A Monster Lurking - The World Professional Association for Transgender Health

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On 6^th September 2022, the World Professional Association for Transgender Health (WPATH) published their updated Standards of Care (Version 8).

WPATH were founded in 1979 and have stated that their purpose is to “promote evidence-based care, education, research, advocacy, public policy, and respect in transgender health”.

There have been concerns over the years that the organisation acts as more of a partisan lobby group, rather than an independent, safeguarding-focussed organisation, particularly given the make-up of senior members of WPATH, many of whom identify as ‘trans’ or ‘non-binary’ themselves and/or are activists in this space.

Gender ideology appears at the forefront of the organisation’s work. By way of example, WPATH run an ‘Online Sexuality Workshop’, which focusses on “supporting trans erotic embodiments from a pleasure-centred praxis…working with children, adolescents…”.

Furthermore, in the ‘recommended reading’ section on their website, they suggest the following ideologically driven books (amongst others):

·      ‘Real Talk For Teens: Jump-Start Guide to Gender Transitioning and Beyond’, by Seth Rainess

·      ‘Transgender Warriors: Making History from Joan of Arc to RuPaul’, by Leslie Feinburg

The latest version of the WPATH Standards of Care is extremely concerning from a medical ethics and child safeguarding perspective. WPATH state that “these internationally accepted guidelines are designed to promote the health and welfare of transgender, transsexual and gender variant persons…”

The most concerning aspects of Version 8 of the Standards of Care are as follows:

·      Ideologically Driven Language – The guidelines feature language based in ideology, rather than medicine or biology, throughout. For example, irreversible medical and surgical interventions are referred to as “gender-affirming health care”. Double mastectomies are called “chest masculinization surgery”. Ideological terms such as “cisgender” are used, as well as the scientifically and factually inaccurate term “sex assigned at birth”. Regardless of the risks and impact on the safety and wellbeing of women, health providers are told to implement “gender neutral toilets”.

·      Removal of Minimum Ages for Irreversible Medicalisation – Any nuanced concern for the welfare and wellbeing of vulnerable children is omitted. Particularly when we consider that gender dysphoria is a mental health condition and many young people suffering from gender dysphoria will have other co-morbidities or mental health diagnoses. The guidelines have removed any minimum age limit for a child to be able to avail of puberty blockers, cross-sex hormones or sex-reassignment surgery (so long as that child has reached ‘Tanner Stage 2’ of puberty, which can be as young as 9 years old). Interestingly, minimum ages had been included in the originally published document before these were quickly removed via a ‘correction’ online. The guidelines state that double mastectomies, euphemistically called ‘chest masculinization surgery’, “can be considered in minors”. Equally, ‘vaginoplasty’ may be considered for under 18-year-olds. The guidelines make it clear that there should be no requirement for a child to have taken cross-sex hormones prior to availing of surgery, “if not desired” by a child – emphasising the consumeristic nature of these guidelines. Hormone treatment is recommended even though it can cause “infertility”.

·      Chest Binding/Genital Tucking – Healthcare professionals are instructed to provide education to children on both ‘chest binding’ and ‘genital tucking’, on the basis that this will provide “comfort” and “lower rates of misgendering” for a young person. However, this is regardless of the fact that the former can cause pain, infection and even fractures and the latter can cause decreased sperm concentration.