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Leaked WPATH files show gender clinician abuses

Adolescents and mentally ill people are among the patients discussed within the files. Credit: Getty

March 5, 2024 - 7:00am

Over the last few years, prominent doctors, medical experts and media figures have claimed that the best way to help adolescents in distress about their gender is to give them puberty blockers, hormones, and surgeries to align their physical sex with their gender identity. The alternative to doing this, they have said, is suicide. And yet a new study published last month found no scientific evidence to support the claim that drugs and surgeries prevent suicide among people with gender dysphoria.

While we should be concerned about children and adolescents experiencing distress over their biological sex, there is new evidence to warrant far greater caution in how we treat them. Last year, whistleblowers presented me with a video and selection of messages from an internal chat system sent between members of the World Professional Association For Transgender Health (WPATH).

A message from the WPATH files

The WPATH files show surgeons, therapists, and activists discussing internally how to treat people with gender distress. They reveal that what is happening is neither good science nor good medicine. There is a discussion, for example, of blocking the puberty of a 10-year-old girl and a 13-year-old developmentally delayed child. Another exchange details carrying out genital surgery on people with schizophrenia and dissociative identity disorder, formerly known as multiple personality disorder.

At the core of medical ethics is the principle “do no harm”. Doctors and medical professionals obtain what is known as “informed consent” from the people receiving the medicine or their caregivers.

Yet these files outline overwhelming evidence that some gender clinicians associated with WPATH know that they are not receiving consent from children, adolescents, and vulnerable adults or their caregivers. They are fully aware that the so-called “gender-affirming care” they provide can result in lifelong complications and that their patients do not understand the implications, including sterility and the loss of sexual function.

A message in which a WPATH doctor acknowledges the preponderance of mental illness among patients.

The documents also reveal that, despite decades of surgeries and drugs, there is nothing scientific at all about so-called gender medicine. WPATH has produced eight versions of its “Standards of Care”, but they are based on ideology rather than science. As a result, the surgeons, doctors, and therapists practising “gender medicine” are essentially making it up as they go along, conducting uncontrolled experiments and doing barely anything to follow up on whether they work.

After I received these files, my colleagues and I tried to report on them as journalists would. We quickly became overwhelmed by the size and complexity of the project, and decided to produce a full report about the files for Environmental Progress, our nonprofit research institute, to provide context of the best available science about gender distress. That report, written by journalist Mia Hughes, is now available to read, its entirely justified subtitle referring to “Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults.”

Like most people, I have no problem with adults changing their bodies. But we should all be concerned with uncontrolled medical experiments being conducted on people who, due to their age or mental ability, are unable to consent. The files aren’t easy to read, but we urge you to do so.


Michael Shellenberger is the founder and president of Environmental Progress, as well as the author of the best-selling book Apocalypse Never (HarperCollins 2020) and San Fransicko (HarperCollins 2021).

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Hale Virginia
Hale Virginia
2 months ago

This issue has had me reassessing my orientation to religion and god more than anything else has, because I truly do not see how this is anything but the work of evil forces and people. Thank you so much for your work Mr. Shellenberger and all at Environmental Progress

Adrian Smith
Adrian Smith
2 months ago
Reply to  Hale Virginia

There are many aspects of gender ideology which can accurately be described as a god less religion. There are plenty of atheists that call it out for being that.
I do however think it is just another example of where humanity has lost its way since we lost sight of what human values really are and got tangled up in human rights – one of the key arguments for allowing these mutilations to continue is that there is a right for people to be able to do it.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

It is a lie it is any ideology. You child-abusing liars have the only ideology involved.
It boils down to your faith at least one of two idiocies is real, that there is no such thing as the gender of person as being any physical aspect of their biology, and it instead of gender there is only arbitrary preference and taught behaviors. The evidence refuting that faith of yours has been overwhelmeing for years, decades even.
Or your belief the gender between the ears of a person is produced by the sex of the person, or by the same mechanism, such that they are always congruent to each other. The medical fact is they are produced by differing mechanisms at differing times along the duration of a pregnancy only indirectly linked to the XX and XY chromosomal patterns.
In fact they go awry from each other regularly enough 1 in 150 people perceive it to be so in themselves. Many people who so perceive themselves do so as children, and frequently contemporaneously to when most people develop a sense of the gender of people, usually but no not always between the ages of 3 to 5.
Trying to force someone to undergo the puberty of their birth sex when they meet the criteria for medically assisted transition is an atrocity you wish to inflict them for the sake of your ideology. It is your child sacrifice, done to flatter your moral vanity.
None of you have or will engage on the level with the facts I mention here, all you have done is ignore or baselessly dismiss the facts which refute your faith.:
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men
Or in my no doubt soon to be deleted for the second time reply directly to the child abusing liar Shellenberger, what other facts I mention or bring to your attention there.
And all you social conservatives are child-abusing liars in this, no more, no less.
You really drop the mask with this line.

we lost sight of what human values really are and got tangled up in human rights

There are no human values of worth apart from respect for human rights. Anything you call “human values” which is not respectful of human rights is the abuse and not infrequently a crime done against a person.
And there are crimes and abuse you seek to commit against those you think are worthy of your abuse, including some children. Their existence offends your moral vanity.

Kate Madrid
Kate Madrid
2 months ago
Reply to  Talia Perkins

Thank you for taking the time to post this reply. You clearly saw this wasn’t a space that shared your beliefs about this issue. I certainly don’t (share your beliefs). So much so that I have struggled to imagine how people could justify the the patholigization of healthy bodies to the point of mutilating them surgically. So you have shown me one of the mechanisms whereby a person can convince themselves of that.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Kate Madrid

It’s no matter of “convincing”, only a natural occurrence of biology occurring in some people. Try taking testosterone and try gender dysphoria on for yourself — you won’t like it at all.
Then consider that social conservatives want to inflict that on people including children permanently.
You’d know better then what is and is not “mutilation”.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

Dysphoria by definition is a psychological disorder ( hence the prefix ‘dys’). It is the opposite of Euphoria – which is what we are told transitioners experience once their transition has been fulfilled. The issue is that neither state is a picture of healthy balance, and both states are transitory. The best, least damaging remedy for dysphoria is counselling and therapy not hormones and surgery.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

No, it is not necessarily a psychological disorder. In the case of gender dysphoria, it is the expected distress of a variance in physical sexual dimorphism.
“It is the … has been fulfilled.” <– No, in the technical term of art as defined inthe DSM5, euphoria for expression of gendered behaviors and the perception of being seen as members of a gender not that of your sex as assigned at birth is gender dysphoria for that assigned gender.
“The issue is that neither state is a picture of healthy balance, and both states are transitory.” <– It is as healthy a balance for a transgender person to be happy with transitioned as it is for a cisgender person to not be.
“The best, least damaging remedy for dysphoria is counselling and therapy not hormones and surgery.” <– No, because no therapy, no talking cure, has ever done any good at all.
Put simply, your way was tried for 50 plus years and it never worked. For 20 years now gender affirming care which does work well is the standard because it works well.

Christopher Michael Barrett
Christopher Michael Barrett
2 months ago
Reply to  Talia Perkins

How do you account for detransitioners then?

Talia Perkins
Talia Perkins
2 months ago

At the rate of ~<1% of people who transition medically. Did I not make that clear?

Adrian Smith
Adrian Smith
2 months ago
Reply to  Kate Madrid

Talia does do a great job of demonstrating the unhinged cult like aspects of this horrible ideology, which does more to increase “transphobia” through the insane way they trample over any belief that does not accord with their own. If you have any dealings with trans people, try to remember they are no all like Talia.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“Talia does do a great job of demonstrating the unhinged cult like aspects of this horrible ideology, which does more to increase “transphobia” through the insane way they trample over any belief that does not accord with their own. If you have any dealings with trans people, try to remember they are no all like Talia.” <– Except the overwhelming majority are exactly like me — they have the facts as well as I do.
You have no relevant facts.
Not all belief is had on an equally legitimately basis, you have none for what you claim. You do not argue honestly.
Your opinions are deserving of no respect.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

What you are calling ‘gender’ is simply personal characteristics and personality.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

Nonsense, since it is seen in every human population throughout history, and the few times it is well documented anyone tried to change someone’s gender, they failed.

Sula McClain
Sula McClain
2 months ago
Reply to  Talia Perkins

What you describe is a belief system that relies on acceptance of others to affirm that belief as there is no way to objectively measure the ‘born in the wrong body’ assertion other than through language itself. A child born in total isolation from society could never become trans, it is purely a reaction to a variety of stimuli or traumas in socially constructed human society. Teaching children to hate their bodies and that surgery is the solution should be a criminal offence. Even many trans activists no longer subscribe to the born in the wrong body mantra as they know it is magical thinking at best and dangerous lies at worst. The cry of ‘trans rights are human rights’ is particularly pointless and misleading: all human rights are important and whatever someone’s particular disposition is shouldn’t affect that. I fail to see what rights a trans adult doesn’t have that any other pressure group has. I support all human rights whether trans or flat earthers but I don’t have to subscribe to their beliefs to do so and nor do their beliefs affect their human rights.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Sula McClain

Except quite commonly there are objectively measured indicators that someone is or is more likely than others to be transgender. About links number 2 through 8 (10?0) here are about that.
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men
“A child born in total isolation from society could never become trans” <– Nonsense. With respect to physical dysphoria, they would not then have any linguistic tools to express it, that does not mean they would exist at ease.
“Teaching children to hate their bodies” <– Has nothing to do with it and is no part of the standards of care involved. You made it up that it does, or far too credulously bought someone else’s lie.
“that surgery is the solution should be a criminal offence” <– No, medical care which works well for a medical problem should not be criminal.
“Even many trans activists no longer subscribe to the born in the wrong body mantra as they know it is magical thinking at best and dangerous lies at worst.” <– Nonsense. Social media is not medicine or science.
“The cry of … shouldn’t affect that” <– And yet you are here to imply transgender people do not really exist, hence have no rights as they are actually mentally ill cisgender people.
“I fail to see what rights a trans adult doesn’t have that any other pressure group has.” <– Transgender people are not a pressure group other in response to the presuure of the likes of you.
“I support all human rights whether trans or flat earthers but I don’t have to subscribe to their beliefs to do so and nor do their beliefs affect their human rights.” <– You are the flat earther here, by analogy, and no belief exists on the part of transgender people other than that we do exist and are not a mental illness of an actually cisgender person.
You have no evidence to the contrary — you only have a factually baseless belief.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

‘Transgender’ is a construct; a means to describe someone who for whatever reason doesn’t feel comfortable in their own sexed body, and who feels a desire; even an overwhelming desire, to present as the opposite sex.
The word ‘ transgender’ is used nowadays rather than transsexual – because it is well established that one cannot really change sex, all one can do is change the social presentation in line with cultural expectations and stereotypes. Gender is a social and imaginal construct – not an inherent property.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

No, transgender is a word for a physical atypical result in individual sexual dimorphism.
Plainly you nothing real about it — you buy a Leftist, soft science view of it hook line and sinker.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

Most male transitioners are now autogynephiles; those who a decade ago would have been referred to as cross dressers or transvestites; people like Eddie Izzard – who have been dressing up, usually illicitly, in their sister’s or mother’s clothing since childhood. See also, Grayson Perry- who writes about the emotional and sexual motivations behenid this compulsion. Nothing to do with “atypical sexual dimorphism”. ‘Being female’ is reduced to artefacts of femininity such as long hair, make-up, high heels and other socially and/or culturally determined expressions. Often with a focus on coquettish expressions and superficial flirtatious gestures.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

Autogynephilia does not exist, other than as baseless a theory as is the Phlogiston theory of fire.
You can not make the evidence of a purely physical origin to people being transgender evidence go away by ignoring it, neither can Perry. You can’t even address it.
Everything you claim is evidence for your opinions is refuted by the fact of the counterexamples — some MtF transgender women are quite butch, and you can not add enough epicycles to the horses–t your own inadequacies require you to parrot to change the fact they are epicycles.

Talia Perkins
Talia Perkins
2 months ago

“And yet a new study published last month found no scientific evidence to support the claim that drugs and surgeries prevent suicide among people with gender dysphoria.” <– BS, even that study as rigged as it was found gender affirming care cut suicide attempts by a factor of 3. And it was rigged.
https://www.erininthemorning.com/p/fact-checked-new-problematic-finnish
Not only was it rigged, it was rigged by someone UnHerd has lied to claim was a pioneer of gender affirming care, when that fraud Kaltiala has really been a life long ideologically motivated opponent of it.
https://www.erininthemorning.com/p/abusive-practices-and-conversion
” The alternative to doing this, they have said, is suicide. ” <– And until recently, the complaint by social conservatives was the suicide rate was suicide rate was very high — and now you apparently claim otherwise.
“They reveal that what is happening is neither good science nor good medicine. ” <– Prove it. Nothing you cite is evidence of that, only that you are stupid or dishonest to claim a person can only have one problem at a time — and I note you quote nothing of it. It like you feel the need to obscure your lies and half truths.
“At the core of medical ethics is the principle “do no harm”” <– And instead you want avoidable harm done.
“They are fully aware that the so-called “gender-affirming care” they provide can result in lifelong complications and that their patients do not understand the implications, including sterility and the loss of sexual function.” <– Prove it, don’t claim it. Nothing you quote supports your claims.
“After I received these files, my colleagues and I tried to report on them as journalists would.” <– Of course you did not, you are an ideologically motivated bigot.
“That report, written by journalist Mia Hughes, is now available to read, its entirely justified subtitle referring to “Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults.”” <– A deceitful hack job like what I am replying, no doubt.
“Like most people, I have no problem with adults changing their bodies. ” <– Uhuh, sure, you only want to force some girls to have beards and deep voices and you want to force some boys to have breasts and periods.
Where is your evidence you want anything else? I know you have none, I just want to see what lies you make up next.
This is what is real and representative which you could report, if you were not a dedicated bigot.
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men

Mike Downing
Mike Downing
2 months ago
Reply to  Talia Perkins

A ‘lady’ called Talia Perkin
Said ‘I’m trans so I’ll put lotsa work in
And spew online hate
In every debate
But I’m definitely keeping my gherkin’.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Mike Downing

What hate? Only loathing for your willful expressed desire to abuse people grotesquely — and you have no factual answer for it.
“But I’m definitely keeping my gherkin’.” <– So what? Who said you should not?

Mike Downing
Mike Downing
2 months ago
Reply to  Talia Perkins

I’ve been censored.

Mike Downing
Mike Downing
2 months ago
Reply to  Talia Perkins

21 down votes and no other comments…

Where is your mettle, fellow subscribers ?

Adrian Smith
Adrian Smith
2 months ago
Reply to  Mike Downing

Calm down Mike, Talia’s comment is just a subset of what she always posts on all such articles. She never actually engages in proper discussion, but just spews out more of the same. It is useful though for people to be able to read the other side and see how badly flawed it is.

Mike Downing
Mike Downing
2 months ago
Reply to  Adrian Smith

My apologies Mr Smith but I am so heartily sick of this nonsense now and who knows; I may get a visit from the thought police…

Adrian Smith
Adrian Smith
2 months ago
Reply to  Mike Downing

Free speech means hearing things you don’t like. As soon as one side is censored, true free speech is lost. There has been far too much censoring of our side of the debate, the answer is not to retaliate by censoring the other side, as that just leaves both sides in their respective trenches mindlessly throwing bombs at each other.
It would be good if we could all “meet in no mans land for a game of footie” and such events have been proposed many times by the moderate gender critical side, occasionally the gender ideologues even agree, but they invariably back out before the event citing the harm to trans people just having the event would do.
As far as the thought police are concerned, you and I are safe for now as gender critical beliefs are protected, however things could change very rapidly under a Starmer government.

Allison Barrows
Allison Barrows
2 months ago
Reply to  Adrian Smith

“She”?

Adrian Smith
Adrian Smith
2 months ago

Yes Allison, I choose to respect peoples’ preferred pronouns wherever possible. I default to respect until respect is lost, thus there are instances where such respect is no longer possible eg in the case of sex offenders. Having a different view to me is not a reason to move away from my default position.
I therefore also respect the choice of people who choose not to respect preferred pronouns. Respect should always be a 2 way street and the default position in any discourse.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

It is a false respect, no different from a white supremacist referring to an ethnically dark skinned debating opponent in public in polite terms while advocating the “whites only” signs go back up.

Julian Farrows
Julian Farrows
2 months ago
Reply to  Talia Perkins

That’s not fair, Talia. To paraphrase Elizabeth I, you’re now claiming to have a window into men’s souls.
I am personally scared of transgender ideology, because those who most ardently support it seem most keen to use newly-made hate-laws to silence any debate on the matter, particularly debate on whether minors should be permitted to use drugs and/or surgery to slow puberty or radically alter their genitalia.
Some of the stories I have heard from people who regret their ‘transition’ are heart-wrenching: deformed sexual organs, intense pain, damaged digestive or urinary tracts, inability to reproduce, and reduced sexual pleasure. Surely, these are crucial factors to consider when weighing whether children should be permitted to undergo such drastic procedures?

Talia Perkins
Talia Perkins
2 months ago
Reply to  Julian Farrows

“That’s not fair” <– Of course it is, it is exactly analogous to Adrian’s schtick here.
“I am personally scared of transgender ideology, because those who most ardently support it seem most keen to use newly-made hate-laws to silence any debate on the matter, particularly debate on whether minors should be permitted to use drugs and/or surgery to slow puberty or radically alter their genitalia.” <– I have no reason to care what you claim to fear, when all I care about is what is provably real, among which facts is there is no such ideology. I am American, I frankly have contempt for the greater degree to which the UK is “progressive” in every aspect of the concept. You have no rights at all, you are subjects of Parliament which is limited only by what they feel they can not get away with. You are their property. I pity you.
“Some of the stories I have heard from people who regret their ‘transition’ are heart-wrenching: deformed sexual organs, intense pain, damaged digestive or urinary tracts, inability to reproduce, and reduced sexual pleasure. Surely, these are crucial factors to consider when weighing whether children should be permitted to undergo such drastic procedures?” <– You have no excuse to pretend they are not considered, but are instead concealed, and you have no excuse to pretend more than 1% regret such an undertaking as being a misdiagnosis.

Francisco Menezes
Francisco Menezes
2 months ago
Reply to  Talia Perkins

A Doyle cameo!

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

I always engage factually, and you never have any relevant, factual reply.
“It is useful though for people to be able to read the other side and see how badly flawed it is.” <– You never manage to point out any flaws though, you just repeat your lies over and over.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

I always engage in a proper discussion. I am always arguing with logic based on facts.
You dismiss facts a priori which undermine and refute you, and without revealing any factual grounds ton which to do so.

Martin Goodfellow
Martin Goodfellow
2 months ago
Reply to  Mike Downing

Save your effort. There is no point in replying to the incorrigible.

Talia Perkins
Talia Perkins
2 months ago

Yes there is. I do it so the incorrigible can not hide from the truth of the lies they love, and the harm they do and seek to do.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

I love the way you scream prove it and then dismiss all the proof as an ideologically motivated hack job with ad hominem attacks on anyone who dares provide proof you don’t like. By doing so you help prove the cult like aspects of this monstrous ideology.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

But you never have any proof of what you say.
You will not be able to pick out any claims made or implied by Shellenberger which are supported by what they quote.
The whole pastiche is nothing burger.

Christopher Michael Barrett
Christopher Michael Barrett
2 months ago
Reply to  Talia Perkins

https://segm.org/regret-detransition-rate-unknown

What do you have to say to the fact that every single study on “gender affirming care” satisfaction/regret has garbage methodologies. WPATH waited ten years to release the results of one study until they could manipulate the data to be positive (they excluded any patient from the study who no longer identified as transgender).

If the evidence exists it would be high quality, rather it’s low quality trash with short follow up times, confounding variables, selection bias, and author bias.

Talia Perkins
Talia Perkins
2 months ago

“What do you have to say to the fact that every single study on “gender affirming care” satisfaction/regret has garbage methodologies.” <– It is not a fact. Now Zucker and Littman, there are some garbage methodologies — even outright fraud.
“WPATH waited ten years to release the results of one study until they could manipulate the data to be positive (they excluded any patient from the study who no longer identified as transgender).” <– Liar. When a long range study is done, you claim it took that long to cherrypick data. When a short term study is done, you claim there are no long term studies.
Back up what you claim, liar.
I know you can not.
There are no “high quality” studies backing you up — none.
All of the high quality work supports gender affirming care, and it scarcely matters there is not much of it because by the definition of “high quality” used, only 15% of all medical care is backed up by “high quality” evidence.
In case you were not aware, for much of medicine, the definition of high quality in use there is such that it is not physically possible to carry out a “high quality” study.

Heidi M
Heidi M
2 months ago
Reply to  Talia Perkins

Wow. Your source for what you consider to be “factual” refutations is a militant transgender person who has not only an incredible bias but also every motivated reason to not look at things objectively. The hypocrisy here is truly amazing.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Heidi M

Shellenberger is an ideologically motivated liar. Whom you are complaining about, you can find no factual errors in what she says.
But she is pointing out lies and distortions on Shellengerger’s part.
He and you will have no factual counter reply to Reed.
There are good guys and bad guys — social conservatives are the bad guys here. You are literally advocating grotesque child abuse for the sake of your moral vanity — your pretending the world is the way you want it to be, not the way it is.
Just like Adrian imagining human rights are a problem to be destroyed in favor of their superior “human values” — he goes straight to the idea that those who do not agree with him are not human enough to count.

Andrew Morgan
Andrew Morgan
2 months ago
Reply to  Talia Perkins

‘you are an ideologically motivated bigot.’ The irony.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Andrew Morgan

No irony. The are ideologically motivated. They are bigots. I am bringing facts here, not ideology.

Jim Veenbaas
Jim Veenbaas
2 months ago

MS is absolutely relentless at exposing the censorship industrial complex, and the junk science driving much of the policy from progressives. The west owes him a debt.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jim Veenbaas

Junk science is the only science on his side in this.

Jane Watson
Jane Watson
2 months ago
Reply to  Talia Perkins

Saying that someone was born in the wrong body makes as much sense as saying they were born with the wrong head.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Watson

Except it is a perfectly cromulent metaphor for a man born with a vagina, or a woman born with a p***s.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Watson

No it does not, because the body can not be “right” in preference to the head because the head is the person.

Darlene Craig
Darlene Craig
2 months ago
Reply to  Jim Veenbaas

Far too much space here responding to someone who spouts the same nonsense over and over. Little room for actual discussion of the WPATH files. MS’s point is there is little to no actual research, that the trans movement is ideological. And that the real needs of patients are being ignored in the service of this ideology. It is a medical scandal and absolutely evil that the young are being groomed in its service. I know families who have TWO “trans” children! How is this possible? How can we call it anything but a mass mental illness, a metaphor for our collective disassociation from what it means to be human.
Sex is binary and immutable. I am not a bigot for saying this. It is not possible to be born in the wrong body. Mutilating bodies and supplying people, including minors, with drugs to feed their delusions will not change this.
it is past time for us to speak this truth plainly without fear of the poor souls who will invariably throw tantrums in response.

2 plus 2 equals 4
2 plus 2 equals 4
2 months ago

I’m sure there is much in the report which is shocking, though for me it simply comes down to straightforward formulation.

A child who is not old enough to give consent to a tattoo is not old enough to give consent to amputating healthy body parts or taking life-altering hormone treatments.

That’s the signal. Pretty much everything else is noise.

Adrian Smith
Adrian Smith
2 months ago

The ages at which certain things are allowed vary between countries and cultures. What we are talking about here is not personal choices where adults should be allowed to make their own (bad) decisions, but minors are not deemed capable of making those choices. What needs to be considered here is what is the best way to treat a mental health condition, which presents either pre-puberty or in puberty and will, in the majority of cases, if left alone, resolve themselves as the brain matures. There are absolutely no relevant similarities with tattoos.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

Liar, it is not any mental health condition, and you have no factual basis for claiming it resolves spontaneously — the upper bound of the rate at which it might do so is < 1% of the time.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

https://www.england.nhs.uk/wp-content/uploads/2023/06/Interim-service-specification-for-Specialist-Gender-Incongruence-Services-for-Children-and-Young-People.pdf
“Providers delivering The Service must be an established specialist tertiary paediatric unit with a strong partnership with mental health services;” Why when it is not a mental health condition? 
“The clinical management approach should be open to exploring all developmentally and psychosocially appropriate options for children and young people who are experiencing gender incongruence. The clinical approach should be mindful that this may be a transient phase, particularly for pre-pubertal children, and that there will be a range of pathways to support these children and young people and a range of outcomes.”
“Some children will remain stable in a gender identity they articulate in early life that is discrepant from natal sex and for others it will be a transient phase. While intensity of early gender incongruence in children may be an important predictor of persistence of gender incongruence, gender trajectories in prepubescent children in particular cannot be reliably predicted and may evolve over time.” Ie at the moment there is no way to diagnose which children will benefit from medical treatment and which will be permanently harmed by it.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“Why when it is not a mental health condition?” <– Because there are mental conditions which can superficially resemble gender dysphoria which must be excluded as confounding factors to that diagnosis.
If you had any actual idea what you were going on about you would know that.
“Ie at the moment there is no way to diagnose which children will benefit from medical treatment and which will be permanently harmed by it.” <– No, that conclusion by you does not follow. It says nothing at all to denigrate the idea that the regret rate does not exceed 1%.
Again if you will not insist on 100% accuracy of diagnosis for all medical care, you cannot legitimately insist on 100% accuracy for this medical care. You cannot insist the regret rate is far larger that 1%, until you actually have some evidence it is far larger than 1%.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

What I insist on is evidence led medicine. Ideologue activists have deliberately prevented evidence being gathered, analysed and presented – even some prominent members of WPATH agree:
“Dr Laura Edwards-Leeper, a clinical psychologist in Oregon who treats transgender youths and a co-author of WPATH’s new Standards of Care for adolescents and children, said MacKinnon’s work represents some of the most extensive research to date on the reasons for detransitioning and the obstacles patients face. She said the vitriol he has encountered illustrates one reason so few clinicians and researchers are willing to broach the subject.
“People are terrified to do this research,” she said.”
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
Each time evidence comes out which does not support your ideology all you do is ignore it. I have posted links to really strong evidence (evidence is not proof) numerous times.
Evidence led medicine requires positive evidence that the benefits disproportionately outweigh the risks before proceeding, until then treatments must be considered experimental. Had the experiments been done in accordance with the standard methodologies rather than relying on ideology then there would be more than enough evidence one way or the other. All you are doing is trying to use the lack of evidence people like you created to justify continuing with what is clearly an extremely harmful practice.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“What I insist on is evidence led medicine” <– No you do not, you insist evidence which you do not approve of is ignored.
It has to pass your ideological test.
No more, no less.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

All sorts of people say all sorts of things to make a splash, the fact is there is far more than enough money on your side of things that the only rational reason there are no studies supporting your viewpoint is the real world denies your views have legitimacy.
You can’t even find a citation which supports you now!
“They insist, as MacKinnon once did, that detransitioning is too rare to warrant much attention, citing their own experiences with patients and extant research to support their view. When someone does detransition, they say, it’s almost never because of regret, but rather, a response to the hardship of living in a society where transphobia still runs rampant.”
That is what the people who detransition for any reason say to the tune of 30 or more to 1, and MacKinnon is never quoted anywhere there as saying detransition owing to misdiagnosis is anything but rare.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

“You can’t even find a citation which supports you now!”
“as MacKinnon once did” Note MacKinnon is a Trans man and therefore predisposed to believe that.
“In the past year, MacKinnon and his team of researchers have talked to 40 detransitioners in the United States, Canada and Europe, many of them having first received gender-affirming medical treatment in their 20s or younger. Their stories have upended his assumptions.”
“Many have said their gender identity remained fluid well after the start of treatment, and a third of them expressed regret about their decision to transition from the gender they were assigned at birth. Some said they avoided telling their doctors about detransitioning out of embarrassment or shame. Others said their doctors were ill-equipped to help them with the process. Most often, they talked about how transitioning did not address their mental health problems.”
“MacKinnon is never quoted anywhere there as saying detransition owing to misdiagnosis is anything but rare.”
A properly designed large scale study that looked +5 years, +10 years and +15 years would be needed to answer the question. Such a study has not been done.
“Dr Laura Edwards-Leeper, a clinical psychologist in Oregon who treats transgender youths and a co-author of WPATH’s new Standards of Care for adolescents and children, said MacKinnon’s work represents some of the most extensive research to date on the reasons for detransitioning and the obstacles patients face. She said the vitriol he has encountered illustrates one reason so few clinicians and researchers are willing to broach the subject.
“People are terrified to do this research,” she said.”
“WPATH’s guidelines acknowledge the lack of research on long-term outcomes for youth who didn’t undergo comprehensive assessments”
“You can’t even find a citation which supports you now!” – Who’s the liar now?

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“Who’s the liar now?” <– You are, you continue to decieve with lies and half truths, and out of context quotes.
Merely the fact they could only find 40 detransitioners to talk to supports the <1% regret rate very well. They could find in the US alone a total of over 7 thousand before they would even have found all “detransitioners”.
“A properly designed large scale study that looked +5 years, +10 years and +15 years would be needed to answer the question. Such a study has not been done.” <– Yes, it has — you dismissed it because you did not like the results.
There is no more to you than that.

S Gyngel
S Gyngel
2 months ago
Reply to  Talia Perkins

The regret rate is not certain because – disgracefully- nobody has been keeping records or conducting long-term follow-up. See the recent Genspect conference….Prof. Wilfred Reilly calculated a 30% regret rate at the very least. He explained in great detail how he arrived there. Whistleblower Jamie Reid spoke at the end of his speech. She said 30% of her patients simply disappeared from the programme

Sula McClain
Sula McClain
2 months ago
Reply to  Talia Perkins

Over 85% of children who think they are trans desist later on and many are simply gay. Any cohort where in the majority of cases doing nothing medical is the solution is pretty good odds for success.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Sula McClain

“Over 85% of children who think they are trans desist later on” <– No, they do not.
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2815512
“and many are simply gay” <- No, they are not. Being gay and being transgender do not look alike, and are not clinically confused with each other.
You will never find any evidence for what you have said which stands up to any scrutiny. Zucker lost his job over the sort of fraud you are holding up to be “evidence”.

S Gyngel
S Gyngel
2 months ago
Reply to  Talia Perkins

Zucker worked with transidentifying people for decades until he was attacked by activists and completely cancelled. He sued and won.

Theresa Guirato
Theresa Guirato
2 months ago
Reply to  Talia Perkins

First The WPATH Files; then the NHS reverses course and halts puberty blockers; now The Times of London has weighed in, and citing the Wpath Files, calls GAC “Quack Medicine,” and urges that it be “reined in entirely.”
Add the recent Federal lawsuit by 16 female athletes against the NCAA for discrimination contrary to Title IX and, confident of a victory, the foundations of TRANSGENDERISM will be turned to rubble.
In fact, I feel the walls of their church cracking right now.

Aidan Trimble
Aidan Trimble
2 months ago
Reply to  Talia Perkins

Heerrre he is !!

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“but minors are not deemed capable of making those choices” <– but you are talking about medical care, which is never withheld from children on that basis they are unable to consent for any other condition.
And it is not a mental condition — your claiming it is is your gender ideology speaking.
“What needs to be considered here is what is the best way to treat a mental health condition, which presents either pre-puberty or in puberty and will, in the majority of cases, if left alone, resolve themselves as the brain matures.” <– An outright lie. One of many from you. You can not back that up at all.
The fact is that for youth who actually meet the diagnostic criteria, they do not “desist”.
https://jamanetwork.com/journals/jamapediatrics/article-abstract/2815512
That’s just come to my attention yesterday.

Talia Perkins
Talia Perkins
2 months ago

Then there must be no medical treatment of child for any medical treatment ever, because they can not consent to it.
Or,
You admit you only object to this medical treatment, and then you have to justify your objections on the basis of some objective grounds.
And you can not — there are none.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

For once I have voted you up because I agree with that tiny bit of your argument.
Medical treatments are different to life choices, like tattoos. The process for gaining consent with children must always include the parent.
The principle of first do no harm is a good one, but there are always risks in any medical procedure. Informed consent is about the consentee (this maybe the parents on the child’s behalf) having a full understanding of both the risks and benefits.
Hopefully we are agreed on the above, though you may be one of the total nutcases, who believes children know their own minds and parents should be kept in the dark.
From there we diverge. There has been an ideologically based overstatement of the benefits and an ideologically driven deliberate concealment of the risks. Stonewall’s #nodebate has been largely responsible for this lamentable state of affairs, whilst the active promotion of gender ideology in UK schools by Stonewall, has driven far too many adolescents into the hands of ideologically driven medics, who have allowed this twisted ideology to override the fundamental principles of medicine.
Fortunately the pendulum is finally swinging back towards sanity in UK and around the world, but it is a slow process and it could easily start going back the other way if a lunatic Labour party gets the chance to drive it that way.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“The process for gaining consent with children must always include the parent.” <– Then there must be later consequences fpr parents who are people like you who for ideological reasons deny medical care to their children.
“There has been … it that way..” <– That is your factually baseless assertion.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

So you are one of the nutcases who think children know best and parents should be kept out of it. I thank god that I never had to face the dilemma that parents of gender dysphoric kids have to face and my heart genuinely goes out to them, whatever they decide. That you believe those who withhold consent should face consequences is just another indication of just how far down this ideological cult rabbit hole you have gone.
“Give consent or else!” completely undermines the whole principle of consent.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

I know that if children are harmed by their parent’s adherence to an ideology, legal recompense should be quite possible for those surviving children to seek legally from those parents.
That you think a parent should be able to force a boy to have breasts and a period and girl to have a beard and a deep voice without consequence, and that you fear the balance of such suits would not favor your ideology says all that really needs to be said of you.
You know you are wishcasting and grandstanding, for the sake of your ideology.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

Yeah and they should be guilt tripped further with the dead son versus living daughter lie and if that does not wise them up, call the lawyers!

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

You pretend they should feel no guilt.
That is how you are a monster.
You pretend there should be no lawyers unless they agree with you.
That is a way you are a cowardly fraud.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

Talia, it is you who is adhering to the outlandish ideology. The idea that there is some kind of immutable soul that can get trapped in the ‘wrong body’.
Struggle with identity formation and struggle with the developing pubertal body is a common rite of passage for all of us. It is also well established that children who will go on to be gay or lesbian struggle even more intensely, as do children on the autistic spectrum.
Gay clinicians at the Tavistock gender clinic for children continually tried to alert senior staff that gay children were effectively being transitioned; and furthermore most of the young people had several other mental health issues alongside the dysphoria.
Parental desires and parental phobias around the sex of their child also transmit through a kind of osmosis to the child – who then responds accordingly. The mother who really wanted a daughter, but got a son instead. The father who cannot countenance his son being gay and who castigates his senstive child for being ‘girly’ and so on.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

“immutable soul” has nothing to do with it, and you can quote nothing I’ve said giving you any excuse for pretending I said any such thing.
Everything have mentioned is only physical biology. I have said nothing other.
“Struggle with identity formation and struggle with the developing pubertal body is a common rite of passage for all of us.” <– Which has nothing to do with it, since this is only about biology created in utero.

“. It is also well established that children who will go on to be gay or lesbian struggle even more intensely, as do children on the autistic spectrum.” <– Which also has nothing to do with it, since those are eventualities of birth existing independently of biological gender.
Autism and variant from usual sexual orientation are not easily confusable with gender dysphoria.

“Gay clinicians at the Tavistock gender clinic for children continually tried to alert senior staff that gay children were effectively being transitioned;” <– Prove it, then prove they were even correct. You have to be correct both times to have any point at all, and then you only have a point with respect to those few cases — and even in such cases as may be can only be pointing out incompetence in the practioners involved — as such effort is directly contrary WPATH standards of care.
“Parental desires an d… and so on.” <– None of which do you have any evidence is in play here. You are expressing wished for explanations of how the world is really how you want it to be, and it is not how you want it to be.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Talia Perkins

Gender is a made up concept – a social construct. How can a concept form in the uterus?

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

Nonsense. That is the evidence free “soft science” definition of it. Actual physical measurement and history say nothing of the sort. Evidence proves the soft sciences confuse gendered behaviors with being gender itself.

Sula McClain
Sula McClain
2 months ago
Reply to  Jane Anderson

Absolutely. And we can never know what influences, what apparently minor utterances on the part of the parent or a teacher or a friend went into creating such self-hatred. It could be a throwaway remark that has had a profound effect on an autistic child who might take thing literally or it could be a traumatic memory long forgotten but still felt as an aftereffect. We can never know exactly what creates anyone’s complex identity but we do at least know that the person we are at 12 or 17 is not who we are at 28 or 36 or 65. We change. Trans ideology is like a death cult, stopping the constant motion of life itself.

Jane Anderson
Jane Anderson
2 months ago
Reply to  Sula McClain

Yes, ‘identity’ becomes fixed in stone; whereas in reality our identity evolves and grows throughout our lives in response to experience and circumstance.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Anderson

It does not “become” fixed in stone, that is how it is created. You will find no instance of it being malleable by experience.
In fact, in the case of David Reimer, you will find if you are honest that it is perfectly durable in the face of literal torture.
But then, you will have no honest reply, will you?

Aidan Trimble
Aidan Trimble
2 months ago
Reply to  Talia Perkins

You need to calm down Sir.

Jeremy Bray
Jeremy Bray
2 months ago

It is easy to look back at some of the barbaric behaviour of our ancestors towards one another and ask how on earth they could have thought this was right. Today we can see how clearly barbaric experimental and unethical practices can flourish as approved and desirable procedures.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Jeremy Bray

The closest analogue often cited is lobotomies:
https://en.wikipedia.org/wiki/Lobotomy
The question is why have we not learned the real lessons from these things?

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“The closest analogue often cited is lobotomies:” <– Which is no analog at all, not anymore than the excision of a skin cancer is.

Jeremy Bray
Jeremy Bray
2 months ago
Reply to  Talia Perkins

Lobotomy was an attempt to cure a mental problem by cutting healthy tissue. The injection of hormones and surgical removal of healthy tissue seems a pretty analogous means of curing another mental problem. As you say the excision of diseased cancerous tissue is indeed not analogous.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jeremy Bray

And you are conclusorily presuming it is healthy for a girl or woman to have a p***s, and healthy for a man or boy to have a vagina — also you are conclusorily presuming it is not possible for such a circumstance to arise.
The actual facts deny you.

Jeremy Bray
Jeremy Bray
2 months ago
Reply to  Talia Perkins

There seems little point in discussing the matter since except in the rare cases of hermaphroditism there are no boys with vaginas or girls with a p***s. Your assertion to the contrary is not a fact but a fantasy. There may be people who believe they are “in the wrong body” but factually they are mistaken. It is only a legal fiction that allows those with the necessary certificate to claim to be a member of another sex.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jeremy Bray

“There seems little … of another sex.” <– As I mentioned, with no factual excuse for it whatsoever, you pretend transgender people do not actually exist, and are instead mentally cisgendered people.
Thank you for being so frank about your delusion and dishonesty.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jeremy Bray

Except there is nothing experimental or barbaric about it. Those are just lies you tell yourself to justify your abuse of transgender people.

Jeremy Bray
Jeremy Bray
2 months ago
Reply to  Talia Perkins

That is a matter of opinion. It is not a matter fact so can’t be a lie. I am not abusing any transgender people. I am simply expressing a distaste for those who would deny children who been persuaded to believe they have a gender different to their sex a normal physiological development at a stage when their full mental development has not yet occurred and when they have limited life experience to draw on.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jeremy Bray

It is an opinion which can only be held by the deliberately ignorant, malignant and insane. There is no honest, informed, beneficient person holding your opnions.
“I am not abusing any transgender people.” <– Yes, you are here to do that as much as you can with your “opinions” and to advocate for more of the same, by law and policy.
“I am simply… to draw on.” <– You have no excuse to pretend that is happening in any improvable way or to any notable degree.

Gordon Buckman
Gordon Buckman
2 months ago
Reply to  Talia Perkins

You are batsh!t crazy. Also a master of projection. I for one see your loose grip on reality. I actually pity you. You need professional help. Preferably under lock and key.
Failing that, stay away from children.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Gordon Buckman

“You are batsh!t … away from children.” <– No.
Your sort are the only hazard to children here.

Katja Sipple
Katja Sipple
2 months ago
Reply to  Gordon Buckman

Of course he is! He is not a she, but one of the radical trans ilk, in case you don’t know.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Katja Sipple

Exactly the sort of mindless bigotry used to justify the persecution of LGBT people. The real world is more complicated then you can deal with — you should stop abusing people and instead get a soft helmet for yourself.

Mike Downing
Mike Downing
2 months ago

I’ve been censored.

Adrian Smith
Adrian Smith
2 months ago

What upsets me most about these experimental procedures is that, because they believed in gender ideology, the medics deliberately did not follow experimental processes to evaluate the outcomes of their experiments properly. I am sure Talia, our resident gender ideologue, will be along later to claim a 99% satisfaction rating for the treatments. The truth is nobody really knows, because the studies have not been done. Those that have been done all have significant weaknesses and show regret rates anywhere between 1% and 25%. Some prominent members of WPATH admit that the reason why the studies have not been done is because of fear of activist reaction. When contraindications to the affirmation dogma do arise they are dismissed by WPATH on some pretext or another – they choose not to listen.
https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/
In order to do proper experiments the subject need to be tracked from beginning to end in a consistent and coherent manner. If we start doing it properly now, it will take between 5 and 10 years to have confidence in the results. Given the deliberately wasted years, I believe it is right to stop the experimentation on under 25s (the age at which major brain development ceases and it is no longer likely that Gender Dysphoria will just sort itself out). Yes this does mean that some who would have benefited from earlier intervention suffer for longer, but that is better than unnecessarily mutilating people with mental health conditions (Gender Dysphoria is a mental health condition from a family of body dis-morphia mental health conditions). Once the experimentation has been stopped, then studies on past data and on those who suffer Gender Dysphoria, but are managed through means other than affirmation, can be done to see if it there is evidence for hormonal or surgical intervention earlier in some specifically diagnosed patients, ie not just anyone who walks through the door claiming to be of the opposite sex.
The above is a very long winded way of saying make medical care for Gender Dysphoria evidence led rather than ideologically led, ie no different to any other health condition.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

Of the two of us you have the only belief in any “gender ideology’ involved. I’m bringing facts to the discussion — you pretend they do not exist. You have no factual grounds on which to dismiss anything I have said or cited — you have never pointed any actual flaw in any of the work I have linked to. You claim “those that have been done all have significant weaknesses” and never prove it. You can not. It is only what you prefer to claim.
The fact is the regret rate at medically assisted transition was about 5% when first measured many decades ago, and as diagnostic criteria have improved has declined to under 1% in recent decades. Decades. Not last year. Seen to be so in thousands of people almost enough to have a 95% confidence level with respect to the whole human population now living.
The fact is that with all your ilk’s ambulance chasing, you have drummed up at most a few tens of people worldwide to be your shills. That itself is proof of not merely the low regret rate, but that the fact so many numerous professionals of good skill and ethics are involved, that borderline all people who should not transition medically are already weeded out from medically supervised transition.
If being under 25yo is any reason to deny medical transition, then you have to show how any medical care may be rendered to anyone under 25yo. If you scoff then at your own principle claimed there, you convict yourself of merely making a special pleading which amounts to you admitting only that you don’t like this medical care — and only for emotional reasons, since you have no facts whatsoever backing anything you have said.
Gender affirming care is already evidence led. You want that evidence ignored because you don’t like it, no more no less.
For the sake of your ideology, you want to force some boys to have breasts and a periods, and you want to force some girls to have beards and deep voices. That is necessarily a consequence of what you say you want.
For the sake 1 who might otherwise individually lie their way into medical treatment for a condition they do not have or honestly be confused in such a way their unfitness for it can not be detected, you want at least 99 people to be monstrously abused by the denial of the medical care their condition warrants.
I will have no factual reply from you, only a mulish insistence by you that what you wish were true is true.
Your sort has the only ideology and at that delusion involved here.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

This is so laughable it does need picking out:
“The fact is the regret rate at medically assisted transition was about 5% when first measured many decades ago, and as diagnostic criteria have improved has declined to under 1% in recent decades”
“first measured” – it has never been measured, that’s the point. You make up “facts” just to support your twisted ideology.
“diagnostic criteria have improved” what diagnostic criteria? Anyone who says they are in the wrong body is sent down an affirmation path – anything else is trans genocide, according to the ideology.
The best study done recently is a Dutch study, which warns it maybe under reporting because there is a year long screening process and that gives a 2% drop out rate from further treatment. The weakness of all studies, including the Dutch one is that they do not follow up consistently over a long enough period. Most rely on some element of recorded data rather than talking to people.
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(22)00254-1/abstract
Additional to actual detransitioners, of which there is a growing number, there are those for whom the treatments have not worked (ie they still suffer from Gender Dysphoria just as badly if not worse) but they have not sought to reverse them, because they are irreversible. There are those who keep quiet because of the abuse they get from what they once considered to be their own community. There are also the near misses who start with “thank god I did not…”. All of those need to be found and listened to if there is to be an evidence led approach to the medical treatment of Gender Dysphoria.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“it has never been measured, that’s the point” <– Yes, it has, and you have no facts speaking to the contrary.
“You make up “facts” just to support your twisted ideology.” <– Not so you have ever manged to cite any which I have made up.
“You make up “facts” just to support your twisted ideology.” <– And that study equally supports a rate well under 1% — error bars go both ways.
“704 (98%) people who had started gender-affirming medical treatment in adolescence continued to use gender-affirming hormones at follow-up” <– Which speaks to the accuracy of the induction criteria in the first place and to a bit of further weeding out before any actual changes are undertaken.
“Most rely on some element of recorded data rather than talking to people.” <– Except of course that work I cite with almost 8,000 subjects includes talking to people and is undertaken over decades time. There is no legitimacy to anything you claim. For that mater, prove the recrde3d data is not what people then said — while being “talked to”.
“Additional to actual detransitioners, of which there is a growing number” <– Not growing faster than number of those availing themselves of gender affirming care for gender dysphoria in the first place though.
“there are those for whom the treatments have not worked (ie they still suffer from Gender Dysphoria just as badly if not worse) but they have not sought to reverse them, because they are irreversible’ <– Demonstrate what proportion of people whom you claim are in such a condition who desire any reversal. And then feel free to move your goalposts again.
Pro tip, people who transition medically and then decide to detransition permanently because they feel it can not “work” for them later who do regret their transition are not excluded from the regret statistics.
“There are those who keep quiet because of the abuse they get from what they once considered to be their own community” <– You will find, if you ever adopt honesty, there is no such abuse but for those who claim their generally willful deceit is any excuse to prevent others from transitioning categorically — and that those who few who detransition who take no such position only have the support of the transitioned community.
“. There are also the near misses who start with “thank god I did not
”.” <– Evidence the screening works is not evidence it does not.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

“Anyone who says they are in the wrong body is sent down an affirmation path – anything else is trans genocide, according to the ideology.”
It is genocidal to mandate the abuse you desire for transgender people, and gender affirming care is that careful exploration you claim you want. That is why the regret rate is so low. It takes years. Everything but gender affirming care is conversion therapy — there are not other treatment approaches than gender affirming care which are not conversion therapy — that is why you can not find and cite any.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

I tend to believe Dr Hillary Cass. GIDS was shut down because it was not providing the level of care you claim.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

Adrian, Cass does not actually support you and GIDS is not in fact shut down.
https://www.bbc.com/news/uk-65687697
GIDS will not be “shut down” until and unless there is more of gender affirming care available.

Adrian Smith
Adrian Smith
2 months ago
Reply to  Talia Perkins

The Cass report is a horror story. GIDS was closed to new referrals.
https://cass.independent-review.uk/wp-content/uploads/2022/03/Cass-Review-Interim-Report-Final-Web-Accessible.pdf
It is to be replaced by a much better care model which “should remain open and explore the child or young person’s experience and the range of support or treatment options and their implications that may best address their needs,”
The problem has been finding suitable people to run the new service who are not so badly infected by gender ideology that they just go back to the affirmation is the only way dogma. Your own link to the BBC article says that:
“Prof Butler has been awarded a key role in shaping the new service, as one of several people tasked with implementing a new training programme, underpinned by Dr Cass’s recommendations.
However, BBC Newsnight has learned Prof Butler – the current service’s most senior doctor – has publicly questioned the need for change and described Dr Cass’s recommendations as “slightly unusual”.”
“In the recording, which was then handed to Newsnight, he was also heard questioning the personal integrity of Dr Cass”

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

So you are admitting you lied when you said it was closed. It is operating now.
“should remain open and explore the child or young person’s experience and the range of support or treatment options and their implications that may best address their needs,” <– And never managed to show that is not inherent to the WPATH Standards of Care, which are gender affirming.

““Prof Butler has … integrity of Dr Cass”” <– There is no dogma to gender affirming care, and there are so few practitioners willing to be Mengele and instead attempt conversion therapy, they will have a long search if they really are trying to move away from gender affirming are.
In fact they are not. They are trying to roll out more of it, gender affirming care.

Mint Julip
Mint Julip
2 months ago
Reply to  Talia Perkins

“Trans genocide” IS happening because “transitioners” appear to be rendering themselves unable to procreate. Surely an own goal, or is this why people like yourself are so desperate to inculcate others (especially children) into this cul-de-sac?

Talia Perkins
Talia Perkins
2 months ago
Reply to  Mint Julip

““Trans genocide” IS happening because “transitioners” appear to be rendering themselves unable to procreate.” <– Genocide by definition is only what is done unwilling to people. I realize facts are not your friend.
There is no possibility of “inculcating” people to be transgender, it is a condition of birth arising from the mix of genes in common circulation.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

Of the two of us you have the only belief in any “gender ideology’ involved. I’m bringing facts to the discussion — you pretend they do not exist. You have no factual grounds on which to dismiss anything I have said or cited — you have never pointed any actual flaw in any of the work I have linked to. You claim “those that have been done all have significant weaknesses” and never prove it. You can not. It is only what you prefer to claim.
The fact is the regret rate at medically assisted transition was about 5% when first measured many decades ago, and as diagnostic criteria have improved has declined to under 1% in recent decades. Decades. Not last year. Seen to be so in thousands of people almost enough to have a 95% confidence level with respect to the whole human population now living.
The fact is that with all your ilk’s ambulance chasing, you have drummed up at most a few tens of people worldwide to be your shills. That itself is proof of not merely the low regret rate, but that the fact so many numerous professionals of good skill and ethics are involved, that borderline all people who should not transition medically are already weeded out from medically supervised transition.
If being under 25yo is any reason to deny medical transition, then you have to show how any medical care may be rendered to anyone under 25yo. If you scoff then at your own principle claimed there, you convict yourself of merely making a special pleading which amounts to you admitting only that you don’t like this medical care — and only for emotional reasons, since you have no facts whatsoever backing anything you have said.
Gender affirming care is already evidence led. You want that evidence ignored because you don’t like it, no more no less.
For the sake of your ideology, you want to force some boys to have breasts and a periods, and you want to force some girls to have beards and deep voices. That is necessarily a consequence of what you say you want.
For the sake 1 who might otherwise individually lie their way into medical treatment for a condition they do not have or honestly be confused in such a way their unfitness for it can not be detected, you want at least 99 people to be monstrously abused.
I will have no factual reply, only a mulish insistence that what you wish were true is true.
Your sort has the only ideology and at that only delusion involved here.

Talia Perkins
Talia Perkins
2 months ago

Deleted as the censored content did after many hours appear.
EDIT: and it disappeared again. Oh how jealously you liars guard your lies.

Talia Perkins
Talia Perkins
2 months ago

The mere fact of how often what I have to say disappears is clear evidence of how much UnHerd loves the echo chamber of it’s herd.

Lizzie J
Lizzie J
2 months ago
Reply to  Talia Perkins

I have never reported or down voted you and I find your contributions worth reading.

I suspect you get censored more for hurling insults – liar, deluded, ignorant, insane – than for your content.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Lizzie J

To the objective and the honest, I prove those I say are lying, deluded, ignorant, and insane are such.
My content is simply ignored, dismissed because it does not affirm the herd’s prejudices.

Francisco Menezes
Francisco Menezes
2 months ago
Reply to  Talia Perkins

Sounds like Titania McGrath with PMS? Mr. Doyle is such a funny man.

Talia Perkins
Talia Perkins
2 months ago

Sounds like you have nothing factual or relevant to say, and you think child abuse is funny when you approve of it.

edwin cruden
edwin cruden
2 months ago

“Like most people, I have no problem with adults changing their bodies.”
I’m not convinced most people, when they dig down into the thinking behind this position, will actually have “no problem” with it. We should be aiming away from the free-for-all of Consent (only) Culture & making it more difficult to modify & mutilate that which has traditionally been held to be sacred, or at the very least, medically healthy.

M. Jamieson
M. Jamieson
2 months ago
Reply to  edwin cruden

There seems to be little exploration into whether wanting to change one’s body is a reflection of anything like mental health.
I’d also question whether or not medical practitioners can ethically have any role in people deciding to change their bodies.

leculdesac suburbia
leculdesac suburbia
2 months ago

One unfortunate dynamic in the WPATH tragedy is the collusion of male-pleasing, and particularly gay-male-pleasing, female therapists. Many professions weed out the most independent thinkers–or they go into private practice & stay away from big conventions & standards committees. Unfortunately, lots of female therapists (and HR & educators) operate at the midwit level of bloviating male TV “analyst” or poli sci PhD who writes up poorly conceived surveys as “research.” Gender critical feminists are familiar with this type of female who’ll throw other women, and women’s issues, under the bus, to get the approval of men in authority–and these days, it’s “progressive” men in authority. I’ve seen it personally. Otherwise potentially bright women psychologists who think deferring to every position of an outspoken gay male psychiatrist or psychologist makes them progressive and intellectual. This is not to say that gay men are responsible for this monstrous movement, but that the LGB movement (particularly the G part) has been hijacked by autogynephiliac straight males and misogynistic gay males to destroy women’s rights, promote lesbophobia (somehow gay men aren’t pressured by lots of trans-men), and endanger children.

I’ve been stunned at how quickly the many female therapists throw their female patients under the bus for crumbs of affirmation from gay colleagues as progressive, edgy, gender-affirming therapists. The late great writer Florence King called them “Malkins.”

Therapy was already unsafe for a range of reasons, per Shrier and the anti-psychiatry movement (60? years old at this point), but more dangers await. The betrayal by a female you go to deal with betrayal trauma is one of the worst gaslighting experiences in the world. And there are many insecure misogynistic gay men sitting in psychiatrists’ chairs eager to exact their resentment onto vulnerable women patients–who now have to go to them just to get a prescription for autoimmune or MS fatigue. In a just world they’d get disbarred & sued. That world doesn’t exist.

Jane Watson
Jane Watson
2 months ago

I know a gay male psychiatrist who worked at the Tavistock, and numerous gay male psychotherapists, who think transitioning young people is anti-gay. Young women and men who would/should be gay are being encouraged to think they are trans. See Az Hakeem’s book ‘DeTrans’.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Jane Watson

“I know a gay male psychiatrist who worked at the Tavistock, and numerous gay male psychotherapists, who think transitioning young people is anti-gay. Young women and men who would/should be gay are being encouraged to think they are trans. See Az Hakeem’s book ‘DeTrans’. <– Prove it.
Hakeem’s BS is obvious bunk merely because medical gender transition does not change anyone’s sexual orientation — once they have equipment they want to use, they may first reveal it, that is a different thing.
The fact is that post transition almost exactly as many transgender people are gay as are bi as are straight — it almost literally breaks down by thirds.
Hakeem has nothing to complain about on that score.
Being gay and being transgender do not look alike, not even superficially.

Dillon Eliassen
Dillon Eliassen
2 months ago

Has anyone seen the full report? The link is requesting permission.

R Wright
R Wright
2 months ago

From the report
“Metzger responded that “it’s always a good theory that you talk about fertility preservation with a 14-year-old, but I know I’m talking to a blank wall,” adding, “they’d be like, ew, kids, babies, gross.” “Or, the usual answer is, ‘I’m just going to adopt.’ And then you ask them, well, what does that involve? Like, how much does it cost? ‘Oh, I thought you just like went to the orphanage, and they gave you a baby.’”

This remark was met with smiles and nods from the panel. These comments prove that WPATH members are aware that the young patients who will lose their fertility as a consequence of gender-affirming treatments don’t yet understand what they are sacrificing.”

These people are evil.

Talia Perkins
Talia Perkins
2 months ago
Reply to  R Wright

“the young patients who will lose their fertility as a consequence of gender-affirming treatments” <– But they will not necessarily do so, and in the US at least insurance generally pays for gamete preservation and most transition for youth is done under the plan of an insurance company.
Perhaps what you say is true of the “die on time” socialist NHS system.

Talia Perkins
Talia Perkins
2 months ago

And, now Shellenberger is debunked.
https://www.erininthemorning.com/p/fact-check-216-instances-of-factual
Seriously, did no one notice not one of their “quotes” from WPATH or it’s members backed up what they said it did?
Did you actually read Shellenberger’s piece? Any one of you?

Adrian Smith
Adrian Smith
2 months ago

I have asked for access to the report mentioned but it has not yet been granted.
However this UK Government report tells us all we really need to know:
https://researchbriefings.files.parliament.uk/documents/POST-PB-0055/POST-PB-0055.pdf
The Cass Review commissioned two systematic reviews of evidence to report on what is known about the clinical effectiveness, safety and cost effectiveness of these treatments for children and young people. These reviews were compiled by the National Institute of Health and Care Excellence (NICE) in 2020 and examined:
‱ GnRH analogues to block puberty to treat gender dysphoria 4
‱ gender-affirming hormones to treat gender dysphoria
Both studies concluded that the quality of evidence available at the time of the review was low and that the certainty about the outcomes of their use is low when assessed with GRADE, a tool used to measure the quality of evidence in clinical practice. This relates to the lack of reliable comparative studies on hormone treatments used in this context; incomplete reporting of treatments used; different approaches to measure outcomes; the influence of bias, confounding effects and chance on the results; and a lack of longterm follow up.
The Scottish Government commissioned Healthcare Improvement Scotland to conduct a rapid review (not peer-reviewed) of the evidence on using GnRH analogues, published after the NICE review, in order to inform national commissioning of services. Published in July 2023, it concluded that although a few new studies had been published since the NICE review, they are of low quality and do not lend more certainty to the conclusions of the NICE evidence review. 
Another systematic review of both types of hormone therapy was commissioned by the Swedish Agency for Health Technology Assessment and Assessment of Social Services, and was published in 2023. Of the 10,000 studies identified for consideration in the review, only 24 were of sufficient quality to be included. Of those included, the authors reported that the evidence was of low quality. This related to a lack of studies using a randomised control method to minimise bias, studies with small participant numbers, and a lack of long-term follow-up data.
Another academic systematic review of treatments was published in August 2023. This used an analytical tool called PRISMA, allowing researchers to evaluate outcomes from multiple studies. It included 19 studies, reported that there was no impact on gender dysphoria symptoms and drew the same conclusion as the previous reviews relating to a paucity of evidence and a lack of follow-up research on participants. 
Unsurprisingly the interim policy on use of these powerful drugs on children:
https://www.engage.england.nhs.uk/consultation/puberty-suppressing-hormones/user_uploads/interim-policy-on-puberty-supressing-hormones-for-gender-incongruence-or-dysphoria.pdf
“Puberty suppressing hormones (PSH) are not recommended to be available as a routine commissioning treatment option for treatment of children and adolescents who have gender incongruence/dysphoria”

Hooray in UK at least we are now finally seeing the principles of evidence led medicine being applied to this area for children. We just need the same for young adults and we are there.

Talia Perkins
Talia Perkins
2 months ago
Reply to  Adrian Smith

That <1% regret rate is confirmed again.
https://www.erininthemorning.com/p/groundbreaking-study-shows-extremely
By a large, long term study just released.
You lose.
Because you deserve to.
You favor your emotions over facts and logic.

Theresa Guirato
Theresa Guirato
2 months ago

First The WPATH Files; then the NHS reverses course and halts puberty blockers; now The Times of London has weighed in, and citing the WPATH Files, calls GAC “Quack Medicine,” and urges that it be “reined in entirely.”
Add the recent Federal lawsuit by 16 female athletes against the NCAA for discrimination contrary to Title IX and, confident of a victory, the foundations of TRANSGENDERISM will be turned to rubble.
In fact, I feel the walls of their church cracking right now.