WPATH: Our Standards of Care Are Just an Opinion

AP Photo/Jacquelyn Martin

Last month the FTC and four states sued WPATH, the World Professional Association for Transgender Health, claiming the group had made "deceptive claims" in its published healthcare guidance which promoted gender affirming care.

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The legal action, filed in Texas, reflects an escalation in the Trump Administration’s efforts to put an end to gender-related care for minors across the nation. While the administration has already threatened to pull funding from hospitals that deliver such treatments, this effort targets guidelines that have provided a basis for health insurance coverage of the treatments.

The lawsuit takes aim at the World Professional Association for Transgender Health, or WPATH, and its U.S. counterpart. Those nonprofit organizations, made up of medical experts, issued an updated version of care standards in 2022, a document that drew scrutiny for omitting age limits for procedures including breast augmentations, genital surgeries and hysterectomies.

Joe Simonson, director of public affairs at the Federal Trade Commission, said in a media call on Wednesday that parents and children had been misled about the necessity, safety and scientific basis of gender-transition treatments in order to secure insurance coverage.

A competing group called the Society for Evidence-Based Gender Medicine highlighted a document that appears to stem from that trial in which WPATH frames its work as providing opinions and being one-half of an ongoing medical debate.

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Yet for years, WPATH presented its guidelines as an unquestionable medical standard of care. The social and scientific costs of questioning their recommendations were steep and could be career-ending. /2

The other is the pro-"conversion therapy" Chiles v. Salazar ruling. /4

WPATH previously strongly objected to both as forms of conversion therapy.

Now, WPATH argues that although conversion therapy may be "substandard care," the Court rightly protected it as free speech. They argue that, likewise, WPATH's own SOC-8 guidelines should also be protected as "free speech"—even if the care they advocate for is judged as "substandard." /6

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Our reading of the latest WPATH filing: WPATH's message is that its "Standards of Care" are merely an opinion and an expression of free speech. Clinicians who rely on the SOC-8 document—and organizations that refer to it as the implied standard of care for gender-dysphoric youth—are, in fact, taking on independent responsibility for the premise that the document represents trustworthy clinical guidance.

In turn, patients who trust the clinicians following the WPATH Standards of Care should know they are in a "buyer beware" situation. They are being treated based on what WPATH asserts to be merely an expression of "free speech"—representing only one side of an unsettled scientific debate marked by "medical and scientific uncertainty." /7

SEGM also highlighted this response from a scientist who argued that WPATH's standard of care was poor quality.

WPATH claims it is “contributing to [medical] debate.” But as someone “contributing to the debate” from the opposite side, I cannot make sense of my experiences if this is merely a debate.

Why do my coauthors, I, and many others like us need to overcome anxiety, and, for some, even fear, to put our names forward? Why do we need to clear so many hurdles, including some that we would call censorship? Why do we need to face being named and shamed after publishing papers that disagree with WPATH?

WPATH may not be directly involved in these actions. But WPATH is not merely contributing to a debate. WPATH is promoting a model, and many medical organizations and activist groups have bought into it. When faced with challenges, they either remain silent about the lack of evidence supporting the recommendations or defend the model vigorously.

The fact is that this “opinion” of WPATH is perceived and defended as a standard of care. This fact invites examination. For scientists, the examination is whether this standard of care is supported by evidence (no, it isn’t). For public authorities, the examination is whether WPATH has been dishonest in making these recommendations and promoting this model of care to a degree that crosses the threshold of fraud.

There is a distinction between defending a professional body’s freedom of expression and holding a professional body accountable for the consequences of making false claims.

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Some reporters who covered WPATH are reacting to this as well.

What if the medical pioneers who developed lobotomies later admitted there was no science to support their brutal surgical procedure—only their opinion that it might have been a good idea?

That is what just happened with pediatric “gender-affirming” treatments.

It is hard to overstate the importance of this court admission from WPATH, the most influential transgender medical association whose guidelines are still cited by governments and medical groups worldwide as the progressive standard of care. In a Texas federal filing, WPATH now concedes its Standards of Care are merely its opinion—what it claims is one side of a debate marked by “medical and scientific uncertainty.” 

Clinicians and organizations that treat them as binding standards of care, WPATH says, bear “independent responsibility.”

In 2024, I helped break the scandal of the internal WPATH Files, along with @shellenberger and @_CryMiaRiver. The leaked documents exposed that the organization already knew—and hid—the irreversible adverse effects of the very standards they were promoting. They had even removed minimum age limits on surgeries for children.

My reporting at the time in the NY Post: https://nypost.com/2024/03/04/opinion/secret-files-show-how-international-group-pushes-shocking-experimental-gender-surgery-for-minors/

Now in litigation, WPATH admits the guidelines were never science-based. Tell that to the thousands of children who have been permanently maimed in pursuit of an online contagion that convinced them they would be happier in another body—and to the growing number trying to detransition.

I hope the key figures behind the WPATH scandal are eventually held accountable.

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And a doctor:

More reactions:

And now the institution upon which the charade of scientific authority across American institutions relied has said so itself in federal court.

It was a con orders of magnitude worse than Jason Arday, because it implicated nearly every organ of scientific and medical consensus in a conspiracy to tell the most brazen lie ever told by those institutions at the largest scale any such lie has ever been told, and because on the basis of this lie, tens of thousands of confused were medically harmed in pursuit of a delusion that can never be true.

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Almost no one has written about this yet, certainly no major newspapers are covering it. Maybe tomorrow? Maybe never?

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