transgender health group now says its guidelines for treating youth are only 'opinions' in 'intense debate'
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wpath describes itself as a non-profit "dedicated to promoting science-based medical care, education, research and public policy in transgender health."
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critics are alleging the american transgender health organization whose guidelines form the basis of canadian gender care policies has made a significant shift amid a legal battle with the trump administration.
in a new legal filing, the world professional association for transgender health, or wpath, says its guidance to doctors represents one side in a field of “intense medical debate.”
in a motion to dismiss a lawsuit brought by the u.s. federal trade commission alleging the group has made deceptive claims regarding the treatment of children, wpath argues that the challenged statements in its influential standards of care are not presented as “bare assertions of fact but rather opinions” based on the scientific studies cited.
the group’s scientific opinions are “non-actionable” and are protected by the first amendment, and doctors bear “independent responsibility for their own advice,” wpath’s legal filing reads.
critics are calling the arguments a “remarkable humbling in attitude.”
“wpath now agrees that pediatric transgender medicine is marked by ‘medical and scientific uncertainty,'” the society for evidence-based gender medicine (segm), a group concerned with low-evidenced interventions that has been accused of being anti-trans by transgender rights advocates, said in a viral post on x.
“yet for years, wpath presented its guidelines as an unquestionable medical standard of care. the social and scientific costs of questioning their recommendations were steep and could be career-ending,” segm said.
“parents have been told that the wpath approach is not optional, but medically necessary and lifesaving,” posted leor sapir, a senior fellow at the manhattan institute for policy research and co-author of a controversial trump administration report on the treatment of pediatric gender dysphoria.
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wpath “has aggressively promoted that approach, including by suppressing and stigmatizing alternatives,” sapir wrote on x.
“i think it’s disingenuous at best for wpath to now frame its recommendations as merely one opinion in a legitimate debate.”
the chair of the federal trade commission, andrew ferguson, responded on x that wpath “went to great lengths to convince insurance companies, doctors and parents that its standard of care was the ‘settled science.’ and now it’s claiming that the standard of care is worth no more than a student essay in a high school newspaper.”
wpath did not provide a comment to national post before deadline. in a statement to the trans news site assigned media, wpath said critics are taking a literal and narrow interpretation of opinion.
“segm’s characterization of wpath’s legal position is a clear misrepresentation of an established legal distinction by the courts,” the statement said. the organization added that its dedication to its mission and the patient population served “remains unwavering.”
the influential association describes itself as a non-profit “dedicated to promoting science-based medical care, education, research and public policy in transgender health.”
it publishes and updates the standards of care, which wpath says “articulate a professional consensus about the psychiatric, psychological, medical and surgical management of transgender people.”
initially developed in 1979, the most recent version of soc — known as soc-8 — was published in 2012 and has been signed by more than 100 co-authors. most of what is known as gender-affirming care provided in canada has been done in alignment with wpath recommendations. the canadian paediatric society refers to soc-8 in its position statement supporting an affirming approach to care.
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soc-8’s recommendations are “internationally accepted” standards of care, soc-8 reads. a new chapter dedicated to adolescents states the “medical necessity of treatment and care is clearly recognized for the many people who experience dissonance between their sex assigned at birth and their gender identity.”
doctors may choose to depart from wpath’s guidance due to a patient’s “unique anatomic, social or psychological situation,” a research study or other reasons, the guidance reads. however, “these departures should be recognized as such, explained to the patient and documented for quality patient care and legal protection.”
in their lawsuit, the ftc and four american states allege wpath has made “false, misleading or unsubstantiated” statements about the necessity, effectiveness and safety of puberty blockers, hormones and sex-change surgeries.
wpath is seeking to have the complaint quashed. the “core deceptive statements” don’t appear in soc-8 and have been paraphrased from other quotes the group bases on citations in published research, according to wpath’s legal filing. the plaintiffs “fail to allege a single deceptive statement by wpath, much less a statement to consumers.”
the alleged deceptive statements are “non-actionable opinions about subjects on which there is ‘medical and scientific uncertainty,'” the motion reads, citing language used in a recent u.s. supreme court ruling upholding tennessee’s ban prohibiting the prescribing of puberty blockers or hormones to minors. “soc-8 does not tell doctors what to say, much less how to mislead.”<
wpath said its guidelines are intended to be "flexible," don’t promote a “one-size-fits-all” approach and recognize that transgender patients "may need to undergo all, some or none of these interventions." the group alleges the lawsuit is aimed at preventing the organization from publishing materials “developed through a collaborative process with clinicians and providers regarding transgender healthcare for adolescents.”
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“that transgender healthcare is an area of intense medical debate does not entitle plaintiffs to prevent individuals and organizations like wpath from free speech aimed at contributing to that debate,” their motion to dismiss reads.
"many governments and organizations, including new zealand, canada, some u.s. states and the american academy of pediatrics, agree that the evidence supports soc-8," wpath said.
“plaintiffs seek to brand one side of scientific debate as ‘deceptive’ without even considering the science.”
two major reviews by canadian researchers published last year found the evidence is of such low certainty, it’s impossible to say whether the use of puberty blockers and cross-sex hormones in children and teens help or harm.
wpath acknowledges in its motion that the group is on one side of the gender care debate, while others — notably british pediatrician hilary cass, whose four-year review found gender-affirming care is built on remarkably weak and “shaky” foundations — fall on the other “and disagree with how to, or if one should, provide transgender healthcare to adolescents.”
the ftc and fellow plaintiffs are “attempting to insert themselves in the middle of this medical debate and silence those with whom they disagree.”
yet segm said that “for 10+ years doctors have been told wpath’s is the only way.”
wpath’s most recent version of standards of care drew criticism for removing recommended minimum ages for hormones and surgery.
others have responded on social media that medical guidelines always reflect the opinions of the assembled experts tasked with making recommendations.
“all clinical guideline recommendations are evidence informed, but opinion based,” university of toronto professor of medicine dr. laura targownik posted on x.
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“the guidelines for hypertension, for diabetes, for crohn’s disease. pick a disease, pick a clinical scenario, pick a preventative health issue,” targownik said.
“an ‘opinion’ in this context does not imply ill-considered loose thoughts or brain droppings, but specifically refers to a genuinely subjective judgment that cannot be proven true or false and thus cannot be sanctioned merely because the government disagree with it,” targonwik added on substack.
however, a legitimate debate is to be had over whether wpath’s opinions are supported by the evidence, targownik said.
several european countries have tightened requirements in recent years under which a child can be prescribed puberty suppressing drugs. the u.k two years ago imposed an indefinite ban on puberty blockers for the treatment of gender dysphoria for under 18s two years ago, after independent expert advice found the drugs pose an “unacceptable safety risk.”
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