Picture Credit: Michael Siluk/UCG/Universal Images Group via Getty Images
Artillery Row

Down the primrose WPATH

Responsible medical authorities must reject the dangerous nonsense of gender-affirming care

Many critics of gender medicine, myself among them, have long been aware that treatments are being given to children and adolescents for which there is no evidence of benefit, and growing evidence of serious harm, both physical and psychological. These include social transition in early youth, puberty blocking in early puberty and cross-sex hormones from age 16.

Thus we have regarded these treatments in children and young people as experimental, with none of the caution and safeguards required for responsible, evidence-based medicine — for all ages, but most especially when it comes to minors. We think it is not possible that these young people are able to give meaningful consent. This is in part because of their youth, which means they are unable to grasp the true scale of the long-term consequences, which may include sterility. Some are in acutely disturbed states of mind and therefore unable to understand the implications of embarking on a medical pathway with major, permanent consequences. And finally, informed consent requires research data on outcomes, which does not exist.

We have campaigned for years to bring this matter to public attention. But from the beginning we have faced opposition from within the NHS, universities and other public bodies that have been captured by gender identity ideology and abandoned a balanced scientific approach. We have seen articles pulled, speakers dropped and even entire conferences cancelled simply because they are sceptical about overblown, unevidenced claims. Over the past few years this has started to change, and we are increasingly getting a hearing at conferences and in the media. However it has remained an uphill struggle. Only a few weeks ago, the Royal College of General Practitioners considered cancelling a meeting of international experts wishing to address the harm being done to gender-distressed young people (it backed down after robust challenge).

Central to the penetration of ideology into various institutions, including medical ones, has been the World Professional Association of Transgender Health, or WPATH. This body has been treated, both by professional associations of medics and clinicians and by the media, as if it consisted of experts with the knowledge and training to be able to opine with authority.

But this is simply not the case. Membership of WPATH is not restricted to clinicians: anyone at all can join on payment of a modest fee. Its so-called “standards of care” are in fact no such thing. The various chapters of the current version were produced by subgroups containing many people with no medical or therapeutic qualifications, and without reference to standard medical requirements to weigh evidence properly or consider such matters as patients’ capacity to consent and harmful side-effects of treatment.

WPATH promotes “non-binary” identities — neither male nor female — and experimental surgeries that give people the appearance of having both male and female genitals, or neither. There is no evidence base suggesting that such surgeries are medically necessary or advisable, or even that they make people feel any better. It also claims that boys can be born with a “eunuch” gender identity, and that suitable treatment for such boys might be castration. This shocking statement is similarly unevidenced.

In part simply because of the audacious name of the organisation, which makes it sound authoritative, WPATH has had a remarkable and wholly unwarranted degree of influence. Many medical organisations, both in the UK and elsewhere, proudly state they follow WPATH guidelines and standards of care, as if they were following the guidelines of an appropriately constituted authority (such as NICE).

I and many others have known that this ongoing experiment on gender-distressed children and young people has caused, and is continuing to cause, very considerable damage.

One of the most disturbing aspects of the newly released files is that they suggest some members of WPATH know full well that gender-affirming care is experimental — that they know it sometimes causes very serious harm, and that some patients who received irreversible medical treatments were incapable of giving meaningful consent, whether because of their immaturity, learning difficulties or serious mental illness. I cannot find any sign of this awareness in WPATH’s public pronouncements, nor in those of the most prominent cheerleaders for the gender-affirming care that WPATH so enthusiastically promotes.

I would therefore argue that WPATH shares responsibility for any resulting negligence or malpractice. I do not know how any responsible medical authority can do anything after the release of these files but break off all ties with WPATH, and indeed condemn its continued existence.

Enjoying The Critic online? It's even better in print

Try five issues of Britain’s newest magazine for £10

Critic magazine cover