'Full-scale collapse': Gender transition group calls kid guidelines 'opinions' to defeat FTC suit

As the World Professional Association for Transgender Health and Federal Trade Commission sue each other for First Amendment retaliation and deceptive trade practices, respectively, a broader question looms: Has WPATH pulled the financial rug out from so-called gender-affirming care to defeat the federal government?

WPATH, the creator of the 2022 "Standards of Care for the Health of Transgender and Gender Diverse People," now claims the SOC-8 guidelines – covertly and crucially shaped by the Biden administration pertaining to minors – are just "statements of opinion," not settled science, and that states have the prerogative to regulate the industry.

WPATH's surprising concessions, in its July 28 motion to dismiss the FTC lawsuit, were flagged Aug. 10 by the Society for Evidence-Based Gender Medicine. Its generally liberal members played a leading role in the Trump administration's systematic review of youth-gender medicine, concluding that such interventions are not supported.

"It's possible the FTC just got its win, regardless of how this case turns out," the Manhattan Institute's gender-medicine researcher Leor Sapir wrote.

By conceding the "medical and scientific uncertainty" around treatment for minors specifically – quoting the Supreme Court's ruling for Tennessee's ban on the practice – WPATH gave insurers ammunition to deny claims for puberty blockers, cross-sex hormones and surgeries and judges and doctors reason not to defer to WPATH claims, Sapir said.

The organization undermined its own arguments before SCOTUS against Tennessee's ban, that the "widely accepted view of the professional medical community" is that gender-affirming care is "appropriate" and even "necessary" for some adolescents, said Alliance Defending Freedom President Kristen Waggoner.

WPATH even compared SOC-8 to the gender-critical talk therapy derided by gender-affirming care proponents as "conversion therapy" but upheld by the Supreme Court, saying each is free speech even if critics deem them "substandard care," SEGM marveled.

"Overnight, WPATH went from defender of the medical consensus to one voice among many in a disputed debate," Waggoner said, illustrating that "the case for childhood medical 'transition' is in full-scale collapse."

The dam started to break for WPATH's reputation when its leaked discussion forum showed members swapping stories about young patients or colleagues developing life-threatening medical conditions or even dying after years of treatment, not just the sexual dysfunction and developmental problems already revealed by research and federal guidance.

A lawsuit against Alabama's similar ban on treatment for minors subsequently revealed that then-Assistant Secretary for Health Rachel Levine successfully pressured WPATH to remove age minimums from the SOC-8 draft, which Levine warned would "result in devastating legislation for trans care," in the words of Levine's chief of staff.

The author of the email acceding to Levine's pressure, directed to "Rachel," was unmasked this week as then-WPATH President Walter Bouman, when gender medicine journalist Ben Ryan obtained and published the unredacted version. Bouman signed it "in servitude, Walter." 

The unredacted email also reveals who else was involved with removing age minimums outside the Delphi consensus method WPATH claimed to use: adolescent chapters' working group leaders Annelou de Vries and Scott Leibowitz, and SOC-8 chair Eli Coleman and co-chairs Asa Radix and Jon Arcelus.

Judicial Watch sued for related Levine communications when the Department of Health and Human Services ignored its Freedom of Information Act request. Another Judicial Watch document production uncovered evidence that gender-transition providers obfuscated, misled and threatened the media when their procedures on children came under scrutiny.

Squelched review that found 'little to no evidence' for medical transitions in children

The latest filings in lawsuits were Aug. 18, the FTC's amended complaint – joined by Alaska, Iowa, Nebraska and Texas with state-law claims – and WPATH's opposition to the FTC's motion to dismiss the nonprofit association lawsuit.

Both sets of plaintiffs chose courts known for either friendliness or hostility toward the Trump administration. 

U.S. District Judge James Boasberg, in Washington, D.C., is overseeing WPATH's case, while the Northern District of Texas's Judge Reed O'Connor, who ruled against the Affordable Care Act and has been called "the right's favorite district court judge," oversees the FTC's.

"Transition doctors founded WPATH to promote the transition service industry’s financial interests after losing academic support and insurance coverage for medical transition services," the feds and states emphasize to O'Connor.

Clinicians use its representations to diagnose children and promote the "necessity, safety, and purported benefits" of treatment to parents, and SOC-8's drafters admitted leaving out objective criteria and age minimums "to guarantee insurance coverage, the complaint says.

It flags Levine's role in SOC-8, the missing Delphi consensus method and concerns from WPATH leaders and members that it was giving it to political pressure. One committee member groused that "nobody" wanted to eliminate age minimums after they were removed.

Then-President Bouman marveled that a "'reputable' association," the American Academy of Pediatrics, threatened to oppose SOC-8 if it kept age minimums, calling its demands "so thin on scientific evidence." A WPATH member called it "frustrating to have politics in our brains as we make these decisions."

When it commissioned an external review to guide SOC-8, WPATH conditioned publication on the data "advancing transgender health in a positive manner" and refused to publish the final report after researchers found "little to no evidence" for medical transitions in children and adolescents, the complaint says, quoting WPATH and the researchers. 

A youth gender-affirming care study that "formed the evidence base of SOC-8" documented two suicides, but those weren't mentioned in SOC-8, the complaint says. The author of that study, future president of WPATH's U.S. affiliate Johanna Olson-Kennedy, is one of the doctors being sued by a detransitioner.

WPATH's opposition to the FTC's motion to dismiss, before Judge Boasberg, emphasizes its guidelines are "protected activities on matters of public concern," yet the FTC retaliated through a sweeping "civil investigative demand" and then filed suit when Boasberg issued a preliminary injunction against the CID. (He refused to block the Texas suit, though.)

Like many governments in First Amendment retaliation cases, including Colorado in the talk-therapy case now cited approvingly by WPATH, the FTC alleges WPATH's suit is moot because the agency withdrew the CID following Boasberg's injunction.

But the FTC hasn't shown "it will not simply reinstitute these same challenged acts if its gambit in Texas fails," WPATH said. "The FTC has followed this same playbook before to try to avoid a ruling on the merits that it has abused its investigatory powers to silence organizations that it disagrees with." 

The filing omits any mention that WPATH's guidelines are just opinions – the basis for its motion to dismiss the FTC's Texas case – except in one vague allusion. 

"The government is presumed to be acting unconstitutionally when enforcing laws against speech if 'the specific motivating ideology or the opinion or perspective of the speaker is the rationale for the [enforcement],'" it said, quoting a 9th Circuit ruling from 2022.