WPATH Gets Caught

A damning email reveals what they tried to hide

The World Professional Association for Transgender Health is an advocacy group comprised of both activists and clinicians, who appointed themselves world experts and created documents to outline what they consider proper medical and mental health treatment for people who transition. They call these Standards of Care. Many in the gender medicine biz consider these the North Star of guidance.

“We Follow WPATH Standards of Care,” boasts DukeHealth’s Gender Care for Children and Adolescents. Same for University of Washington. A California community health company, too.

Famously, or infamously, their most recent version, SOC8, included a chapter on eunuch gender identity, but cut out a chapter on ethics, and removed almost all age restrictions for surgeries.

It also included this paragraph:

Despite the slowly growing body of evidence supporting the effectiveness of early medical intervention, the number of studies is still low, and there are few outcome studies that follow youth into adulthood. Therefore, a systematic review regarding outcomes of treatment in adolescents is not possible.

Instead of including a systematic review, SOC8 outlined a few of those low number of studies, and said they showed that gender-affirming care was beneficial.

But a document released this week, as part of an ongoing legal case, shows that statement is false. In fact, WPATH had commissioned evidence-based medicine experts from Johns Hopkins to conduct a systematic review. As with all the other such reviews, this one found that there is “little to no evidence about children and adolescents.” That is, there were studies they could look at and that might claim good outcomes (or bad), but because of the studies’ designs or other limitations, they couldn’t be relied on as evidence.

These emails, between Johns Hopkins and the HHS’s Agency for Healthcare Research and Quality, indicate that WPATH prevented the publication of the review.

As for the studies that WPATH included in SOC8, the Cass Review—the recent report commissioned by NHS England to evaluate youth gender medicine—noted that “authors cite some of the studies that were already deemed as low quality, with short follow-up periods and variable outcomes, as well as a selected account of detransition rates.”

WPATH 8 concludes in its statement on the use of gender-affirming medical treatment that: “The evolving evidence has shown a clinical benefit for transgender youth who receive their gender-affirming treatments in multidisciplinary gender clinics (de Vries et al..,2014; Kuper et al.., 2020; Tollit et al., 2019)”.

•De Vries et al. (2014) is the original study of the Dutch protocol sample, which has marked differences to the population being treated currently, and as discussed had much stricter criteria for treatment.

•Kuper et al. (2020) is a study with a one year follow up that showed very modest change. It fell into the group rated by the University of York research team as too low quality to be included in their synthesis of evidence on masculinising/feminising hormones (Taylor et al: M/F hormones).

•Tollit et al. (2019) is a study protocol and does not include any results.

and:

“WPATH 8 overstates the strength of the evidence in making these recommendations.”

The only reliable guidelines Cass could find came from Sweden and Finland, where they implemented high bars to entry for youth gender medicine, with long-term evaluation and long-term follow-up. Their strict protocol came after—wouldn’t you know it—a systematic evidence review.

Will the AAP finally conduct the review that it promised? Will that make a difference? Will WPATH release the Johns Hopkins review? Will any of these medical associations shift gears?

We’ll have to engage in some watchful waiting to find out.