American Academy of Pediatrics will review treatment guidelines for transgender minors

[LoudmouthMormon]

On 8/5/2023 at 9:37 PM, pogi said:

Quote

Cole has said that her doctor did not follow the standards of care from the World Professional Association for Transgender Health (WPATH) and that she did not know detransitioners existed until she was one.

Perhaps this all would have been avoided if the already established standards of care were followed.   There are dumb doctors who do not follow standards of care in all practices - this does not and should not reflect on their field of practice per se, nor should it overshadow the lived experiences of all patients who benefit from that field of practice.  Hence risk vs benefit.  Her experience is important to inform us of the potential risks, but it needs to be grounded in the larger picture of benefits and harms experienced by all patients of these treatments. 

It sounds like her doctor screwed up on multiple levels and hopefully pays the price for it

So, if you go look at the opening post in this thread, you will see how the dumb doctors who set policy - the American Academy of Pediatrics - don't have a single thing to say about standards of care in their policy.  It's "provide gender affirming care", and full stop.  No mention of diagnostic rigor.  No mention of evidence based treatment plans.  The word "Care" appears multiple times, but the word "standards" is absent.   Did her doctor screw up, or was he in an area with a lax governing board who just was running blindly with the AAP policy.

Perhaps you might agree with me, in that the AAP's current policy is dumb, and screwing up on multiple levels.  Perhaps you might join me in cautious hope that the AAP's upcoming review will point out this tragic shortcoming, and it might be revised to something a bit more sane so we can prevent future Chloe Coles from ending up in such a situation.

[LoudmouthMormon]

5 hours ago, The Nehor said:

I wish the anti-transgender movement would accept how rare they are and leave them alone but they don't. They call them groomers. They push through punitive and humiliating laws. They target transgender children in sports. They do this in states where there aren't even confirmed to be any children the laws would apply to in the entire state. Complaining that those who support transgender rights are focusing on a minority when the movement opposed to that minority is passing punitive laws against a minority of that small minority just shows that it is important. Transgender people were okay mostly sliding under the radar. If they hadn't been chosen because they were vulnerable to be the next target of the new moral panic they would still be rarely noticed. They didn't choose this fight.

I'm not a fan of politicians getting in front of outraged crowds and pushing reactionary legislation through in order to gain votes.   And both 'sides' of this issue has that happening in abundance.   It's happening in blue states where legislators are mandating teaching this or that, moving government funds to support this or that.  But yes, my side is doing it in red states as well, where legislators are banning this or that.  I am not a fan.

And it's not the "anti-transgender movement".  It's the "anti-radical-gender-theorists" movement.  So someone shows up with a video of a pride parade (or a drag show in a school) where people put on sexually explicit performances in front of 12 year olds.  That ought to generate outrage, and people ought to be shouting 'groomer'.   So people publish pictures of pages in certain books that show graphic cartoon depictions of oral sex and how to use sex toys or directions on how to sign up to hook-up sites, and parents share photos taken of their school libraries' book shelf where those books are found.  That should generate outrage and people ought to be shouting 'groomer'.     

I won't be posting my dozens of links from states across the nation, because they would violate the site rules against profanity and vulgarity, and would put the whole thread at risk of being closed for becoming a sexually-themed thread.   For posting vids of something happening in public, or photos of what's in certain books carried by certain schools.  Maybe let that sink in a little.

[pogi]

2 hours ago, LoudmouthMormon said:

So, if you go look at the opening post in this thread, you will see how the dumb doctors who set policy - the American Academy of Pediatrics - don't have a single thing to say about standards of care in their policy.  It's "provide gender affirming care", and full stop.  No mention of diagnostic rigor.  No mention of evidence based treatment plans.  The word "Care" appears multiple times, but the word "standards" is absent.   Did her doctor screw up, or was he in an area with a lax governing board who just was running blindly with the AAP policy.

Perhaps you might agree with me, in that the AAP's current policy is dumb, and screwing up on multiple levels.  Perhaps you might join me in cautious hope that the AAP's upcoming review will point out this tragic shortcoming, and it might be revised to something a bit more sane so we can prevent future Chloe Coles from ending up in such a situation.

I would hesitate to denigrate the AAP as "dumb doctors".   They are the largest and very well respected pediatric association.    

I don't know if you are aware but you are linking to a news release of the policy and not the policy itself.  The policy itself does have the word "standard' present.   Here is the policy.   If you read it, it expressly states that it is not intended to serve as a standard of medical care and defers to the World Professional Association for Transgender Health (which Chloe states was not followed), and also to the Endocrine Society for established standards of care.   It further acknowledges that "professional understanding of youth that identify as TGD is a rapidly evolving clinical field in which research on appropriate clinical management is limited by insufficient funding."  Lets limit their funding and then blame them for not having a solid standard of care based on well established evidence and best practices.  Sounds like something a politician might do, no?  

Despite the limited funding, and research, I think the policy they outline is pretty well-rounded and provides the best evidence available.  And yes, by the way, they also mention evidence based care (which you claim is non-existent) with links and references to supporting studies.

I also don't think you fully appreciate the scope of what "gender affirming care" means under their policy.  You seem to think it means a doctor should push/pressure the kid to have surgery and hormone treatments etc. to transition - either that or die of suicide, full stop, right?   All this without discussing other alternatives and without a larger collaborative team of medical and psychological experts guiding the care and discussing options.  That simply is not a fair representation of what the policy states and what happened with Chloe is clearly a deviation from what the policy states and recommends, despite your insistence that that is what the policy calls for.

Quote

Many medical interventions can be offered to youth who identify as TGD and their families. The decision of whether and when to initiate gender-affirmative treatment is personal and involves careful consideration of risks, benefits, and other factors unique to each patient and family. Many protocols suggest that clinical assessment of youth who identify as TGD is ideally conducted on an ongoing basis in the setting of a collaborative, multidisciplinary approach, which, in addition to the patient and family, may include the pediatric provider, a mental health provider (preferably with expertise in caring for youth who identify as TGD ), social and legal supports, and a pediatric endocrinologist or adolescent-medicine gender specialist, if available.6,28 There is no prescribed path, sequence, or end point. Providers can make every effort to be aware of the influence of their own biases. The medical options also vary depending on pubertal and developmental progression.

Most protocols for gender-affirming interventions incorporate World Professional Association of Transgender Health35 and Endocrine Society68 recommendations and include ≥1 of the following elements

Social Affirmation: This is a reversible intervention in which children and adolescents express partially or completely in their asserted gender identity by adapting hairstyle, clothing, pronouns, name, etc. Children who identify as transgender and socially affirm and are supported in their asserted gender show no increase in depression and only minimal (clinically insignificant) increases in anxiety compared with age-matched averages.48 Social affirmation can be complicated given the wide range of social interactions children have (eg, extended families, peers, school, community, etc). There is little guidance on the best approach (eg, all at once, gradual, creating new social networks, or affirming within existing networks, etc). Pediatric providers can best support families by anticipating and discussing such complexity proactively, either in their own practice or through enlisting a qualified mental health provider.

Legal Affirmation: Elements of a social affirmation, such as a name and gender marker, become official on legal documents, such as birth certificates, passports, identification cards, school documents, etc. The processes for making these changes depend on state laws and may require specific documentation from pediatric providers.

Medical Affirmation: This is the process of using cross-sex hormones to allow adolescents who have initiated puberty to develop secondary sex characteristics of the opposite biological sex. Some changes are partially reversible if hormones are stopped, but others become irreversible once they are fully developed (Table 2).

Surgical Affirmation: Surgical approaches may be used to feminize or masculinize features, such as hair distribution, chest, or genitalia, and may include removal of internal organs, such as ovaries or the uterus (affecting fertility). These changes are irreversible. Although current protocols typically reserve surgical interventions for adults,35,68 they are occasionally pursued during adolescence on a case-by-case basis, considering the necessity and benefit to the adolescent’s overall health and often including multidisciplinary input from medical, mental health, and surgical providers as well as from the adolescent and family.69,–71 

Did you note that 50% of the recommended interventions in the gender affirming care model are non-medical options?

The bold and underline above is mine.  I underlined the word "whether" to note that GACM may not always be recommended in every case depending on careful assessment of risks and benefits with the collaborative multidisciplinary team.  Your claim that they push GACM (which you insinuate always includes medical intervention) or die "full stop", simply is unfounded.  

Edited August 8, 2023 by pogi

[LoudmouthMormon]

Good post @pogi!  There's a lot I know about this issue, but there's also a lot I don't know.

2 hours ago, pogi said:

I would hesitate to denigrate the AAP as "dumb doctors".   They are the largest and very well respected pediatric association.    

This seems to be a broad consensus across opinions.  No matter what position you take, you recognize the AAP as a large respected group.  One might say powerful.  What they say carries weight.

 

2 hours ago, pogi said:

I don't know if you are aware but you are linking to a news release of the policy and not the policy itself.  The policy itself does have the word "standard' present.   Here is the policy.

Thank you for the link - I was not aware!   I will have to spend some time reading through and digesting the actual policy (which I assumed existed, but I also assumed it would be behind a paywall.)

I will spend some time with this document.  At first blush after a 5 minute scan:   "Standards of care" is mentioned once, in context of "we really need more research so we can look at 'em to see if they suck or not" (hyperbole mine, but I think I nailed the context perfectly.) The word "rigor" doesn't appear.  Or "mature".  "Hesitation" shows up once, in the context of how to get family members to overcome their hesitation to affirm.  "Affirm" shows up 50+ times, "support" around 25.    "Evidence" = 9, with lots of footnotes, so that's nice.

 

3 hours ago, pogi said:

I also don't think you fully appreciate the scope of what "gender affirming care" means under their policy.  You seem to think it means a doctor should push/pressure the kid to have surgery and hormone treatments etc. to transition - either that or die of suicide, full stop, right?

I have a better grasp than you acknowledge.  The heat I'm bringing isn't because I believe all doctors push/pressure this stuff, telling hesitant parents "you can either have a living son or a dead daughter".  The heat I'm bringing is because I keep hearing from a growing number of people (Chloe is currently the loudest and best known, but I literally hear from a new one or three every month), who relay that such was their experience.  Doctors prescribing hormone blockers after a single zoom call.  A whole bunch of "I wasn't trans, I was a confused autistic, and nobody even bothered to find that out first."   Much "I learned about this on reddit when I was 12, thought it fit, and every single time I talked about it, I got nothing back except 'you're probably trans'."    Yes, I've heard the claim "doc said living x or dead y" from at least 3 different unrelated people telling their own personal stories online.   And more than a little "I never mentioned being suicidal, never thought that way, until after the transition."

So, somewhere between your "this stuff pretty much never happens", and your strawman of "LM believes this always happens", I believe is where we find the truth.  

 

3 hours ago, pogi said:

Lets limit their funding and then blame them for not having a solid standard of care based on well established evidence and best practices.  Sounds like something a politician might do, no? 

Yep, not a fan of that.   

Now it's your turn:   Let's claim there's no problem, silence dissent because we've already got the best standards of care, and then cry foul and oppose and vote against someone who wants to sue for malpractice.  Sounds like something a politician might do, no?

 

 

[pogi]

2 hours ago, LoudmouthMormon said:

Good post @pogi!  There's a lot I know about this issue, but there's also a lot I don't know.

This seems to be a broad consensus across opinions.  No matter what position you take, you recognize the AAP as a large respected group.  One might say powerful.  What they say carries weight.

 

Thank you for the link - I was not aware!   I will have to spend some time reading through and digesting the actual policy (which I assumed existed, but I also assumed it would be behind a paywall.)

I will spend some time with this document.  At first blush after a 5 minute scan:   "Standards of care" is mentioned once, in context of "we really need more research so we can look at 'em to see if they suck or not" (hyperbole mine, but I think I nailed the context perfectly.) The word "rigor" doesn't appear.  Or "mature".  "Hesitation" shows up once, in the context of how to get family members to overcome their hesitation to affirm.  "Affirm" shows up 50+ times, "support" around 25.    "Evidence" = 9, with lots of footnotes, so that's nice.

 

I have a better grasp than you acknowledge.  The heat I'm bringing isn't because I believe all doctors push/pressure this stuff, telling hesitant parents "you can either have a living son or a dead daughter".  The heat I'm bringing is because I keep hearing from a growing number of people (Chloe is currently the loudest and best known, but I literally hear from a new one or three every month), who relay that such was their experience.  Doctors prescribing hormone blockers after a single zoom call.  A whole bunch of "I wasn't trans, I was a confused autistic, and nobody even bothered to find that out first."   Much "I learned about this on reddit when I was 12, thought it fit, and every single time I talked about it, I got nothing back except 'you're probably trans'."    Yes, I've heard the claim "doc said living x or dead y" from at least 3 different unrelated people telling their own personal stories online.   And more than a little "I never mentioned being suicidal, never thought that way, until after the transition."

So, somewhere between your "this stuff pretty much never happens", and your strawman of "LM believes this always happens", I believe is where we find the truth.  

 

Yep, not a fan of that.   

Now it's your turn:   Let's claim there's no problem, silence dissent because we've already got the best standards of care, and then cry foul and oppose and vote against someone who wants to sue for malpractice.  Sounds like something a politician might do, no?

For those who are interested in becoming socially engaged in fighting or defending any specific model of care in regards to transgender individuals, it might be worth the time and effort to understand the ins and outs and pros and cons of each model.  I would highly recommend reading this article which discusses the 3 models of care that have been developed and historically used in transgender interventions.   This is from 2017, so it is fairly old, but seems to cover some good basic info.  The AAP policy was developed after this paper and may be based on more current evidence.  The soon to be up-dated AAP policy will be based on even more current and thorough data with hopefully even better guidance.  Here is the paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448699/

The 3 models are: 

1) Living-in-your-own-skin model.  This is by far the most conservative with by far the most evidence suggesting that the risks outweigh the benefits with this model. 

2) The watchful waiting model.  This has been referenced previously by bluedreams and is the model that was developed in the Netherlands and has historically been used in Europe (although that is being challenged due to developing evidence suggesting that children "thrive" when allowed to live as the gender they identify).  This is the model that is probably used more in Europe, although that seems to be changing. 

3) The gender affirmative model.  This is the model currently supported by the AAP.

The consensus seems to agree that the first model is a no-go with overwhelming evidence of bad results.  The last 2 models have compelling evidence for and against each, in my opinion.   

One compelling argument for the watch and wait model is this:

Quote

In the most recent review of these studies, it was found that 63% of the children seeking services at a gender clinic at a young age, and diagnosed with gender dysphoria, no longer had that diagnosis at puberty, while 37% did have the diagnosis consistently from early childhood to adolescence

However, the AAP review states this in response:

Quote

This developmental approach to gender affirmation is in contrast to the outdated approach in which a child’s gender-diverse assertions are held as “possibly true” until an arbitrary age (often after pubertal onset) when they can be considered valid, an approach that authors of the literature have termed “watchful waiting.” This outdated approach does not serve the child because critical support is withheld. Watchful waiting is based on binary notions of gender in which gender diversity and fluidity is pathologized; in watchful waiting, it is also assumed that notions of gender identity become fixed at a certain age. The approach is also influenced by a group of early studies with validity concerns, methodologic flaws, and limited follow-up on children who identified as TGD and, by adolescence, did not seek further treatment (“desisters”).^45,47 More robust and current research suggests that, rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family.

What I like about the gender affirmative model is that it provides the support for where the child is at in the present state, and is flexible to adjust to a more fluid idea of gender in the future.  It does not require medical intervention at these younger ages, but allows the child the social support to live as they feel at the time.

The following may be enlightening to some who are opposed to any medical intervention before adulthood: 

Quote

All of the three models of care referenced earlier share in common the administration of hormonal treatment in adolescence. 

Even the most conservative care model recommend hormonal treatment in adolescence.   There is not a single plan that doesn't recommend it.  So, I'm not sure why this is so controversial when all evidence seems to support that approach for at least some. 

2 hours ago, LoudmouthMormon said:

So, somewhere between your "this stuff pretty much never happens", and your strawman of "LM believes this always happens", I believe is where we find the truth.  

While I didn't say what you quoted, I did say is that all evidence seems to suggest that this is an outlier with only 2 known law suits over this type of issue.  What I also said is that there is no known care model that recommends the type of intervention that Chloe received.  Her doctor was going rogue from all known recommendations of professional medical associations.   I have only seen a tiny handful of anecdotes reported among the thousand and thousands of actual interventions, so yes, I stick to my suggestion that this seems to be an outlier and relatively rare occurrence for doctors to deviate from and go completely against all recommended care models known to medicine.  I don't think the truth is in the middle.  It is firmly on my side.  

I also never said what you have quoted me saying about you, and calling it a strawman.  What I said is that you seem to imply or suggest that the care Chloe received was based on the care model that is currently recommended by the AAP.  I based that on the following quotes by you:  

On 8/7/2023 at 2:10 PM, LoudmouthMormon said:

I mentioned the current policy is totally devoid of any mention of diagnostic rigor, opined that I find that problematic to the point of lunacy, guessed there will be a revision that adds some.  And I offered a bet to anyone who disagrees. 

7 hours ago, LoudmouthMormon said:

So, if you go look at the opening post in this thread, you will see how the dumb doctors who set policy - the American Academy of Pediatrics - don't have a single thing to say about standards of care in their policy.  It's "provide gender affirming care", and full stop.  No mention of diagnostic rigor.  No mention of evidence based treatment plans.  The word "Care" appears multiple times, but the word "standards" is absent.   Did her doctor screw up, or was he in an area with a lax governing board who just was running blindly with the AAP policy.

Contrary to what you state above.  They did mention a standard of care, they acknowledge that they don't have their own that they recommend but did  refer to the WPATH as a model, along with one other by the Endocrine Society.  I doubt you have read the WPATH standards of care, but it does mention rigorous interventions to distinguish between children who merely display "cross-gender expressions" vs those who display cross-gender "identity".   Despite claiming no mention of evidence based treatment, it is replete with evidence based treatment.  Despite insinuating that Chloe, received "gender affirming care" that the AAP recommends, she in fact, did not.  The AAP recommends a diverse, comprehensive, and collaborative multidisciplinary team approach.  It does not recommend rogue doctors acting alone, without offering any alternative and non-medical interventions which are all part of and viable options in the gender affirming care model.   To answer your last question - yes, the doctor screwed up big-time and was not following any governing board or model of care known to medicine.  I hope that answers your question. 

My guess is that the new policy will be some kind of hybrid between the gender affirmative model and the watchful waiting model.  

Edited August 8, 2023 by pogi

[Calm]

8 hours ago, LoudmouthMormon said:

d it might be revised to something a bit more sane so we can prevent future Chloe Coles from ending up in such a situation.

My guess is there will always be malpractice since doctors are human, some are lazy or out to make money, others are too busy through no fault of their own except trying to help and are overwhelmed so make mistakes, some shouldn’t be doctors in the field they are in (I don’t think my daughter’s doctor should have been a pediatric psychiatrist, but chosen a field that was more science and less art and more clinical tests and less patient interviews, for example)

I would like to see percentage rates for this type of malpractice before concluding any change in standards would likely prevent most of these cases (are they really because of the standards or in spite of them; are they more aberration or common for the uncommon treatment?)

Edited August 8, 2023 by Calm

[Calm]

13 hours ago, LoudmouthMormon said:

Yes, I've heard the claim "doc said living x or dead y" from at least 3 different unrelated people telling their own personal stories online. 

Have these identities been confirmed?  Just checking.  I wouldn’t trust Reddit or a message board like ours and other sites it is easy to create sock puppets for.  Too many have agendas.

Edited August 9, 2023 by Calm

[The Nehor]

17 hours ago, LoudmouthMormon said:

I'm not a fan of politicians getting in front of outraged crowds and pushing reactionary legislation through in order to gain votes.   And both 'sides' of this issue has that happening in abundance.   It's happening in blue states where legislators are mandating teaching this or that, moving government funds to support this or that.  But yes, my side is doing it in red states as well, where legislators are banning this or that.  I am not a fan.

Oh good, a “both sides” defense. Le sigh.

17 hours ago, LoudmouthMormon said:

And it's not the "anti-transgender movement".  It's the "anti-radical-gender-theorists" movement.  So someone shows up with a video of a pride parade (or a drag show in a school) where people put on sexually explicit performances in front of 12 year olds.  That ought to generate outrage, and people ought to be shouting 'groomer'.   So people publish pictures of pages in certain books that show graphic cartoon depictions of oral sex and how to use sex toys or directions on how to sign up to hook-up sites, and parents share photos taken of their school libraries' book shelf where those books are found.  That should generate outrage and people ought to be shouting 'groomer'.     

No, it is the anti-transgender movement. I would like to know what school is putting on provocative drag shows. That seems unwise. Or do you consider all drag performances to be provocative?

They should not be shouting “groomer”. They should look up the term groomer and realize that their propagandists are lying to them. You can argue that pride shows go too far and that children shouldn’t be at some events. I would even agree with you. But it is not grooming. That is a loaded term. It is like “woke”. The definition is kept nebulous and general to link things with pedophilia that don’t involve pedophilia.

I am also not going to take their outrage seriously when some of those provoking this outrage are literally taking their young kids to Hooters for their birthday dinner. Pride events usually happen a few times a year in any given city but all the heterosexual provocative venues are ignored. That is because it is actually not about protecting kids from sex. It is about targeting the vulnerable and spewing hate and distrust about the lgbt community. It is amazing how specific the concern for sexual content is. You might want to shut all those down too but your allies don’t. When are you going to be outraged at those perverts?

17 hours ago, LoudmouthMormon said:

I won't be posting my dozens of links from states across the nation, because they would violate the site rules against profanity and vulgarity, and would put the whole thread at risk of being closed for becoming a sexually-themed thread.   For posting vids of something happening in public, or photos of what's in certain books carried by certain schools.  Maybe let that sink in a little.

Let your unshared personal list of vulgarity (why do you have this?) sink in? Ummmm……no. First I don’t trust the people you are getting your information from. Second I stand by the lgbt community not being behind most child grooming and exposing kids to sex too young. You might be outraged but your outrage is focused on certain targets. Why are your propagandists not taking a holistic approach to the whole problem?

Spoilers: It is because they don’t actually care about children. They just want a stick to beat their enemies with.

[LoudmouthMormon]

Half a year later, I searched around a little for an update to this story.  I found 2 relevant articles:

Major medical society re-examines clinical guidelines for gender-affirming care by Jen Christensen, CNN (bolding mine)

Quote

Every major US medical association – including the American Medical Association, the American Psychiatric Association and the American Academy of Child & Adolescent Psychiatry – agrees that gender-affirming care is clinically appropriate for children and adults.

When the American Academy of Pediatrics called for a systematic review of the evidence last fall, some people were initially concerned that association was backing away from the practice, but instead it affirmed its support.

 

2nd thing I found was a blistering 70 page report, highly critical of WPATH based on 169 pages of leaked internal messages, by Mia Hughes with the org Environmental Progress:

The WPATH Files: Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults

Quote

Press Release: JDA Worldwide for Environmental Progress

March 4, 2024

Newly leaked files from within the leading global transgender healthcare body have revealed that the clinicians who shape how “gender medicine” is regulated and practiced around the world consistently violate medical ethics and informed consent. The files, which were leaked from within the World Professional Association for Transgender Health (WPATH), were published today by the US-based think tank Environmental Progress.

WPATH is considered the leading global scientific and medical authority on “gender medicine,” and in recent decades, its Standards of Care have shaped the guidance, policies and practices of governments, medical associations, public health systems and private clinics across the world.

However, the WPATH Files reveal that the organization does not meet the standards of evidence-based medicine, and members frequently discuss improvising treatments as they go along. Members are fully aware that children and adolescents cannot comprehend the lifelong consequences of “gender-affirming care,” and in some cases, due to poor health literacy, neither can their parents. 

“The WPATH Files show that what is called ‘gender medicine’ is neither science nor medicine,” said Michael Shellenberger, President and founder of Environmental Progress. “The experiments are not randomized, double-blind, or controlled. It’s not medicine since the first rule is to do no harm. And that requires informed consent.”

The raw files have been published in a report called The WPATH Files: Pseudoscientific surgical and hormonal experiments on children, adolescents, and vulnerable adults, which contains analysis by journalist Mia Hughes that puts the WPATH Files in the context of the best available science on gender distress. 

Environmental Progress has made all files available to read at the end of the report. The leaked files include screenshots of posts from WPATH’s internal messaging forum dating from 2021 to 2024 and a video of an internal panel discussion. All names have been redacted other than several WPATH members of public significance, such as Dr. Marci Bowers, an American gynecologist and surgeon who is the President of WPATH, and the Canadian pediatric endocrinologist Dr. Daniel Metzger.

In the WPATH Files, members demonstrate a lack of consideration for long-term patient outcomes despite being aware of the debilitating and potentially fatal side effects of cross-sex hormones and other treatments. Messages in the files show that patients with severe mental health issues, such as schizophrenia and dissociative identity disorder, and other vulnerabilities such as homelessness, are being allowed to consent to hormonal and surgical interventions. Members dismiss concerns about these patients and characterize efforts to protect them as unnecessary “gatekeeping.”

The files provide clear evidence that doctors and therapists are aware they are offering minors life-changing treatments they cannot fully understand. WPATH members know that puberty blockers, hormones, and surgeries will cause infertility and other complications, including cancer and pelvic floor dysfunction. Yet they consider life-altering medical interventions for young patients, including vaginoplasty for a 14-year-old and hormones for a developmentally delayed 13-year-old. 

The WPATH Files also show how far medical experiments in gender medicine have gone, with discussions about surgeons performing “nullification” and other extreme body modification procedures to create body types that do not exist in nature.  

A growing number of medical and psychiatric professionals say the promotion of pseudoscientific surgical and hormonal experiments is a global medical scandal that compares to major incidents of medical malpractice in history, such as lobotomies and ovariotomies.

“Activist members of WPATH know that the so-called ‘gender-affirming care’ they provide can result in life-long complications and sterility and that their patients do not understand the implications, such as loss of sexual function and the ability to experience orgasm,” Shellenberger said. “These leaked files show overwhelming evidence that the professionals within WPATH know that they are not getting consent from children, adolescents, and vulnerable adults, or their caregivers.”

Environmental Progress has written to every WPATH member named in the files, as well as additional members whose names have been redacted, to confirm their comments and offer a right of reply. Two people responded – one confirmed that the comments attributed to them were correct, and another did not deny their comments but refuted Environmental Progress’ interpretation of them. Mention of Environmental Progress’ outreach to members via email was then later seen in the form of comments on WPATH’s internal messaging forum.

 

I'd be interested in @pogi's reaction to the report.  I didn't know anything about WPATH (and I still really don't, other than this totally negative report), but it seems like you had a measure of respect for them back last year in this thread:

On 8/8/2023 at 4:31 PM, pogi said:

They did mention a standard of care, they acknowledge that they don't have their own that they recommend but did  refer to the WPATH as a model, along with one other by the Endocrine Society.  I doubt you have read the WPATH standards of care, but it does mention rigorous interventions to distinguish between children who merely display "cross-gender expressions" vs those who display cross-gender "identity".   Despite claiming no mention of evidence based treatment, it is replete with evidence based treatment.

 

Sheesh.  Everyone wants what's best for the children.  But holy crap are there some strong narratives for and against gender-affirming care for minors.  As a layman with no particular dog in the fight (other than wanting a culture that does right by children), it's hard to sort through it all.

 

[california boy]

4 hours ago, LoudmouthMormon said:

Half a year later, I searched around a little for an update to this story.  I found 2 relevant articles:

Major medical society re-examines clinical guidelines for gender-affirming care by Jen Christensen, CNN (bolding mine)

 

2nd thing I found was a blistering 70 page report, highly critical of WPATH based on 169 pages of leaked internal messages, by Mia Hughes with the org Environmental Progress:

The WPATH Files: Pseudoscientific Surgical and Homonal Experiments on Children, Adolescents, and Vulnerable Adults

 

I'd be interested in @pogi's reaction to the report.  I didn't know anything about WPATH (and I still really don't, other than this totally negative report), but it seems like you had a measure of respect for them back last year in this thread:

 

Sheesh.  Everyone wants what's best for the children.  But holy crap are there some strong narratives for and against gender-affirming care for minors.  As a layman with no particular dog in the fight (other than wanting a culture that does right by children), it's hard to sort through it all.

 

Just so I understand where you are coming from.  Do you think that there are SOME cases where gender-affirming care IS in the best interest of the child?  And if that care is in the best interest of the child, who do you think is best adults to make that judgement other than the parents and their doctors?

 

[LoudmouthMormon]

17 minutes ago, california boy said:

Just so I understand where you are coming from.  Do you think that there are SOME cases where gender-affirming care IS in the best interest of the child?  And if that care is in the best interest of the child, who do you think is best adults to make that judgement other than the parents and their doctors?

I put where I was coming from at the end of my post.

4 hours ago, LoudmouthMormon said:

Sheesh.  Everyone wants what's best for the children.  But holy crap are there some strong narratives for and against gender-affirming care for minors.  As a layman with no particular dog in the fight (other than wanting a culture that does right by children), it's hard to sort through it all.

Basically, Pogi had opined previously about WPATH, so I'm hoping to hear if he has any opinion on the report.   Happy to hear what anyone has to say about it.

[The Nehor]

The WPath leak wasn’t really a leak. They had a members only forum that anyone willing to pay the cost ($225 with discounts depending on where you live) could get on. While most of those who joined were medical personnel others were not.

This is akin to someone pulling a bulk download of these forums and arguing that it is damning to the church or to the anti-Mormon movement or whatever. These aren’t leaked internal memos. It is randos talking about transgender issues ‘off the cuff’ on the internet. This isn’t a brilliant expose. It is just people (mostly unnamed) talking on the internet about transgender issues.

So why are people trying to spin it as a mass conspiracy to hide the truth? On a forum anyone could get access to by paying a relatively small fee. The anti-transgender movement doesn’t respect their audience’s intelligence enough to bother trying to make their accusations credible if you look at the data. They have learned that they don’t have to.

Here is one take on it:

https://www.assignedmedia.org/breaking-news/wpath-nothingburger-waste-of-time

Edited March 8, 2024 by The Nehor