🚨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: 🧵
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.
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:
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.
Internal @WPATH communications suggest that "a global consensus" on the use of puberty blockers to treat gender dysphoria in adolescents "does not exist."
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:
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:
WPATH members' comments on social contagion, cont:
"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."
As @JesseSingal reported, the @AmerAcadPeds put pressure on @WPATH during the drafting processes for the 2022 Standards of Care 8:
"@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.
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:
"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.
"@WPATH made changes to the SoC8 for the explicit purpose of minimizing members' risk of malpractice liability," @JamesCantorPhD writes.
"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.
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:
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:
"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.
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."
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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I would very much like to know whether the unnamed source got cold feet and demanded a retraction of his quote (and if so, why), or if his words and his capacity to recall a time from about six or seven years ago were somehow misrepresented in the first place.
WaPo reports:
Xander Luke, another high school classmate, said he remembers Tyler Robinson being smart, funny and active online, trafficking in silly memes and jokes.
They would talk politics, Luke said, and discuss their “frustration with the system,” particularly feeling let down by the two major political parties. Robinson did not appear to like “hateful people” and “people who would talk down” to others, said Luke, 22.
I report for @UnHerd on the tangled and tortured case of Gordon Guyatt, the towering figure of evidence-based medicine who has caved to transgender-activist pressure and thrown under the bus the funder of his systematic reviews of pediatric gender-transition treatment, @SEGM_EBM. He and his colleagues also contradicted their own research findings by adopting activist language touting the benefits of these interventions as “medically necessary.”
My reporting plumbs the depths of the internal tensions at McMaster University, where Guyatt is a star professor, over the mounting activist pressure. I spoke with one of the authors of the review papers, who was sharply critical of Guyatt’s decision to take sides on how his work should be used in the policy arena. This source shared with me internal emails diagramming the thought process of Guyatt and one of his key McMaster colleagues as they tried to quell the furor over their commissioned work for SEGM.
I also report on how Guyatt’s team is seeking to sink or at least divorce themselves from two other systematic reviews about youth gender medicine, and also kill an analysis of @WPATH’s trans care guidelines.
Dr. Steven Montante, a plastic surgeon in Richmond, Va., was among the four review-paper coauthors who didn’t sign the statement. “I don’t necessarily agree that he has the authority to dictate” how his work is used, he said of Guyatt. “To be so prescriptive waters down the notion of why we do these systematic reviews, and the notion of evidence-based medicine. There should be some level of detachment.”
“Why didn’t the institution defend the science?” said Dr. Paul Garner, an emeritus professor of evidence synthesis in global health at Liverpool School of Tropical Medicine. “I see this is an institutional failure.” He added: “This is obviously a toxic ideological area.”
I interviewed a number of the first monkeypox (mpox) cases in 2022. They were largely affluent gay men who enjoyed traveling around the world and going to sex parties. I am not certain how stigma is connected to such a pastime.
During the outbreak, the CDC downplayed how central sex between men was to driving the outbreak. Dr. Daskalakis in particular invariably led with the exceptions to the rule of who was at risk, such as by uttering the misleading slogan, “Anybody can get monkeypox.” I once challenged him on this fact during a press call in August 2022 and asked why he wasn’t instead being direct and clear that gay men were overwhelmingly the ones at risk. He responded by saying he thought he and the CDC were doing a fantastic job.
Meanwhile, I was constantly getting DMs from parents who were scared to send their kids back to school or to daycare, despite the fact that their children were literally at greater risk of being struck by lightning than getting mpox.
Many people were angry that summer that some of the same people who insisted on masking children or keeping everyone at home during Covid were now insisting that gay men should not be asked to take a break from sex with multiple partners. It is evident that this contradiction eroded trust in public health, as you can see here from what @steveguest is saying:
I cannot begin to tell you how much rage people directed at me for simply saying gay men should modify their sexual behaviors to lower their risk of monkeypox. I broke a cardinal gay sin: Never tell a gay man to reel in his sex life. washingtonpost.com/opinions/2022/…
Nearly 40 percent of students at Brown University identify as something other than straight. The growth has been largely among students identifying as bisexual or as queer, pansexual, asexual or questioning. There has been little growth in gay identity.
Mother Jones is re-upping this article from January. The study in question found that, among minors with private health insurance, by age 17, about 1 in 1,000 were on cross-sex hormones during 2018 to 2023. The rate was higher than that for natal girls and was likely higher overall by 2023.
One way of reporting this news is to simply provide readers with the figures and let them decide whether they represent a little or a lot. open.substack.com/pub/benryan/p/…
Puberty blockers themselves, multiple studies have found, are not actually associated with any change in mental health metrics.
The Advocate reports: "Asked whether a parent concerned about their child facing a trans kid in girls’ sports 'has a case,' Pete Buttigieg @PeteButtigieg said, “Sure.” But he rejected blanket policies like the federal bans being enacted by the Trump administration, saying, “These decisions should be in the hands of sports leagues and school boards and not politicians, least of all politicians in Washington trying to use this as a political pawn.”
This statement has inspired a blistering response on Bleuskie—see the 🧵⬇️
Journalist Walter Bragman issues a blistering response to @PeteButtigieg’s statement over trans inclusion in sports, calling it “craven shit” and saying Mr. Buttigieg is catering to bigots.
“To just put a fine point on it: Parents do not, in fact, have legitimate concerns about trans kids playing sports,” Mr. Bragman says.
“Just because they believe bullshit doesn’t make it legitimate.
“Fuck anti-trans bigots.”
@PeteButtigieg A person called Guillotine Hunger Force argues that sports is not about winning.