Things are going poorly for the World Professional Association for Transgender Health. Documents unsealed in Boe v. Marshall, a lawsuit challenging Alabama’s ban on hormonal and surgical transgender procedures for minors, reveal that WPATH manipulated the evidence review process when drafting its recommendations for treating youth and adults. It then misled the public and colleagues in the medical profession, claiming that its eighth version of “standards of care” (SOC-8) was “developed using an evidence-based approach.” Eli Coleman, SOC-8’s committee chair and lead author, claimed that the SOC-8’s developers employed “the most rigorous protocol in the world to ensure these standards reflect scientific evidence and meet the needs of transgender patients.”
The documents also reveal that Rachel Levine, a top official at the U.S. Department of Health and Human Services, used an aide to pressure WPATH to eliminate age minimums for procedures including double mastectomy and genital surgery. Additionally, they showed that members of WPATH’s guideline-development group privately denounced the American Academy of Pediatrics’s 2018 policy statement on “gender-affirming care” as non-evidence based and as having “a very weak methodology.” When the American Medical Association declined to endorse SOC-8, the incoming president of WPATH dismissed AMA leaders as “probably some white cisgender heterosexual hillbillies from nowhere.”
Now, supporters of pediatric sex-trait modification are grappling with the fallout from the Alabama disclosures. Federal administrative agencies have molded their policies and legal advocacy around WPATH and SOC-8; HHS’s Levine has said that “the standard” for health-care decisions in this area is “set” by WPATH. Hospitals around the country use SOC-8 as the authoritative guideline for their providers, in some cases using it to pressure providers to set aside any doubts about the propriety of approving vulnerable teenagers for hormones. […]
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