in the lawsuit.

What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

When therapists are also activists, patients can get left behind.Image
LINK:

What The Detransitioner Clementine Breen’s Gender “Therapy” Looked Like

When therapists are also activists, patients can get left behindjessesingal.substack.com/p/what-the-det…Image
Detransitioner Sues Johanna Olson-Kennedy, a Top Pediatric Gender Medicine Doctor, For Medical Negligence

Dr. Olson-Kennedy is the most prominent doctor yet to be sued by a detransitioner—for medical negligence after overseeing a mentally ill girl's gender-transition starting at 12 and mastectomy at 14.benryan.substack.com/p/detransition…Image
Read 5 tweets
Dec 26, 2024
In response to a WaPo article in which an Italian child travels to Spain to obtain puberty blockers and does so on the first appointment following a single online consultation, journalist Evan Urquhart claims there “still hasn’t been a single reported example of a minor getting blockers or hormones without a lengthy assessment.”

Evan is ignoring Jesse Singal’s Economist article from earlier this month about Clementine Breen getting blockers after a single appointment with Johanna Olson-Kennedy.

And he is forgetting my reporting that since 2018, it has been Boston Children’s policy to provide only a single two-hour assessment appointment with a psychologist to determine whether a minor should get blockers or hormones.Image
Image
Read 7 tweets

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