The extremism of the Biden administration apparently knows no bounds. Today the NY Times reports that the administration pushed the World Professional Association for Transgender Health (WPATH) to remove age limits for transgender surgery.

The draft guidelines, released in late 2021, recommended lowering the age minimums to 14 for hormonal treatments, 15 for mastectomies, 16 for breast augmentation or facial surgeries, and 17 for genital surgeries or hysterectomies.

The proposed age limits were eliminated in the final guidelines outlining standards of care, spurring concerns within the international group and with outside experts as to why the age proposals had vanished.

A minor can't buy an alcoholic drink or get a tattoo but the Biden administration, in the form of assistant secretary for health at the Department of Health and Human Services Rachael Levine, thought limiting hysterectomies to 17 was a bridge too far. 

The concern about listing the age limits in the final guidelines was that it would highlight exactly this sort of contradiction and would therefore open a debate about what Americans believed the proper ages for such medical interventions should be. Better not to say anything than to openly admit exactly what you're doing. After all, it's hard to deny you are promoting irreversible surgery on minors if your guidelines are explicit about it.

The bigger story here may be the degree to which the entire decision making process for these supposedly science-based policies was guided by US politics.

One excerpt from an unnamed member of the WPATH guideline development group recalled a conversation with Sarah Boateng, then serving as Admiral Levine’s chief of staff: “She is confident, based on the rhetoric she is hearing in D.C., and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care. She wonders if the specific ages can be taken out.”

Another email stated that Admiral Levine “was very concerned that having ages (mainly for surgery) will affect access to care for trans youth and maybe adults, too. Apparently the situation in the U.S.A. is terrible and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them.”

The excerpts were filed by James Cantor, a psychologist and longstanding critic of gender treatments for minors, who used them as evidence that the international advisory group, referred to as WPATH, was making decisions based on politics, not science, in developing the guidelines.

Dr. Bowers, the head of WPATH, denied the decision to remove the age guidelines was political, though her precise wording seemed a bit confused: "It wasn’t political, the politics were already evident." So it wasn't political because it was already political? Okay, glad you made that clear for us, Dr. Bowers.

Meanwhile, the emails show that other people working on the guidelines felt this decision was veering beyond science. "If our concern is with legislation (which I don’t think it should be — we should be basing this on science and expert consensus if we’re being ethical) wouldn’t including the ages be helpful?" one member of the team wrote.

The Supreme Court just agreed to take up a case out of Tennessee where bans on gender medicine, including puberty blockers and surgery, have been put in place. The Times points out that the DOJ is citing the "WPATH guidelines among its primary 'evidence-based practice guidelines for the treatment of gender dysphoria.'"

So the Biden administration pushes WPATH to remove age guidelines for political reasons. Then the administration uses the guidelines it helped shape to undermine a Tennessee law banning such treatments on the grounds that WPATH's guidelines are the best science available. It's politics all the way down. 

This is extremely dishonest but not surprising. The Biden administration is taking an extreme view on this issue, one increasingly cut off from the more conservative guidelines being put in place in European countries.