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

Feb 24
"The science doesn’t seem so settled after all, and it’s important to understand what happened here. The approach of left-of-center Americans and our institutions — to assume that when a scientific organization releases a 'policy statement' on a hot-button issue, that the policy statement must be accurate — is a deeply naïve understanding of science, human nature and politics, and how they intersect," writes @JesseSingal for @NYTOpinion.

GIFT LINK: nytimes.com/2026/02/24/opi…Image
For @NYTOpinion, @JesseSingal writes:

The A.P.A. presents a particularly striking case of why transparency is important. In 2024, it published what it touted as a “groundbreaking policy supporting transgender, gender diverse, nonbinary individuals” that was specifically geared at fighting “misinformation” on that subject. But when I reached out to the group this month, it pointed me to a different document, a letterwritten by the group’s chief advocacy officer, Katherine McGuire, in September in response to a Federal Trade Commission request for comment on youth gender medicine.

The documents, separated by about a year and a half (and, perhaps as significantly, one presidential election), straightforwardly contradict each other. The A.P.A. in 2024 argued that there is a “comprehensive body of psychological and medical research supporting the positive impact of gender-affirming treatments” for individuals “across the life span.” But in 2025, the group argued that “psychologists do not make broad claims about treatment effectiveness.”

In 2024, the A.P.A. criticized those “mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence.” In 2025, it cautioned that gender dysphoria diagnoses could be the result of “trauma-related presentations” rather than a trans identity, and noted that “co-occurring mental health or neurodevelopmental conditions (e.g., depression, anxiety, autism spectrum disorder) … may complicate or be mistaken for gender dysphoria.” It seems undeniable that the 2025 A.P.A. published what the 2024 A.P. A considered to be “misinformation.” (“The 2024 policy statement and the 2025 F.T.C. letter are consistent,” said Ms. McGuire in an email, and “both documents reflect A.P.A.’s consistent commitment to evidence-based psychological care.”)Image
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@nytopinion @jessesingal Jesse Singal on youth gender medicine in @NYTOpinion: “I’ve been covering this controversy for about a decade from a left-of-center perspective, and I’ve found that anyone who questions these treatments, even mildly, is invariably accused of bigotry.”

Bluesky: “YOU TRANSPHOBE!! Image
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Read 9 tweets
Feb 23
NEWS: Mt. Sinai, the sprawling hospital system, has joined NYU Langone in shuttering its pediatric gender clinic in the face of threats from the Trump administration of cutting off its Medicaid funding.

NYC Mayor Zohran Mamdani @ZohranKMamdani @NYCMayor pledged in his campaign to spend $65M in city funds on gender-transition treatment to evade pressures from the Trump administration to cut off such access. But since NYU announced it would no longer provide gender-transition drugs or surgeries to minors, the mayor has been mum on the potential for spending public funds on these interventions.Image
The blue-state pediatric gender clinic closures started with Children's Hospital Los Angeles last July and have continued steadily since then. benryan.substack.com/p/dr-johanna-o…Image
Read 4 tweets
Feb 19
Taylor Lorenz Plagiarism Scandal Erupts

YouTube sleuths found: @TaylorLorenz apparently copied substantial portions of a TechDirt article about Joseph Gordon-Levitt @hitRECordJoe and Section 230.

Lorenz appeared to pass off the article's text as if it was her own script.🧵⬇️Image
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Go to 4:22 in this video to see the part where the YouTube hosts assert that @TaylorLorenz has plagiarized her narration from a TechDirt article about Joseph Gordon-Levitt @hitRECordJoe and Section 230:
youtube.com/live/JXI9uRwfG…
Here is @TaylorLorenz's video in which Lorenz appears to have lifted much of her script from a TechDirt article. Go to 9:34:
youtube.com/watch?v=b0RRxR…
Cross reference with this article: techdirt.com/2026/02/12/jos… Image
Read 11 tweets
Feb 18
I can’t even begin to enumerate all the nasty things Parker Molloy has said about me in an effort to punish me for reporting about pediatric gender medicine and to scare off other reporters who might dare to enter this arena. My policy with responding to such behavior is I report what people such a Molloy say or do, and will often fact check errors. They then turn around and make vicious and demeaning claims about who I am.
Update: Parker Molloy is expressing her rage toward me on Bluesky right now.
Update: Parker Molloy is not an activist. Nothing in her behavior, rhetoric or discourse would suggest she is one. Image
Read 5 tweets
Feb 10
The Federal Trade Commission has opened a consumer protection probe into the American Academy of Pediatrics and has demanded its records regarding pediatric gender medicine.

In 2018, the AAP published its foundational policy document on the gender-affirming care method. It was written by a single medical resident, Dr. Jason Rafferty, and edited by a small committee. It was subjected to a brutal fact check by Canadian sex researcher Dr. James Cantor the following year. The AAP never responded to the fact check. In 2023, the AAP reaffirmed the policy statement with no changes.

The statement asserts that even very young children know their gender identity as well as anyone and should be trusted to guide the way in their own pathway of transition.Image
Read 6 tweets
Feb 7
How Can Doctors Like This Provide Competent Care To Their Patients?

Some beef with Dr. Jonathan Howard, by @JesseSingal.
jessesingal.substack.com/p/how-can-doct…
Dr. Jonathan Howard, a neurologist and psychiatrist at @NYULangone Health, is furious at Michael Shermer, the founding publisher of Skepticmagazine.

Howard is an impressive figure. Like many doctors at university-affiliated medical centers, he also serves as a professor, in this case at the @NYUGrossman School of Medicine. He has, according to his biography, “authored and edited multiple textbooks” on multiple sclerosis, his area of specialty.

Why is Dr. Jonathan Howard furious at @MichaelShermer? It has to do with a recent exchange between Senator Josh Hawley and an OB-GYN named Dr. Nisha Verma. Hawley, seeking to make a point about “gender ideology” (as he might call it) during a hearing, repeatedly asked Verma if men can get pregnant and Verma could not give a straight answer. Shermer chimed in to suggest an answer Verma could have given that accounts for the fact that, as Shermer (and anyone else using the traditional, biological definition of the term) sees it, men cannot, in fact, get pregnant.

That’s why Howard is furious, and that’s why he wrote a deeply aggrieved article in Science-Based Medicine about Shermer’s bigotry. The headline? “The Anti-Trans Obsessions of ‘Skeptic’ Michael Shermer: Hallucinating Imaginary Demons to Empower Actual Villains, Once Again.” The subheadline? “I want to demonstrate to Michael Shermer that it’s possible for men like us to not talk about trans people constantly. If I can do it, so can he.” (If you’re unfamiliar with Science-Based Medicine’s strange recent trajectory, see here or here.)

Not only does Dr. Jonathan Howard of NYU Langone Medical Center disagree with Michael Shermer that men can’t get pregnant — Howard thinks that to even ask this question puts other humans in danger.

That probably sounds like a caricature on my part, or a sloppy and inaccurate gloss of Howard’s actual views. But that’s exactly what he wroteImage
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Jonathan Howard has gotten it into his head, meanwhile, that I am personally responsible for the MAHA movement because once I published an essay on Vinay Prasad’s Substack about trans medicine researchers deceiving the public. This is bonkers conspiracy thinking by Howard.
After @jessesingal explained in exacting detail why the study Jonathan Howard cited as evidence of pediatric gender-transition treatment’s efficacy was bunk, Howard respond with this mischaracterization of what Singal said about Howard’s inability to understand the paper. Image
Read 6 tweets

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