University students hold materials from the Rainbow Coats, March 8, 2023, in Morgantown, W.Va. PHOTO BY KATHLEEN BATTEN/AP PHOTO

Leaked files expose the ethical rot behind modern transgender medicine

Improvisation and disregard for informed consent have guided the standard-setters behind Canadian gender medicine

The World Professional Association for Transgender Health (WPATH) promotes its standards of care (SOC) as a lodestar for the treatment of gender dysphoria. Its devotion to the “affirmation” transition model for gender-confused children, involving rapid introduction to hormones and surgery that allegedly prevent suicide, have long dictated policy in hospitals, health authorities and medical schools, including those in Canada.

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Last week, WPATH was hit by a bombshell: the release of the “WPATH Files,” a collection of leaked internal communications between WPATH members from 2021 to 2024. The files were analyzed by Mia Hughes, a women’s rights activist, and published by investigative journalist Michael Shellenberger’s Environmental Progress.

In her summary of the 250-page report, Hughes states that “WPATH-affiliated health-care providers advocate for the destruction of healthy reproductive systems, the amputation of healthy breasts and the surgical removal of healthy genitals as the first and only line of treatment for minors and mentally ill people with gender dysphoria, eschewing any attempt to reconcile the patient with his or her birth sex.”

This, in spite of repeated admissions by WPATH health care professionals “that their practices are based on improvisation, that children cannot comprehend them and that the consent process is not ethical.” For example, one doctor shown in the WPATH files is revealed to tell colleagues in a video call that “most of the kids are nowhere in any kind of brain space to really, really, really talk about (fertility risks) in a serious way.”


Irish psychotherapist Stella O’Malley of Genspect describes the report as “a clinical medical scandal” of proportions “I don’t think anyone in history has ever seen.” Colin Wright, evolutionary biologist and publisher of the newsletter Reality’s Last Stand, accuses WPATH of conducting “a vast, troubling experiment on mentally distressed children and adults.” Graham Linehan, Irish comedy writer, but for several years now a full-time activist for biological women’s rights, says the report reveals “ethical rot and medical malpractice on an almost unimaginable scale.”

I spoke with Roy Eappen, a Montreal endocrinologist and active member of Do No Harm Medicine, an organization dedicated to “protecting health care from the disastrous consequences of identity politics.” Eappen has published op-eds in the Wall Street Journal and in the Post on the subject. His most recent commentary, “There is no medical consensus on child gender transition,” referenced the many European jurisdictions — the United Kingdom, Norway, Sweden, Finland and France — which have begun “tapping the brakes on youth gender transition.”

Eappen finds the revelations in the WPATH Files very troubling, particularly in light of the organization’s eighth and latest iteration of the standards of care (SOC8). In this version, released 2022, the ethics chapter present in earlier volumes has been removed, while a new chapter encouraging surgical solutions to meet the needs of people who identify as eunuchs has been added.

“It puzzles me why the SOC8 removes age restrictions for medicalizing children,” he told me. “The informed consent issue alone should make these treatments a non-starter.”

He sees evidence in the WPATH Files of a medical society captured by activists with an agenda, and deplores the “massive influence” WPATH has on professional organizations like the American Endocrine Society and the American Academy of Pediatrics. Eappen would like to see “all WPATH’s guidelines re-evaluated, based on new evidence and systematic reviews.”

Increasingly, Canada is looking like an outlier on this file. No reviews have been set in motion to interrogate the WPATH standards. And most Canadian media carry water for gender ideologues. In December 2017, only hours before it was scheduled to air, the CBC cancelled the broadcast of a BBC documentary, “Transgender kids: Who knows best?” in response to activists’ accusations that the documentary was “transphobic” for including arguments that children diagnosed as trans might be suffering from other treatable issues.

Specifically, activists were furious at the documentary’s respectful attention to Dr. Ken Zucker, a world authority on gender dysphoria, and former head of the gender identity clinic at Toronto’s Centre for Addiction and Mental Health. Zucker was, shamefully, fired in 2016 for activism-generated political reasons. In the film, Zucker explains his approach to gender dysphoric children as “developmentally informed therapy,” stating, “It’s an intellectual and clinical mistake to think there is only one single cause that explains all gender dysphoria.” Common sense, but anathema to the gender ideologues.

By an ironic coincidence in timing, on Feb 29, the French-language arm of the CBC, Radio-Canada — which quite often takes a far less politically correct approach to cultural issues than its English-language sister — broadcast its own critical documentary (with subtitles), “Trans express.”

Many of the problems raised in the WPATH Files were interrogated by Radio-Canada: the rapid affirmation of teenagers with known mental health issues, a rush to medical and surgical intervention, a refusal by therapists to consider parents’ concerns. It’s well worth the time of Canadians who have been overwhelmingly exposed to a happy-clappy ideological narrative rather than to sobering epidemiological evidence that cries out for prudence and “developmentally informed therapy.”

The CBC made a mistake in 2017 by caving to the activists. But so did every school board, every political party, every health association and almost every media outlet. “Trans express” notes that there has been no formal review of Quebec protocols for treating children and teens with gender dysphoria. We need an all-Canada review, and pronto. And Zucker should chair it.