For some time it has seemed obvious that so-called “gender-affirming care” falls far short of established medical standards but, still, newly-leaked files by the World Professional Association for Transgender Health (WPATH) vividly reinforce the point.
From the mouths of doctors we find risky experimental surgeries recommended for minors, and a relative disregard for complications that in any other branch of medicine would be treated as unacceptable.
Perhaps the most shocking revelation from the leaked files is a clinician prepared to recommend a radical double mastectomy for a 16-year-old girl already suffering from liver cancer, despite believing – along with the girl’s surgeon and oncologist – that the cancer is probably due to the cross-sex hormones she had been prescribed.
Highly debilitating side effects of surgeries and hormone treatments in young patients – including pelvic inflammatory disease, vaginal atrophy, incontinence, excruciating pain, and an increased rate of abnormal smear tests – appear to raise only vague disquiet at most.
It also seems to be recognised by many WPATH members that teenagers who go straight from puberty blockers on to cross-sex hormones may be made permanently infertile; but again, the response to this information appears to be relatively apathetic.
On one conference panel, a participant acknowledges that children cannot understand what they might be losing; but the point is greeted by the audience with smiles and nods rather than with the incredulous degree of alarm it deserves.
To the average outsider stumbling across this information for the first time, an outraged response comes easily – which raises the interesting question of why ethical sensibilities within WPATH seem to be so coarsened. Partly, no doubt, this is a result of a general fact famously observed by writer Upton Sinclair; namely “it is difficult to get a man to understand something, when his salary depends on his not understanding it”. But partly it’s also a function of the guiding myth of the modern transactivist movement: the supposed moral imperative of gender affirmation.
In day-to-day life, this demand that gender be affirmed manifests itself as an expectation that a person’s preferred pronouns should be used, and that they get access to spaces, resources, and sports teams that best fit with their inner sense of who they are. But in the context of medicine, affirmation requires something even more serious: access to irrevocable drugs and surgeries in order to try to make a person’s outer body fit with their inner feelings and ideas.
The justification offered in all such cases is that the practice saves lives – quite literally – because without it, a trans-identified patient is likely to suffer horribly, or even take their own life. Viewed in this light, any side effects of medical treatment, no matter how severe, will seem tolerable and less serious in comparison.
Unfortunately, though, the premise is fatally flawed. There is no convincing evidence that refusing to affirm a trans-identified young person makes suicide inevitable or even strongly likely; and in fact, for some, affirmation demonstrably makes mental health outcomes worse.
Were this point to be properly faced, the house of cards would fall. But thanks to decades of distortions from transactivist organisations and figureheads, the message is still not getting through.
The scandal of an international organisation like WPATH may seem irrelevant to the UK, but it is not. For years, the organisation has been mindlessly cited in British medical contexts as a source of “international best practice”.
Though the NHS has officially distanced itself, the beleaguered Tavistock GIDS service remains underpinned by a service specification that says treatment is “in line with WPATH”. Several senior clinicians in NHS gender dysphoria clinics for over-17s are also listed as current WPATH members.
In short, there is much for NHS bosses to review here as a matter of urgency. For when it comes to responsibility for the healthcare of vulnerable young people, WPATH now looks seriously compromised.
For some time it has seemed obvious that so-called “gender-affirming care” falls far short of established medical standards but, still, newly-leaked files by the World Professional Association for Transgender Health (WPATH) vividly reinforce the point.
From the mouths of doctors we find risky experimental surgeries recommended for minors, and a relative disregard for complications that in any other branch of medicine would be treated as unacceptable.
Perhaps the most shocking revelation from the leaked files is a clinician prepared to recommend a radical double mastectomy for a 16-year-old girl already suffering from liver cancer, despite believing – along with the girl’s surgeon and oncologist – that the cancer is probably due to the cross-sex hormones she had been prescribed.
Highly debilitating side effects of surgeries and hormone treatments in young patients – including pelvic inflammatory disease, vaginal atrophy, incontinence, excruciating pain, and an increased rate of abnormal smear tests – appear to raise only vague disquiet at most.
It also seems to be recognised by many WPATH members that teenagers who go straight from puberty blockers on to cross-sex hormones may be made permanently infertile; but again, the response to this information appears to be relatively apathetic.
On one conference panel, a participant acknowledges that children cannot understand what they might be losing; but the point is greeted by the audience with smiles and nods rather than with the incredulous degree of alarm it deserves.
To the average outsider stumbling across this information for the first time, an outraged response comes easily – which raises the interesting question of why ethical sensibilities within WPATH seem to be so coarsened. Partly, no doubt, this is a result of a general fact famously observed by writer Upton Sinclair; namely “it is difficult to get a man to understand something, when his salary depends on his not understanding it”. But partly it’s also a function of the guiding myth of the modern transactivist movement: the supposed moral imperative of gender affirmation.
In day-to-day life, this demand that gender be affirmed manifests itself as an expectation that a person’s preferred pronouns should be used, and that they get access to spaces, resources, and sports teams that best fit with their inner sense of who they are. But in the context of medicine, affirmation requires something even more serious: access to irrevocable drugs and surgeries in order to try to make a person’s outer body fit with their inner feelings and ideas.
The justification offered in all such cases is that the practice saves lives – quite literally – because without it, a trans-identified patient is likely to suffer horribly, or even take their own life. Viewed in this light, any side effects of medical treatment, no matter how severe, will seem tolerable and less serious in comparison.
Unfortunately, though, the premise is fatally flawed. There is no convincing evidence that refusing to affirm a trans-identified young person makes suicide inevitable or even strongly likely; and in fact, for some, affirmation demonstrably makes mental health outcomes worse.
Were this point to be properly faced, the house of cards would fall. But thanks to decades of distortions from transactivist organisations and figureheads, the message is still not getting through.
The scandal of an international organisation like WPATH may seem irrelevant to the UK, but it is not. For years, the organisation has been mindlessly cited in British medical contexts as a source of “international best practice”.
Though the NHS has officially distanced itself, the beleaguered Tavistock GIDS service remains underpinned by a service specification that says treatment is “in line with WPATH”. Several senior clinicians in NHS gender dysphoria clinics for over-17s are also listed as current WPATH members.
In short, there is much for NHS bosses to review here as a matter of urgency. For when it comes to responsibility for the healthcare of vulnerable young people, WPATH now looks seriously compromised.