WPATH scandal: 'therapies' for children with dysphoria are improvised and prescribed without real consent

The World Professional Transgender Health is considered the leading global scientific and medical authority on 'gender medicine': over the past decades its standards of care have shaped the guidelines, policies and practices of governments, medical associations, public health systems and private clinics worldwide, including the WHO. But leaked documents reveal the neglect of children -including children with severe mental disorders- subjected to improvised treatments, without taking into account the long-term consequences and without being sure they were clear about what they were doing
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The news manages to shock even those who have long struggled with affirmative therapy -puberty blockers, hormones and surgery- for gender non-conforming minors, such as the psychoanalyst David Bell who exposed the scandal at the Tavistock Clinic in London: "For me, too, the contents of these files are shocking and disturbing' he stated. "The files suggest that some WPATH members are aware that gender-affirming treatments sometimes cause very serious harm and that some patients who received irreversible medical treatment were unable to give meaningful consent'.

The files mentioned by Bell are a video and a selection of messages taken from an internal chat between members of the World Professional Association For Transgender Health (WPATH). WPATH is considered the leading global scientific and medical authority on 'gender medicine' and in recent decades its standards of care have shaped the guidelines, policies and practices of governments, medical associations, public health systems and private clinics worldwide, WHO including.

This may indeed be one of the biggest scandals in the history of medicine.

The WPATH files reveal that the organisation does not meet the standards of evidence-based medicine. In the chat the members -surgeons, therapists and activists- admit that they often improvise treatments as they proceed and are fully aware that children and adolescents cannot understand the lifelong consequences of affirmative therapy -such as infertility and impaired sexual function-. Dan Metzger, a Canadian endocrinologist, said: 'In theory it's good to talk to a 14-year-old about preserving his fertility, but I know it's like talking to the wall.... Most kids don't have any brain space to really talk about it in a serious way'. So many say, 'Um, babies, babies, that's gross'. Or the usual response is: 'I'll just adopt'.

In some cases, due to low health literacy ('people who did not even study biology in school') not even their parents can offer reasoned consent. "I have problems," says one therapist, "with the fact that some parents cannot even express what they would like to know about a medical intervention for which they have already signed consent.

There is a discussion about blocking puberty for a 10-year-old girl and a 13-year-old boy with mental retardation. Another exchange describes in detail the execution of genital surgery on persons suffering from schizophrenia and dissociative identity disorder (formerly known as multiple personality disorder).

Scandalo WPATH: le "terapie" per i minori con disforia sono improvvisate e prescritte senza reale consenso

A member asks for advice on a 14-year-old patient who identifies himself as a girl and requests the removal of penis and testicles by repositioning the tissue to create a pseudo-vagina. But this surgery requires lifelong dilatation practices: is he too young for that? Marci Bowers, president of WPATH and a pelvic and gynaecological surgeon in California, herself transgender, said she considered any age limit 'arbitrary', however, would not have done it: 'The tissue is too immature, the dilation routine too complicated'. Put simply, boys who are too young do not have enough genital tissue for the operation and the surgeon has to take a segment of intestine to construct the false vagina. Even Bowers admits that this can lead to 'problematic surgical outcomes'. Bowers who has performed more than 2,000 vaginoplasties, the best known patient being Jazz Jennings, a very young trans woman operated on live during the reality show "I'm Jazz'. In Jazz's case, three corrective surgeries were necessary to solve the problems of the original vaginoplasty. Bowers, however, advises against waiting until the age of 18 for this type of surgery, should be practised 'some time before the end of high school as they are under parental supervision in the house where they grew up'.

In other files, we talk frankly about the complications of transitional surgery for girls, a phalloplasty in which a non-functional pseudo-penis is modelled with tissue from the forearm or thigh. A complete hysterectomy and surgical removal of the vagina is performed. Other serious consequences are also discussed, including pelvic inflammatory disease, vaginal atrophy, incontinence. Several members speak of patients with similar conditions, some with debilitating intestinal problems or bleeding and excruciating pain during sex ('feeling of broken glass').

Then there is the case of very young patients who feel neither male nor female and identify themselves as non-binary. Several dozen so-called de-gendering' surgeries were planned to create a smooth, asexual cosmetic appearance, unknown in nature. There is even a experimental 'bi-genital' surgery that attempts to construct a second set of genitalia. WPATH enshrined this concept in its Standards of Care, the same document first endorsed the chemical or surgical castration for patients who identify themselves as eunuchs. These sci-fi surgeries are not just for adults.

"How can we develop appropriate standards for non-binary patients?" wondered Thomas Satterwhite, a San Francisco-based plastic surgeon who has operated on dozens of patients under the age of 18 since 2014. "I have found that recently more and more patients are requesting non-standard' procedures." Non-standard procedures include the "Non-binary superior surgery', a mastectomy that also eliminates the nipples. The goal, as a San Francisco surgical clinic states on its website 'is a smooth and neutral body, aesthetically devoid of sexual identification'. On TikTok the trend is called 'flat front'.

A therapist said that once sought the consensus of all the different personalities of a patient who had an identity disorder before prescribing hormone therapy. It is even admitted that some very young patients have developed tumours as a result of hormone therapies: one 16-year-old girl, for example, was found to have a liver tumour following the administration of hormones.

I raw files were published in a report entitled The WPATH Files: Pseudoscientific surgical and hormonal experiments on children, adolescents and vulnerable adults. "The members of WPATH know very well that the so-called 'gender affirming cures' they provide can cause lifelong complications and sterility and that their patients do not understand the implications, such as the loss of sexual function and the ability to experience orgasm' he said Michael Shellenberger, president and founder of Environmental Progress, the research institute that made the internal chat public. "These leaked files offer overwhelming evidence that WPATH member professionals know that they cannot obtain real consent from children, adolescents and vulnerable adults or their caregivers". Shellenberger is Time Magazine's 'environmental hero', winner of the Green Book Award, the Dao Journalism Prize and holder of the C.B.R. Chair in Politics, Censorship and Freedom of Speech at the University of Austin.

In WPATH files, the lack of consideration for the long-term consequences in the lives of patients despite the awareness of the debilitating and potentially fatal side effects of cross-sex sex hormones from other treatments.

The dossier, together with the definitive denial of suicide risk in these patients if not medicalisedconstitutes a irreversible turning point on the treatment of children with gender non-conforming behaviour.


On WPATH files foreign press articles here, here e here.

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