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

Mar 24
100s of NIH research grants have been summarily canceled over the past couple of weeks, on the grounds that they support DEI, trans issues, or are at Columbia. Now Trump is targeting mRNA studies, which scientists tell me could jeopardize research into new cancer treatments, for one, as well as the quest for and HIV vaccine. Many of these grants have nothing to do with DEI per se or are particularly focused on transgender people in particular. They seem to have been flagged simply because they have key words that have drawn the attention, and ire, of DOGE. I only have second-hand reports of what DOGE has been doing inside of the NIH and the NIAID.
Today, a titan of biomedical research called me and was reduced to pleading over and over, “Why are they doing this?” as he watched in fear that his life’s work would be destroyed by the Trump administration.
I spoke with one prominent epidemiologist who said that their skills would not be of use outside of academia and that they’d discussed having to move to some cheap place in the country to be able to survive financially.
Read 5 tweets
Mar 12
LEAKED: Trans-Care Training Videos By Beleaguered Top Gender-Clinic Doctor, Part 1

I have obtained 12 hours of videos of top pediatric-gender-clinic physician Dr. Johanna Olson-Kennedy and her colleagues, including her husband, providing training to mental-health providers on how to treat minors who have gender dysphoria or otherwise identify as transgender or nonbinary.

This is the first of 12 installments I will post during the coming weeks of these videos. Subscribe to my newsletter (link in bio) to receive all of them as I publish them.

A 19-year veteran of the pediatric gender medicine field and one of its leading physician-researchers and advocates, Dr. Olson-Kennedy is the medical director of the gender clinic at Children’s Hospital Los Angeles. According to figures she provided during this particular video, annual referrals to her clinic surged from just 25 in 2010 to 436 in 2022—following a similar pattern seen in clinics throughout the Western world.

The past six months have been challenging for Dr. Olson-Kennedy, to say the least.

Dr. Olson-Kennedy is the principal investigator on a National Institutes of Health grant for a long-running research project concerning pediatric gender-transition treatment, one that has received over $10 million to date. In October, The New York Times reported that she has withheld null findings from a study of puberty blockers funded by this grant, doing so for political reasons. The grant is now the subject of a probe by congressional Republicans. In November, however, she asserted in a sworn deposition in a civil case that the Times had mischaracterized her words.

In December, Dr. Olson-Kennedy was sued by a former patient, Clementine Breen, who reported that the gender doctor prescribed her puberty blockers at age 12—on her first appointment, without a psychological assessment—and testosterone at age 13, and then referred her to receive a double mastectomy at age 14. Ms. Breen, now 20, has since detransitioned, reverting to presenting and identifying as a woman.

The Trump administration has unleashed an onslaught against the field of pediatric gender medicine, seeking to wipe it off the map. In recent weeks, the NIH has been canceling research grants related to transgender people, including those conducted with animal models. There is currently a preliminary injunction in place to block the president’s executive order that would freeze federal funds to hospitals that provide gender-transition interventions to those under age 19. Prior to the injunction, Dr. Olson-Kennedy’s clinic had “paused” new cross-sex hormone treatments for youth, only to lift the pause a couple of weeks later.

It remains unclear whether the grant for which Dr. Olson-Kennedy is the top investigator has been canceled. But it is no longer listed on the NIH site where active grants are described.

I reached out to Dr. Olson-Kennedy and her co-principal investigators on the grant to ask about its status. I did not hear back.

Prior to the October Times article, Dr. Olson-Kennedy was perhaps best known by the general public for a previous leaked video in which she was giving a training in 2018 to mental health care providers on how to write referral letters for minors seeking gender-transition surgeries. In the video, she expresses exasperation with what she sees as hand wringing over whether natal girls will later regret having their breast removed during adolescence. (At least 1,000 such surgeries have been conducted annually in recent years.)

She says: “What we do know is that adolescents actually have the capacity to make a reasonable, logical decision. And here’s the other thing about chest surgery. If you want breasts at a later point in your life, you can go and get them!”

Ms. Breen recently reported that she was undergoing reconstructive surgery to provide herself with new breasts. However, it is very unlikely she will ever be able to breastfeed should she have children.

Dr. Olson-Kennedy is also newly the president of USPATH, the U.S. branch of the medical-activist group the World Professional Association for Transgender Health. WPATH, which despite is name is largely a U.S.-based organization, has been besieged by damaging publicity over the past year, in particular after internal documents subpoenaed by Alabama’s attorney general revealed that its leadership was aware that the evidence behind pediatric gender medicine was weak and sought to paper over this fact.

12 hours of leaked Olson-Kennedy training videos

The 12-hour training in what is known as the gender-affirming care method for minors who identify as trans or nonbinary took place in late April 2024—a few weeks after Britain published the Cass Review, which found that this medical field is based on “remarkably weak evidence.” The training was led by Dr. Olson-Kennedy; her husband, Aydin Olson-Kennedy, who has a doctorate in social work and is a transgender man; and licensed clinical social worker Darlene Tando.

I obtained the videos a few months ago.

The training videos are a window into not just the methods of these individuals, but their overall attitudes about gender dysphoria and transgender and nonbinary identification in children. A prevailing attitude they share is one of indignation and irritation with a medical system that demands that children betray a substantial level of distress before they are granted gender-transition medications. Overall, these three favor less gatekeeping and less pathologizing of the mental states and internal lives of the children in their care. If a gender-incongruent child arrives in their care absent any particular distress about their identification as the opposite sex, they believe that that child should be granted the opportunity to medically transition by taking puberty blockers and cross-sex hormones if the family wishes.

I have edited the videos to snip or crop out images that would identify the participants in the training, whether because of Zoom-chat questions that pop up in the right-hand corner of the screen, or moments when a matrix of the participants is visible. You can watch the video at the beginning of this Substack. Otherwise, I wrote a summary below:
LINK:
LEAKED: Trans-Care Training Videos By Beleaguered Top Gender-Clinic Doctor, Part 1
benryan.substack.com/p/leaked-trans…
I am publishing 12 hours of videos of Dr. Johanna Olson-Kennedy and colleagues in which they train mental-health providers on treating children who have gender dysphoria or otherwise identify as trans.

Subscribe to my newsletter to receive all the videos as I publish them.Image
Video number 1: Johanna Olson-Kennedy on the gender basics
benryan.substack.com/p/leaked-trans…
Dr. Olson-Kennedy opens the video by charting the recent shift in transgender visibility in popular media, which she says has improved dramatically in recent years. Previously, transgender people were frequently presented as sex workers, according to at GLAAD analysis. But these days, TV has benefited from the likes of Jazz Jennings and shows like Transparent and Pose that center on the transgender experience, Dr. Olson-Kennedy says. Having stories about youth in the media in particular, she says, has influenced the seeking of gender-transition treatment by young people.

She expresses concern that the trans kids whose stories have been told in the media are generally white. This is reflective, she says, of the disproportionately white patient population at gender clinics in the U.S. and Europe. “It is important for all of us to think about what those barriers to care are for other communities and work really hard to dismantle those barriers.”

This remark speaks to a common dichotomy among advocates in this medical field: They will at once characterize the number of children receiving these treatments as low (as Dr. Olson-Kennedy does a bit later in the video), emphasizing that the political firestorm over this population is disproportionate to its size, while also decrying how few kids are receiving the treatment.

Since 2021, Dr. Olson-Kennedy says, we’ve seen a “problematic” visibility of trans youth as states have moved to ban these treatments. She shows a Google search she conducted of “transgender youth care” the night before. “All of these six headlines, and there’s many more,” she says, “are negative, and they speak to moves being made to ban access to care.”Image
Read 20 tweets
Mar 9
Research indicates that even after undergoing lengthy testosterone suppression and estrogen treatment, natal males who identify as female hold a competitive advantage in women’s sports. This is not just about height. It’s about muscle strength, shoulder and hand size, oxygen processing, etc.

And there are teenage boys who can bear Katie Ledecky, one of the most unbeatable long-distance swimmers in history.Image
*beat Katie
Read 4 tweets
Mar 7
The difference between the trans sports question and past battles over interracial and same-sex marriage is that there was never any rational scientific support for opposition to those rights. But research does indicate that trans women maintain a competitive advantage in women’s sports. @mattyglesias @drvoltsImage
So is it “morally repugnant” as @drvolts claims, for @mattyglesias to back trans-girl exclusion from girls’ sports if their inclusion is unfair to c-s girls, per scientific research? Is inclusion more important than fairness?

I would be very interested to know why David Roberts thinks it is fair to include trans girls and women in girls and women’s sports.
Read 6 tweets
Feb 10
$544,000-a-Year, Newly Nonbinary @ACLU Executive Makes Incorrect Claims About Pediatric Gender Medicine: Will This Impact Landmark Supreme Court Case?

🧵👇I report for the @NewYorkSun: Hired in 2019 as the ACLU’s first DEI chief, AJ Hikes has also emerged at the center of a labor-rights case against the nonprofit that deemed it illegally fired a staffer on unsubstantiated claims of racism.Image
GIFT LINK: $544,000-a-Year, Nonbinary ACLU Executive Makes Incorrect Claims About Pediatric Gender Medicine: Will This Impact Landmark Supreme Court Case?
nysun.com/article/544000…
Hired in 2019 as the ACLU’s first DEI chief, AJ Hikes has also emerged at the center of a labor-rights case against the nonprofit that deemed it illegally fired a staffer on unsubstantiated claims of racism.Image
The @ACLU's 4th highest-paid staffer, AJ Hikes, who was hired in 2019 as its first DEI officer, whose 2023 salary exceeded $540K, and who wields considerable influence as a close advisor to the executive director, has drawn unflattering attention to the storied legal group. Image
Read 20 tweets
Feb 9
How the NIH cuts would decimate pediatrics research at UNC and likely undermine the hospital system:
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Recall how vitally important fertility is to JD Vance in particular. Keeping babies from dying is central to such an aim.
Read 4 tweets

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