This is a response to the WPATH statement regarding medical ‘gender affirming’ treatment including puberty blockers for transgender adolescents.
The World Professional Association for Transgender Health, along with their European, United States, Asian, Canadian, Australian and New Zealand associated groups, have issued a statement saying they strongly disagree with the recent judgement of the High Court in Bell vs. The Tavistock saying “we believe this decision will result in significant harm to the affected children and their families we oppose this ruling and urge that this ruling be appealed and overturned”
In their statement they admit that children under the age of 16 must first seek authorisation from the court of law to obtain, in their words, “necessary and effective medical care”. Now, immediately, we notice in the very first paragraph of the statement that they are perpetuating the myth, the lie, that gender-affirming medical interventions are necessary and effective. They are not necessary and, as recent research has shown, they are not effective either.
Later in the introduction, WPATH says that several studies demonstrate the “clear mental health benefit of gender-affirming medical treatment”, we know now that there are also several studies which repudiate and refute that there are mental health benefits to gender-affirming medical treatment, WPATH goes on to say that withholding such treatment is “harmful and carries potential lifelong social psychological and medical consequences”. If this statement did not have the impact of perpetuating the lie of benefits of gender-affirming treatment it would be risible. Where they say withholding such treatment is harmful, it is irrefutable that administering such treatment is harmful and carries potential lifelong social psychological and medical consequences. Keira Bell and countless other detransitioners are testament to the latter being true.
WPATH goes on to say that the treatment of transgender adolescents (if you accept there is such a thing) involving gender-affirming medical interventions is “the most widely accepted and preferred clinical approach in health services”. This is only the case because WPATH, and other groups involved in promoting genderism, have succeeded over many years in lobbying and persuading and cajoling health services to accept that such harmful interventions are to be accepted and preferred. As the mode of treatment for which they advocate comes under ever greater scrutiny, it is becoming abundantly clear that gender-affirming treatment will not be widely accepted or preferred for too much longer. We know that medical treatments go in and out of fashion. The practice of surgical lobotomy for mental health conditions was once widespread.
As part of their statement WPATH refers to two main international guidelines including their own ‘Standards of Care’ and the Endocrine Society clinical practice guidelines. We are aware that both international guidelines have been generated by the lobby in favour of the gender ideology and in favour of transitioning children. Nevertheless, as Michael K. Laidlaw MD points out in this Twitter thread, there is a contradiction in the promotion of these guidelines as being Standards of Care. As ‘Standards of Care’ there is a poor evidence base. As guidelines which advance the ‘gender affirming’ model, that model is under ever growing scrutiny.
The siren voices of WPATH say, unsurprisingly, that ‘puberty blocking’ treatment must commence earlier in the puberty process and not at the age of 16. These people advocating the gender-affirming model of treatment seem to be blind to the harm and the long-term negative consequences of the treatments that they advocate.
The WPATH statement then goes on to address whether puberty blockers lead on to further gender-affirming treatment, i.e., cross sex hormones and surgeries. It says that medical interventions are offered in a “stepwise approach from reversible to irreversible treatments starting with blockers”. We know that blockers are not reversible. Any interruption to normal puberty has profound effects on bone density, neurological development, development of genitalia and social functioning. The statement repeating the lie that blockers affect pubertal development in reversible way is clearly not supported by the evidence as heard by the High Court. They claim it is not the case that one stage invariably leads to the next, well that is just splitting hairs; while one stage does not invariably lead to the next, puberty blockers do leads on to cross sex hormones in 98% of cases. Using an exceptional 2% to claim the treatment pathway is interruptible in general is the height of disingenuity.
In a paragraph entitled “The harmfulness of not providing puberty blockers” WPATH says it has a grave concern that the High Court has overlooked not only the immediate positive effects of puberty suppression but also the lifelong benefits of having a physical appearance which is congruent with one’s gender identity. We know that puberty blockers are harmful, the High Court agrees with that. There is a question as to whether there are any positive effects of puberty suppression. Certainly, there is no consensus on whether it alleviates psychological suffering, and the assumption that having a physical appearance congruent with one’s gender identity can be a lifelong benefit, when we know that having a gender identity is not necessarily a lifelong thing, is clutching at straws. The increasing numbers of detransitioners going public is evidence that a gender identity is something which appears to last only through adolescence in a great many cases, and particularly in the cases of post-pubertal gender dysphoria with which we are most concerned.
The statement goes on to address the issue of the age of consent for opposite sex imitation medicine. It asserts that many minors possess the cognitive and emotional abilities to understand the consequences of their decisions. This might be true; we would suggest however that any minor possessing the cognitive and emotional abilities to understand the consequences of their decisions would not ever make the decision to take puberty blockers and cross sex hormones. Why would they? When WPATH says the determination of the ability of a particular adolescent to give consent should be made by a ‘competent transgender healthcare provider’ who has evaluated the adolescent and not by a court of law is plainly dangerous. Healthcare providers specialising in gender identity are almost entirely working under the false premise that opposite sex imitation is an appropriate treatment pathway for adolescents. One could go so far as to say that ‘competent transgender healthcare provider’ is an oxymoronic concept. Think: weight-loss clinics for anorexics.
Genuinely competent gender identity healthcare would consist of psychotherapy only with no options for hormonal treatment for adolescents with normal endocrine systems.
Finally, in their conclusion, the advocates for the medicalization of gender identities recommend that consent is evaluated on a case-by-case basis by a treating clinician, and not by a court of law. This creates an incredibly dangerous situation because we know there are clinicians in practice who believe such notions as “a transgender woman is a woman”. In believing such tenets of gender ideology, they are not appropriate persons to be deciding what treatment is safe and appropriate for an adolescent with gender incongruence. WPATH does not agree that transgender healthcare is so different in kind to that provided to people without gender identity problems – but no other field of medicine is designed to harm the patient so profoundly.
WPATH says it is gravely concerned that the ruling will have a significantly adverse impact upon what they call gender diverse youth and their families by imposing barriers to care as “costly, needlessly intimidating and inherently discriminatory”. This is just using words to scaremonger. Cost is irrelevant as good medicine would be covered by healthcare plans. Opposite sex imitation medicine needs to be intimidating, ideally, prohibitively. And as for ‘inherently discriminatory’, the statement makes no reference to which people it sees as being discriminated against. An educated guess would be ‘transgender people’ but this pathologizing of healthy, but mentally conflicted, adolescents is just wrongheaded.
People who develop a gender identity at odds with their sex do require timely and appropriate help for their distress. WPATH cannot be widely accepted and preferred as a source of guidance on such matters.
