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EXCLUSIVE: Here’s How A Small Band Of Pediatricians Pushed Medical Org Into Nixing Age Minimums For Sex Changes

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A handful of pediatricians who perform sex-change procedures on children led a successful pressure campaign to push a major transgender medical organization to remove age minimums for life-altering sex-change surgeries from its clinical guidance, according to emails exclusively obtained by the Daily Caller News Foundation.

Emails reveal the American Academy of Pediatrics (AAP) asked just four doctors — all of whom are considered leaders in the field of pediatric sex changes and have performed various transgender procedures — to review and provide feedback on an embargoed copy of the World Professional Association of Transgender Health’s (WPATH) clinical guidance, called the Standards of Care version 8 (SOC-8), weeks before its expected publication.

Based on the four doctors’ review, the AAP strong-armed WPATH into removing sex-change surgery age minimums from the SOC-8.

When the AAP asked the four pediatricians —Jason Rafferty, Ilana Sherer, Juanita Hodax, and Brittany Allen — to review the SOC-8 on the organization’s behalf in 2022, Rafferty, Sherer, and Allen were on the leadership team of the AAP’s Section on LGBT Health and Wellness, a group within the AAP that provides the organization with expertise and education on LGBT issues, according to an archive of its website.

The Biden-Harris administration also pressured WPATH to remove sex-change surgery age limits from their clinical guidance, according to records made public by Alabama Attorney General Steve Marshall while defending Alabama’s law restricting pediatric sex-change procedures.

In an amicus brief submitted in the upcoming Supreme Court case United States v. Skrmetti, Marshall explains that Department of Health and Human Services (HHS) Assistant Secretary for Health Rachel Levine — who is openly transgender — had unsuccessfully pressured WPATH to remove the surgical age minimums, but the pressure from the AAP “tipped the scales,” causing WPATH to remove the child sex-change surgery age minimums.

“Thanks to the Biden Administration and AAP, SOC-8 does not contain age minimums for any transitioning hormonal or surgical intervention except for one: phalloplasty, the surgical creation of a neopenis,” reads Marshall’s brief. “WPATH considers all other surgeries and interventions ‘medically necessary gender-affirming medical treatment[s] in adolescents.’”

Tipping The Scales

In August 2022, after securing an embargoed copy of WPATH’s clinical guidance, AAP state government affairs analyst Jeff Hudson asked the pediatricians to review how the guidance aligned with current AAP policy. Rafferty was the lead author of the AAP’s controversial child sex-change policy, first published in 2018, that supported the use of puberty blockers, cross-sex hormones and sex-change surgeries for minors. Reaffirmed in 2023, the AAP’s transgender policy notably excluded age minimums for drug or surgical interventions.

Hudson stressed the importance of reviewing the SOC-8 before it’s publication, noting it would have “implications” for their “existing legal arguments” as they fought state bans on child sex-change interventions in court.

“I explained our position and reasoning behind securing access to SOC-8 before its publication and WPATH agreed that the AAP and AAP chapters are leading the fight to protect access to this care at the state level and needs to be as prepared as possible,” wrote Hudson.

“There are implications for our existing legal arguments that I’ll work through with our counsel once you’ve reviewed and provided feedback.” 

Hudson requested the feedback quickly so that the AAP would have time to “formulate an advocacy strategy and media strategy” before the SOC-8’s anticipated release in September. Emails show a small group from the AAP, which included Hudson, the gender pediatricians and CEO Mark Del Monte, was given access to the embargoed guidance.   

The DCNF obtained a series of heavily redacted emails that appear to be discussions in which the gender pediatricians reviewed and commented on the embargoed draft of the SOC-8. In one heavily redacted email, Rafferty alluded to differences between the AAP’s policy and the WPATH clinical guidance, writing: “I personally continue to support the AAP’s current position over WPATH in my practice as articulated in the statement.” 

Hudson met with WPATH leadership on Sept. 5, 2022, and the following day reached out to Sherer, Rafferty, Hodax, and Allen, sending an attachment with their final “collated” comments on the SOC-8, promising to touch base with them all about “the plan moving forward.”

On Sept. 8, 2022, then-AAP president Moira Szilagyi sent a letter to WPATH letting them know the final version of the SOC-8 “raised concerns” from their clinical experts, who emails revealed to be Rafferty, Sherer, Hodax, and Allen. The AAP specifically took issue with WPATH’s inclusion of age minimums for pediatric sex-change surgery and their validation of “anti-transgender arguments.”

“AAP experts agree SOC8 lacks the evidence to justify the recommended surgery ages,” Szilagyi wrote, ending with a request that AAP subject-matter experts meet with WPATH for further discussion.

Neither Sherer, Hodax, nor Allen responded to the DCNF’s multiple requests for comment.

‘Very Junior People’

Documents released by AG Marshall detail how the AAP’s refusal to endorse the SOC-8 sent WPATH into chaos.

In response to the AAP’s letter, Scott Leibowitz, a co-lead of the SOC-8 chapter on adolescents, urgently created a task force to review the AAP’s feedback and “figure out next steps,” according to an email sent Friday, Sept. 9, 2022.

“The American Academy of Pediatrics (AAP)- a MAJOR organization in the United States that is typically very pro-transhealth/gender affirming care- voiced its opposition to the SOC8, specifically due to aspects of the Adolescent chapter. Not only did they say they would not endorse the SOC, they indicated that they would actively publicly oppose it,” wrote Leibowitz.

“Clearly, if AAP were to publicly oppose the SOC-8, it would be a major challenge for WPATH, SOC-8, and trans youth access to care in the U.S.,” Leibowitz wrote.

That same day, Jon Arcelus, one of three co-chair’s responsible for leading WPATH’s SOC-8 development team, wrote to colleagues that he did not agree with bending the knee to the AAP’s request to remove sex-change surgery age minimums. In an email, he referred to the AAP’s policy as a “one sided narrative” and said making the changes they demanded “will make a joke of our methodology” and look “weak.”

“We can’t not [sic] write a document that looks like theirs, as it has a one sided narrative, extremely biased. I will be surprised in their guidelines are used at all,” wrote Arcelus.

“I think it will not be in the benefit of our community to remove ages as an suggestion and to make any of the changes that they are recommending. This will make a joke of our methodology and will see us as weak,” he wrote.

Then-president of WPATH Walter Bouman responded to Arcelus, writing: “I have also read all the comments from the AAP and struggle to find any sound evidence-based argument(s) underpinning these. I am seriously surprised that a ‘reputable’ association as the AAP is so thin on scientific evidence.”

Arcelus wrote he was “shocked” that the comments about the SOC-8 had come from “very junior people at the AAP.”

“I was shocked to see the feedback from very junior people from AAP, my suggestion was not to make any changes,” wrote Arcelus.

Leibowitz declined to comment through a Nationwide Children’s Hospital spokesperson. Neither WPATH, Arcelus, nor Bouman responded to the DCNF’s multiple requests for comment.

‘Reached A Deal’

In the early hours of Sept. 10, 2022, Arcelus sent WPATH colleagues his comments on the AAP’s requests to change the SOC-8.

“I am including the pdf with the comments from AAP. I have gone one by one through them and add my comments […] as to why we are not going to make changes or if we are say that we are removing it,” wrote Arcelus.

“Time is a problem as we want the SOC-8 to be out for Montreal, so we need to agree tomorrow whether 1) we ignore all their comments 2) we remove the sections that I suggest or more if you feel,” Arcelus wrote.

WPATH was under pressure to resolve the dispute with the AAP quickly, as it wanted to release the SOC-8 before an upcoming scientific symposium that began Sept. 15, 2022, in Montreal, Canada.

Through a public records request, the DCNF obtained 30 hours of recordings from the private WPATH symposium, where several speakers noted the SOC-8 was published the night before the symposium began.

Around midday on Sept. 10, 2022, Arcelus sent Hudson an email titled “Last version with changes.” The email included an attachment titled “SOC8 Final edit as agreed with adolescent chapter,” informing Hudson that WPATH had removed the age minimums from the SOC-8 as “agreed” upon and asking for the AAP’s endorsement.

“Thank you very much for today’s meeting and the support through this process. We have just finished our meeting and we have agreed to remove the ages and to add the sentence we agreed,” wrote Arcelus. “I hope that by doing this AAP will be able to endorse the SOC8 or at least to support it.”

Hudson forwarded the email to Rafferty, Sherer, Allen, Hodax and Mark Del Monte, asking: “Do you approve of these changes?”

“I think these changes are sufficient so that we would not need to oppose SOC8,” Rafferty responded, adding he didn’t see anything that “explicitly or directly contradicts or opposes our policies.”

“For us all, I think it is important to recognize that the [policy statement] is still our official policy even after SOC8 is released. These changes allow SOC8, especially the recommendations themselves, to at least be aligned with the [policy statement] without anything that explicitly or directly contradicts or opposes our policies,” wrote Rafferty.

Later that afternoon, Eli Coleman reported to his colleagues that the AAP was “satisfied with the proposed changes” and that the group was ready to provide a statement in support of WPATH. 

One person on the WPATH email chain, whose name was redacted, wrote: “May I thank each and all of you for the tremendous effort you made to reach a deal with the AAP and to allow the SOC 8 to be published.”

‘So Much More’

Rafferty played a critical role in the development of the AAP’s child sex-change policy, which has no age minimums for sex-change surgery and refers to puberty blockers as “reversible treatments.”

The DCNF obtained an email written by Rafferty in June 2022 responding to a series of questions from the powerful D.C.-based Covington and Burling law firm, which represents the AAP in litigation seeking to overturn Alabama’s ban on pediatric sex-change, about the appropriateness of pediatric sex-change.

“We recently reviewed a lengthy article in the New York Times Magazine entitled ‘The Battle Over Gender Therapy’ […]. Given the prominence of the NY Times and the tenor of the article, which raises many questions about the appropriateness of gender-affirming care, we expect the article may be cited in support of bans on gender affirming care,” the law firm wrote. “Below we’ve listed some points from the article which may be used to support such bans or to challenge our amicus briefs, and some questions from our team.”

Despite the AAP’s push to remove age minimums from the WPATH SOC-8, Rafferty, when referring to gender exploration, told the law firm that some youth “try it out” without needing intervention.

“Do some youth ‘try it out’ – Yes, as children grow up gender exploration is a NORMAL part of development and understanding the society roles [sic] around them. Exploring one’s gender does not mean that any intervention is necessary aside from support and assuring their safety,” wrote Rafferty.

Unmentioned Risks

In his response to the law firm’s questions, Rafferty described how puberty blockers can cause sterility in children and admitted there were no studies evaluating whether puberty suppression leads to sexual dysfunction.

“Long story short, if you start blockers early in puberty before the eggs or cells that give rise to sperm mature (essentially before someone starts to menstruate or ejaculate), then later go directly on directly to cross sex hormone, then you never allow the maturation to occur and will essentially be sterile,” wrote Rafferty.

Rafferty further explained that while patients who’ve received sex-change interventions may have physical limitations in the mechanics of sexual intercourse, the experience of being sexually intimate in their “chosen” sex was “worth so much more to them.”

“Sexual dysfunction: As far as I know there is no study that looks at this, and frankly it would be a difficult study to do,” wrote Rafferty.

“The mechanics of an ‘internal orgasm’ and pleasure are quite different than penile erection, climax, and release of semen,” Rafferty wrote. “A fundamental point, however, is that for many people who are trans female, penile stimulation and external orgasm may actually be quite dysphoric and lead to an aversion or avoidance of sexual activity. I see this commonly in my practice. In adults post-op, I commonly hear that while there may be limitations, the ability to experience intimacy with a partner in a way that is affirming, or simply to be naked and comfortable in one’s body around another person, is worth so much more to them. I know this is not “a study” but it is the experience so many patients have shared with me.”

Puberty blockers stop the maturation process of the reproductive organs, leaving boys with a small penis and lacking the penile tissue needed for vaginoplasty — a sex change surgery that uses genital tissue to create an imitation vagina for men. Rafferty discussed this in his email to the law firm.

“I will also say that a risk you do not mention for trans females who start on blockers early in puberty is that there may not be enough penile tissue to do an inversion and achieve a full depth vaginal cavity. They may take tissue from the GI track or elsewhere to try to extend the cavity but that has led to complications (e.g. GI tissue tends to secrete a lot of mucous and foul odor),” wrote Rafferty.

Rafferty also noted there had been an increase in “top surgery” among teenagers, which he attributed to Medicaid coverage making the surgeries more accessible.

“Today, we have 3 surgeons in [Rhode Island] doing these surgeries and probably half a dozen in [Massachusetts] plus a pediatric plastic surgeon at Boston Children’s specializing in gender surgeries. Most if not all now take Medicaid – very few patients are paying the fully cost of surgery out of pocket. So, the point is that my experience is not that surgery is ‘more popular’ but just more (or simply just) accessible.”

Rafferty did not respond to multiple requests for comment.

Pursuit Of Excellence 

On September 15, 2022, WPATH released the SOC-8 without age minimums for child sex-change surgery. Upon its release, Hudson sent an internal memo with the AAP’s statement on the SOC-8, which included a FAQ about the AAP’s policy positions. The FAQ included the question, “What is the AAP’s position on the leaked recommendations on surgeries for minors?” The document gave the following answer: “AAP does not recommend surgical interventions for individuals younger than 18, except in rare cases.”

In December 2022, Jeff Hudson was awarded a Pursuit of Excellence award from the AAP for his work on behalf of “trans” youth, according to a LinkedIn post.

“I am extremely honored to have been awarded the AAP Pursuit of Excellence award for my work on behalf of trans and gender diverse youth,” Hudson wrote in the post.

The AAP previously provided the DCNF with a statement that confirmed their partnership with WPATH but explained that the AAP and peer organizations “develop policy guidance independently.”

“The American Academy of Pediatrics (AAP) routinely partners with relevant U.S. medical and mental health associations and global health organizations on a wide range of health issues, including the World Professional Association of Transgender Health (WPATH),” an AAP spokesperson told the DCNF.

“While this collaboration is important, the AAP develops policy guidance independently, as do its peer organizations.”

The American Academy of Pediatrics and Jeff Hudson did not respond to multiple requests for comment.

AUTHOR

Megan Brock

Contributor

RELATED ARTICLES:

‘Social Justice Lawyers’ Told WPATH To Avoid ‘Evidence-Based Review’ Of Sex-Change Guidelines For Minors, Docs Reveal

THE WPATH TAPES: Behind-The-Scenes Recordings Reveal What Top Gender Doctors Really Think About Sex Change Procedures

EXCLUSIVE: Top Pediatric Org Quietly Colluded With Trans Ideologues To Push Child

EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

‘True Conspiracy’: Gender Activists’ Entire Litigation Strategy Looks Like It’s Starting To Crumble

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The purportedly “evidence-based” medical standards that helped score gender activists a few short-term legal victories may soon be their undoing.

Internal communications contained in unsealed documents from an Alabama lawsuit, along with prior leaks and a four-year review of transgender medical studies, have exposed the oft-cited standards published by go-to authority for gender medicine, the World Professional Association for Transgender Health’s (WPATH), as being driven by political and activist agendas rather than scientific evidence about what’s best for patients.

As evidence undermining WPATH’s standards mounts, those working closely on litigation against transgender activist groups believe it will prove too much for courts to overlook.

“We now understand it is not legitimate science dictating the standards of care, but a true conspiracy involving non-medical personnel [who] are activists for transgender agenda,” Alabama Attorney General Steve Marshall told the Daily Caller News Foundation during an interview.

Documents recently unsealed in a case challenging Alabama’s law banning child sex change procedures revealed the reality behind WPATH’s Standards of Care Version 8 (SoC 8) guidelines — not only was there no internal consensus, but the recommendations were apparently not evidence-based despite being advertised as such.

Marshall told the DCNF it was at one point an “effective” strategy to be able to point to medical organizations, like WPATH. Now that strategy appears to be falling apart.

“One of the things litigation has done is bring transparency to what many have contended for a long time, which is that we are engaging in experimentation on kids,” Marshall said. “The idea of informed consent doesn’t exist around the concept of gender affirming care.”

“Gender-affirming care” is a euphemism often used by activists that refers to medical interventions, including life-altering and potentially harmful ones such as cross-sex hormones, puberty blockers and genital surgeries.

WPATH defended the guidelines in a statement to the DCNF, but said it is not a party to the lawsuits and would not comment on the ongoing litigation.

“WPATH could not and did not prohibit the evidence-based review team from publishing,” the group said in a statement. “Furthermore, SOCv8 is evidence-based – and while WPATH is not a party to the Alabama case (or any other case), we are confident the legal process will confirm the quality of SOCv8 and the process through which it was developed.”

‘Political Pressure’

WPATH claims its SOC8 are “evidence-based standards for safe and effective gender affirming health care and represent the most expert, in-depth, and evidence-based and consensus-based guidelines internationally.”

But court documents revealed how WPATH suppressed the publication of evidence reviews that undermined their recommendations, or chose not to seek them at all so they could avoid reporting the results. WPATH’s decision was driven, at least in part, by “social justice lawyers” who suggested evidence-based reviews would put them “in an untenable position in terms of affecting policy or winning lawsuits.”

In an expert report submitted in the case, Canadian sex researcher James Cantor wrote that WPATH viewed “evidence-based” medicine as a threat to its “policy goals” and allowed its guidelines to be influenced by “political pressure, litigation and legislative advocacy strategy, and the financial self-interest of WPATH members.” Internal communications included in Cantor’s report show members of WPATH’s Guideline Development Group acknowledged there was “no consensus” on the use of puberty blockers.

WPATH also appeared to cave to political pressure from the Biden administration.

Assistant Secretary for Health Rachel Levine was “very eager” for the release of SOC 8 to “ensure integration in the US health policies of the Biden government,” according to internal communications included in the court documents. Levine’s pressure also prompted WPATH to remove minimum age recommendations, documents show.

When WPATH released SOC 8 in September 2022, it removed age limits for procedures like cross-sex hormones and surgeries.

‘Weak Evidence’

Opponents to state child sex change bans have cited WPATH’s guidelines to support their legal challenges, and some judges have similarly done so in rulings favoring activists.

In June, District Court Judge Robert Hinkle, a Clinton-appointee, struck down Florida’s law banning transgender procedures for minors, pointing to two “well-established standards of care for treatment of gender dysphoria” published by the Endocrine Society and WPATH.

“Gender identity is real,” Hinkle wrote. “Those whose gender identity does not match their natal sex often suffer gender dysphoria. The widely accepted standard of care calls for appropriate evaluation and treatment.”

Likewise, the Biden administration often cites WPATH guidelines in court filings challenging state pediatric sex change bans, including in its challenge to Tennessee’s law banning child sex changes, United States v. Skrmetti, which the Supreme Court recently agreed to hear. The case considers whether bans like Tennessee’s and Alabama’s, which have been passed in 25 states, violate the Equal Protection Clause of the Fourteenth Amendment.

In its petition for certiorari, the Biden administration claimed that “overwhelming evidence establishes that appropriate gender-affirming treatment with puberty blockers and hormones directly and substantially improves the physical and psychological wellbeing of transgender adolescents with gender dysphoria.”

In April, however, a comprehensive review commissioned by the National Health Service (NHS) England and conducted by Dr. Hilary Cass found “weak evidence” for offering puberty blockers to children, raising crucial questions about WPATH’s guidance. The review also found “no clear evidence that social transition in childhood has any positive or negative mental health outcomes.”

Separately, video footage of a closed-door WPATH education session obtained by the DCNF shows Dr. Gail Knudson, co-chair of WPATH’s Education Institute, admitting a systemic review commissioned by the group found the “strength of significance was low” when measuring if “gender hormone therapy” improved mental health outcomes. However, WPATH’s guidelines cite this study as “strong evidence” for “gender-affirming care” improving outcomes for trans patients.

‘Damage Control’

After the Supreme Court agreed to hear the case out of Tennessee, the DOJ moved to halt proceedings in the Alabama case pending the ruling.

Alabama accused the federal government of trying to shield information about the administration’s involvement in developing the WPATH standards from reaching the justices. Marshall’s office wrote that “the Supreme Court deserves to know the full story, but the United States seems intent on telling just a piece of it.”

Given what documents revealed in the case, they argued “it is no wonder the United States rushed to the Supreme Court with a case without a robust evidentiary record—and then immediately tried to shut this case down.”

A district court judge agreed to pause proceedings in Alabama’s case early July.

“There’s no doubt that there is an effort to engage in damage control by trying to stop the facilitation of the release of other records,” Marshall told the DCNF.

Alliance Defending Freedom senior counsel Roger Brooks said the revelations about WPATH likely would influence United States v. Skrmetti, though the documents are not yet in the formal record.

“I have no doubt that the most important revelations from the WPATH internal emails will be called to the Supreme Court’s attention through one or more Amicus briefs as well as more generally through media coverage,” Brooks told the DCNF, noting it would be “entirely appropriate for the State of Tennessee itself to call the Court’s attention to these internal emails, if only in footnotes.”

‘A Duty Of Care’

The WPATH revelations could also fuel offensive litigation pushing back on gender activists, bolstering malpractice lawsuits against doctors who offer such procedures to children and even exposing the associations pushing the guidelines to legal consequences.

Brooks said the erosion of WPATH’s credibility “will have very serious implications on future malpractice claims based on surgeries or prescriptions inflicted on minors now and in the future.”

“No longer can any doctor credibly defend him or herself by saying ‘Well, I was just relying on the widely accepted WPATH Standard of Care,’” he told the DCNF.

Josh Payne, who co-founded the firm Campbell Miller Payne to provide legal representation for detransitioners, likewise told the DCNF the revelation that activists influenced the development of WPATH’s recommendations “are relevant to the medical malpractice cases brought on behalf of detransitioners.”

One of Payne’s clients, Prisha Mosley, is suing the healthcare professionals that started her on a course towards medical transitioning at just 16 years old, offering her testosterone injections at 17 years old and the removal of her breasts at 18 years old.

Another detransitioner client of Payne’s firm, Isabelle Ayala, sued the doctors who pushed her towards transitioning as a teenager, along with the the American Academy of Pediatrics (AAP), which published a “policy statement” authored by those same doctors backing the “gender-affirming” treatment model used on her.

AAP members plotted ways to circumvent state laws banning child sex changes, including Tennessee’s, emails obtained by the DCNF in June revealed.

Ayala’s lawsuit alleges individuals, like Dr. Jason Rafferty and Dr. Michelle Forcier, tested their “no-questions-asked ‘affirming’” approach on patients like her.

“At the most fundamental level, medical professionals owe a duty of care to their patients,” Payne told the DCNF. “The recently unsealed documents show that members of the healthcare community knew, or should have known, that the drugs and procedures they were prescribing were not supported by sufficient evidence. Failing to disclose that lack of evidence to patients, and prescribing those drugs and procedures anyway, is a breach of the duty of care owed to patients.”

Though Alabama can’t move forward at this point with more discovery, Marshall said he hopes other states engaging in litigation will explore paths to expose other medical associations pushing the transgender agenda.

“Just as we’ve been able to shine the light on WPATH, similarly, I think we’ll see records that are equally disturbing of medical organizations in our country — who I want to believe were trying to look out for kids — but instead, either were willfully ignorant of what was going on, or had their own agenda that was driven by money, which I think is another factor here that people aren’t talking about enough, or their own personal philosophy, ” he said.

AUTHOR

Katelynn Richardson

Contributor.

RELATED ARTICLES:

THE WPATH TAPES: Behind-The-Scenes Recordings Reveal What Top Gender Doctors Really Think About Sex Change Procedures

‘Social Justice Lawyers’ Told WPATH To Avoid ‘Evidence-Based Review’ Of Sex-Change Guidelines For Minors, Docs Reveal

EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

Trans Activist Group Pressuring Corporations To Cover Child Sex Change Drugs In Insurance Plans

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A transgender activist group is pressuring corporations to provide insurance coverage for child sex change drugs and genital surgeries.

The Humans Rights Campaign (HRC) is an LGBTQ+ activist group that champions pediatric sex change interventions such as puberty blockers, cross-sex hormones and sex change surgeries. Since 2002, the HRC has issued their Corporate Equality Index (CEI) survey, which scores corporations based on their commitment to LGBTQ+ activism and adherence to LGBTQ+ ideology; corporations can score up to 100 points if they fulfill all criteria outlined by the HRC.

The HRC claims the benefits of participating in the CEI survey include gaining positive publicity and attracting top talent, noting that the majority of Fortune 500 companies have participated in the survey. Conversely, receiving a low CEI score can make a company a target of media criticism.

However, HRC recently announced they will be updating their 2026 CEI criteria to require corporations offer insurance coverage for child sex change medications to obtain a top CEI score.

The updated criteria state corporations must offer pharmaceutical coverage for sex changes, specifying this includes “puberty blockers for youth.” Corporations will also have to provide insurance coverage for cross-sex hormones and genital surgeries, as well as offer short-term medical leave to transgender individuals.

Additionally, companies can score 10 of the needed 100 points by offering insurance coverage for at least five other transgender healthcare benefits described as “essential services and treatments.” This list of “essential” services includes hair removal required for reconstructive surgery, tracheal shave/reduction, facial feminization surgeries, voice modification surgery, voice modification therapy and lipoplasty/filling for body masculinization or feminization.

HRC has suspended the CEI score of companies they’ve perceived as faltering in their support of the LGBTQ+ agenda. For example, when Bud Light received pushback over their partnership with transgender activist Dylan Mulvaney, HRC suspended Anheuser-Busch’s perfect CEI score for not standing by Mulvaney during the controversy, according to the Associated Press.

They’ve also publicly chastised companies attempting to distance themselves from the index.

For instance, Tractor Supply Company, who obtained an almost-perfect CEI score in 2023, recently faced public criticism for engaging in LGBTQ+ activism. After receiving significant pushback, Tractor Supply Company issued a public statement on June 27, 2024, suggesting they were ending their relationship with the HRC and would not be participating in the survey.

HRC responded by launching a petition against Tractor Supply Company which was posted their social media pages and accused the company of “caving to right-wing extremists.”

“Tractor Supply is turning its back on its own neighbors, including LGBTQ+ people, by caving to far-right extremists on social media,” the petition stated. “Tractor Supply’s decision to no longer participate in the Human Rights Campaign Foundation’s Corporate Equality Index, halt its Diversity, Equity and Inclusion efforts, and desert its carbon emissions goals is only going to hurt customers and families in the communities they call home.”

The CEI is related to the trend of environmental, social, and governance (ESG) investing, a movement that evaluates companies as targets for investment based on how they align with certain left-wing ideas. Companies with low ESG ratings can be viewed as riskier investments by ESG investors.

In fact, the ESG reports of several Fortune 500 companies such as Walmart, Amazon, and Disney explicitly cite the HRC’s index, and the companies’ respective scores. Two major investment firms, Blackrock and Vanguard, obtained perfect CEI scores in 2023.

If companies want to remain appealing to investors by obtaining a perfect CEI in 2026, they will be required to cover insurance coverage for pediatric sex change medications, such as puberty blockers.

Puberty blockers, which are given to children as young as eight years old, can have irreversible effects such as infertility, bone density loss and disruption of brain development.

The harmful impacts of puberty blockers were acknowledged by top child sex change doctors in a series of private educational recordings hosted by the World Professional Association of Transgender Health (WPATH). The recordings were part of WPATH’s Global Education summit in September 2022 in Montreal, Canada, and exclusively obtained by the Daily Caller News Foundation through a public records request.

Several European countries, including England and Scotland, have discontinued treating gender distressed children with puberty blockers citing weak evidence to support their use.

In 2023-2024, 1,384 companies participated in the HRC’s Corporate Equality Index with 595 businesses earning a perfect score by meeting all criteria, according to the “Equality 100” page.”

The HRC recently completed their 2025 CEI survey, according to a copy of the survey on their website. To achieve a perfect score, companies had to have written policies that support employee sex changes, support trans-inclusive restrooms and facilities and offer LGBTQ-inclusive products and services.

The HRC has established LGBTQ+ activism criteria for other domains, including the Healthcare Equality Index, State Equality Index, and Municipal Equality Index.

The Human Rights Campaign did not respond to requests for comment.

AUTHOR

MEGAN BROCK

Contributor.

RELATED ARTICLES:

THE WPATH TAPES: Behind-The-Scenes Recordings Reveal What Top Gender Doctors Really Think About Sex Change Procedures

Top Psychiatrist Argues Schizophrenic Patients Can Consent To Sex Change Surgeries

House Votes to Overturn Biden’s Transgender Title IX Rewrite

EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

Unsealed Court Docs Show Top Gender Medical Org Twisting Science For Politics, Colluding With Biden Admin Official

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A Biden administration official pressured the World Professional Association for Transgender Health (WPATH) to quickly issue its Standards of Care Version 8 (SoC 8) guidelines and remove minimum age recommendations for transgender procedures, despite a glaring lack of scientific justification, according to unsealed court documents.

Canadian sex researcher James Cantor wrote in an unsealed expert report that WPATH saw “evidence-based” medicine as a threat to its “policy goals,” allowing its S0C-8 to be influenced by “political pressure, litigation and legislative advocacy strategy, and the financial self-interest of WPATH members.” Internal WPATH communications contained in Cantor’s report reveal Assistant Secretary for Health Rachel Levine pushed for the development of SoC 8 in order to advance the Biden administration’s political goals, even having a staff member suggest the removal of “specific listings of ages” that could “result in devastating legislation for trans care.”

“I have just spoken to Admiral Levine today, who—as always is extremely supportive of the SOC 8, but also very eager for its release—so to ensure integration in the US health policies of the Biden government,” one message from a WPATH member states. “So, let’s crack on with the job!!!”

Another message stated Levine’s eagerness “should be taken as a charge from the United States government to do what is required to complete the project immediately.”

Despite these concessions, internal communications show certain WPATH members responsible for developing the guidelines agreed with concerns that youth were receiving “sloppy” medical care and worried about the strength of their evidence. Additionally, members recognized privately there is “no agreement” on the use of puberty blockers.

“I’m not clear on which ‘agreement regarding the value of blockers’ is required to be espoused by a WPATH member/mentor,” one message states. “My understanding is that a global consensus on ‘puberty blockers’ does not exist.”

Cantor further claims that WPATH did not ask SoC-8 committee members to identify conflicts of interest, even though some members worked as paid expert witnesses in legal cases relating to transgender procedures.

Moreover, one member of the development group later explained during WPATH’s annual conference that minimum age recommendations were removed “to protect clinicians from lawsuit should the clinician decide to provide a treatment to someone younger than a specified age minimum.”

“Again, this reflects both the existence and the harmful impact of the financial conflict of interest that WPATH and its members faced while developing SOC-8,” Cantor wrote.

Cantor’s report is part of a case, Boe v. Marshall, challenging Alabama’s ban on sex change procedures for minors. WPATH released its SoC 8 in September 2022, rolling back prior recommendations that set age limits for various procedures.

The White House, the HHS and WPATH did not immediately respond to requests for comment.

AUTHOR

KATELYNN RICHARDSON

Contributor.

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EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

THE WPATH TAPES: Behind-The-Scenes Recordings Reveal What Top Gender Doctors Really Think About Sex Change Procedures

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The World Professional Association for Transgender Health (WPATH) is the leading authority in the field of gender medicine. Its guidance is routinely used by top medical associations in the U.S. and abroad, while its standards of care inform insurance companies’ approach to coverage policies.

But behind closed doors, top WPATH doctors discussed, and at times seemed to challenge, the organization’s own published guidelines for sex change procedures and acknowledged pushing experimental medical interventions that can have devastating and irreversible complications, according to exclusive footage obtained by the Daily Caller News Foundation.

WPATH published highly influential clinical guidance called “Standards of Care for the Health of Transgender and Gender Diverse People, Version 8” (SOC 8), which recommends the use of invasive medical interventions such as puberty blockers, cross-sex hormones and sex change surgeries, calling them “safe and effective.”

The DCNF filed a series of public records requests to WPATH SOC 8 co-authors who are employed at taxpayer-funded institutions, making their emails subject to open records laws. Buried in more than 100 pages of responsive records from the University of Nevada was a series of emails between prominent WPATH members and leaders, including WPATH Global Education Institute (GEI) Co-Chair Gail Knudson, that were sent in 2022. In one email, Knudson sent a colleague the link to a folder containing nearly 30 hours of recordings from WPATH’s GEI summit in September 2022 in Montreal, Canada, which included sessions on mental health, puberty blockers, cross-sex hormones and sex change surgery.

These sessions provided WPATH members with in-depth education on the clinical application of topics addressed in the SOC 8 treatment guidelines. However, the footage reveals WPATH-affiliated doctors advocating for children to undergo risky sex change procedures and even pushing for these treatments for patients struggling with severe mental health issues. Several sessions were dedicated exclusively to treating children and included recommendations for minors to receive puberty blockers, cross-sex hormones and surgeries.

For instance, WPATH guidance recommends addressing a patient’s mental health issues before giving them sex change medical interventions. However, in one recorded session, a WPATH faculty member and gender doctor claimed that mental health issues don’t necessarily affect a patient’s ability to receive cross-sex hormones.

READ: Top Psychiatrist Argues Schizophrenic Patients Can Consent To Sex Change Surgeries

In another video, a doctor told attendees children should be informed that cross-sex hormones will likely make them infertile but admitted that he will prescribe them anyway if a child says they want the treatment, regardless of the future consequences.

READ: ‘No Idea About Their Fertility’: Gender Doctors Shed Light On Grim Reality Facing Kids Considering Sex Changes

A surgeon euphemistically referred to a phalloplasty procedure, a surgical series that includes obliterating the vaginal cavity and creating a fake penis with harvested tissue, as an “adventure” for young people. He did this despite later admitting that those same procedures will “definitely” have “complications,” such as permanent issues with bladder function and tissue death.

READ: Gender Doctor Calls Genital Surgery An ‘Adventure’ For Young People While Describing Grisly Complications

One physician called the entire field of cross-sex hormones “off-label,” referring to the concept of drugs being used for alternative purposes than what they were approved for. The doctor went on to say that female patients might actually appreciate drug side effects that cause them to lose hair, because they’d look “more like men.”

READ: Video Shows Prominent Doctors Acknowledging, And Even Challenging, The Experimental Nature Of Sex Change Drugs

The Food and Drug Administration says that when it approves a drug, healthcare providers generally may prescribe that drug for an unapproved use, or off-label, when “they judge that it is medically appropriate for their patient.”

In several other videos, doctors argued in favor of transitioning patients who experience psychotic episodes. One admitted that some of his patients with schizophrenia have to be careful how much cross-sex hormones they take or they can’t “keep the voices down.”

READ: ‘Keep The Voices Down’: In Unearthed Video, Doctors Discuss Putting Mentally Ill Patients, Including Kids, On Hormones

The DCNF consulted medical professionals from respected organizations, such as Do No Harm, who all argued that the comments from WPATH-affiliated doctors show that the transgender medical industry does not have patients’ best interests at heart.

While the average person, nationally and internationally, likely has never heard of WPATH, the modern medical industry is deeply tied to the organization and relies on it to dictate the standards of care for transgender medicine. WPATH’s guidelines are cited as criteria for obtaining insurance coverage by both private insurance companies and tax-funded insurance plans, positioning them as a lynchpin of the sex reassignment industry.

Additionally, their guidelines help inform policy statements from major medical and professional organizations, such as the American Academy of Pediatrics (AAP), the American Psychological Association and the Endocrine Society. The AAP is currently being sued by Isabelle Ayala, a former patient who was medically transitioned as a child, for allegedly rushing her through sex change medical procedures.

There’s been an explosion in the number of young people, including children, being put on hormones and puberty blockers and getting sex change surgeries, according to a study published in August 2023 by the JAMA Network. This surge has been fueled, in part, by groups like Planned Parenthood, which distributes cross-sex hormones to patients as young as 16. Planned Parenthood saw a roughly 125% jump in the number of transgender services it provided between 2020 and 2022.

Twenty-three states, however, have enacted legislation preventing doctors from performing sex change surgeries on minors amid backlash from concerned parents and doctors who don’t subscribe to the WPATH-endorsed “gender-affirming care” model. Gender-affirming care is another euphemism used by medical professionals to describe the idea that doctors should affirm a patient’s wish to live as the opposite biological sex through social transitioning, hormone therapy and even surgery.

The SOC 8 was released just days ahead of the 2022 symposium and contained several significant changes to how doctors and medical institutions implemented transgender medical treatment. For instance, WPATH removed minimum age requirements criteria that established when a child can or should receive transgender medical services such as puberty blockers, cross-sex hormones, and sex reassignment surgeries.

WPATH’s previous guidelines recommended that hormone therapy be given once a patient was over the age of 16, but the updated version removed this barrier and suggests hormone therapy begin at the first signs of sexual maturity.

The videos obtained by the DCNF give the first glimpse at how doctors and mental health professionals discussed implementing the new guidelines. To highlight the most significant portions of the content obtained in the records requests, the DCNF has decided to publish a series of articles collectively called “The WPATH Tapes.”

Following this release, the DCNF intends to publish all of the videos in their entirety in order to provide the public with necessary information about WPATH’s approach to medical care and shine a light on an influential organization that has largely remained anonymous until now.

The WPATH Tapes Table of Contents:

  1. Video Shows Prominent Doctors Acknowledging, And Even Challenging, The Experimental Nature Of Sex Change Drugs
  2. Top Psychiatrist Argues Schizophrenic Patients Can Consent To Sex Change Surgeries
  3. ‘Keep The Voices Down’: In Unearthed Video, Doctors Discuss Putting Mentally Ill Patients, Including Kids, On Hormones
  4. Gender Doctor Calls Genital Surgery An ‘Adventure’ For Young People While Describing Grisly Complications
  5. ‘No Idea About Their Fertility’: Gender Doctors Shed Light On Grim Reality Facing Kids Considering Sex Changes
  6. Leader Of Gender Medicine Org Says Binary Sex ‘Doesn’t Really Hold True,’ Cheers On ‘Deconstructed’ Biology
  7. Private Footage Reveals Leading Medical Org’s Efforts To ‘Normalize’ Gender Ideology

AUTHORS

MEGAN BROCK AND KATE ANDERSON

Contributors.

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Gender Doctor Calls Genital Surgery An ‘Adventure’ For Young People While Describing Grisly Complications

‘Keep The Voices Down’: In Unearthed Video, Doctors Discuss Putting Mentally Ill Patients, Including Kids, On Hormones

EXCLUSIVE: Top Doctors Complain Detransitioners Posed ‘Harm’ To Trans Members At Medical Conference

EXCLUSIVE: Gender Doctor Says Parents Who Oppose Transitioning Their Kid Have ‘Mental Illness’

EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

Medical Associations Silent After Review Finds ‘Weak Evidence’ For Giving Puberty Blockers To Kids

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Major medical associations have remained silent after the results of a four-year review commissioned by the National Health Service (NHS) England undermined their recommendations for giving puberty blockers to children with gender dysphoria

The Cass report, conducted by former Royal College of Pediatrics and Child Health Dr. Hilary Cass and released April 10, found that there is “weak evidence” for offering puberty blockers to children. It concluded that its findings “raise questions about the quality of currently available guidelines” offered by associations like the World Professional Association for Transgender Health (WPATH) and the Endocrine Society, yet neither organization has committed to reviewing their guidelines.

The review references a letter recommending against treating children with puberty blockers outside of a research setting. It also urged “extreme caution” for providing cross-sex hormones to minors under 18 and stressed the need for a “clear clinical rationale.”

The review further suggested a “full programme of research be established” to “look at the characteristics, interventions and outcomes of every young person presenting to the NHS gender services.”

“Although a diagnosis of gender dysphoria has been seen as necessary for initiating medical treatment, it is not reliably predictive of whether that young person will have longstanding gender incongruence in the future, or whether medical intervention will be the best option for them,” the report noted.

The American Medical Association, WPATH, American Academy of Pediatrics, American Academy of Child & Adolescent Psychiatry (AACAP) and Endocrine Society did not respond to multiple inquiries over the past week from the Daily Caller News Foundation asking whether they had concerns with the report’s findings or intended to conduct their own review. Aside from WPATH,  these organizations have largely failed to even address the report publicly.

WPATH wrote in a statement that it “supports policies that increase access to high-quality ethical care for transgender youth,” claiming that the report’s foundation is rooted in a “false premise.”

The organization’s standards of care 8th version states that waiting several years to start a young adolescent on puberty blockers “is not always practical nor necessary given the premise of the treatment as a means to buy time while avoiding distress from irreversible pubertal changes,” though it acknowledges that establishing a “sustained experience of gender incongruence” can be important before starting.

“The foundation of the Cass report is rooted in the false premise that non-medical alternatives to care will result in less adolescent distress for most adolescents and is based on a lack of knowledge of and experience working with this patient population,” the organization said in a press release. “It is harmful to perpetuate this notion and does not acknowledge the very real fact that medical pathways are an important treatment option for many young people.”

The Endocrine Society characterizes puberty blockers as a “reversible pause to puberty” and “a first step in treatment to allow the adolescent to explore their gender identity and/or to provide relief from distress.” WPATH’s guidelines likewise recommend putting adolescents on “puberty suppressing hormones” to “alleviate gender dysphoria.”

WPATH physicians acknowledged puberty blockers can cause irreversible consequences in minors like infertility, bone loss and disruption of brain development in educational sessions from September 2022 previously obtained by the Daily Caller News Foundation.

Both the AMA and AACAP recommend WPATH’s guidance for handling gender dysphoria in children. The AMA often advocates against red state laws that ban sex-change procedures for minors, including puberty blockers.

The Cass report notes “there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.”

The Cass report also questioned WPATH and the Endocrine Society on the “circularity” of their citations, which make support for their positions appear stronger than they are.

Early versions of the two organization’s guidelines influenced “nearly all” guidelines set by other organizations, the report notes. The two organization’s guidelines are also “closely interlinked” because WPATH provided input on the Endocrine Society recommendations, according to the report.

“The circularity of this approach may explain why there has been an apparent consensus on key areas of practice despite the evidence being poor,” the report stated.

AUTHOR

KATELYNN RICHARDSON

Contributor.

RELATED ARTICLE: Chicago: Leftist Muslim teaches American leftists to scream ‘Death to America’ in Farsi

EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

Advocates Say WPATH Could ‘Come Crashing Down’ As Judge Demands Treasure Trove Of Internal Documents

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The World Professional Association of Transgender Health (WPATH) is facing a potential bloodbath, advocates say, after an Alabama judge subpoenaed a treasure trove of documents from the organization as part of an ongoing lawsuit over the state’s laws on transgender treatments.

WPATH is a leading advocate of child sex changes, recently pushing to remove any minimum age requirement to undergo sex change surgeries or cross-sex hormone therapy. Amy Tishelman, the author of the “Child” chapter in the 8th edition of WPATH’s guidelines, said she changed the guidelines so doctors wouldn’t “be sued because they weren’t following exactly what we said.”

U.S. hospitals such as Johns Hopkins, Stanford and Brigham and Women’s use WPATH’s guidelines to guide their own practice of treating transgender-identifying children.

A federal judge in Alabama requested WPATH supply documents pertaining to its guidelines for child sex changes in March. Plaintiffs suing the state of Alabama over its restrictions of child sex changes repeatedly referred to WPATH’s guidelines in their argumentation.

During a similar lawsuit in Florida, a district court in March ordered WPATH, the Endocrine Society and the American Academy of Pediatrics (AAP) to comply with a subpoena of all documents related to their guidance for transgender-identified kids. An amicus brief filed April 7 on behalf of the attorneys general (AGs) for 17 states highlighted the stark contrast between transgender guidance — especially for minors — in Europe with that of the medical establishment in the U.S. The brief also claimed the medical organizations in question are activist in nature.

“I think there’s a good chance that the whole thing will come crashing down when the data are out there,” Dr. Stanley Goldfarb, board chair of the medical group Do No Harm, told The Daily Caller, “and that they really know that there’s no good scientific basis for this out there and they’re just going ahead and implementing an ideology rather than rigorously defined medical treatment.”

“The bottom line is the truth is now coming out, the writing’s on the wall,” January LittleJohn, a parental advocate, told The Daily Caller. “And the truth is coming out at that all of the times where they were relying on this garbage evidence, this very low quality evidence, they were doing these interventions on children with nothing to back it up. And then you have the American Academy of Pediatrics, the AMA, The Endocrine Society all blindly following these guidelines. And now they’re being held accountable.”

WPATH set standards of care for those with a “eunuch” gender identity in 2022, recommending castration as a treatment option. Recommended treatments options included hormone suppression, orchiectomy (removal of the testicles) to stop production of testosterone, orchiectomy with or without penectomy to alter the body to match their self-image and orchiectomy followed by hormone replacement with testosterone or estrogen. In creating these guidelines, WPATH used information from the Eunuch Archive in setting these standards of care, which the medical organization itself described as “filled with fantasy,” containing stories of child castration, pedophilia and sexual torture.

WPATH has also been accused of censoring viewpoints from doctors who believe that children are being rushed into sex changes. In Alabama, the judge asked for information related to how the WPATH treated differing medical opinions on child sex changes.

Dr. Stephen B. Levine, a psychologist known for his work on human sexuality and chair of WPATH’s standards of care committee from 1997-98, filed expert opinion in the ongoing lawsuit between WPATH and Florida in April.

“WPATH claims to speak for the medical profession; however, it does not welcome skepticism and therefore, deviates from the philosophical core of medical science,” he said. “There are pediatricians, psychiatrists, endocrinologists, and surgeons who object strongly, on professional grounds, to transitioning children and providing affirmation in a transgender identity as the first treatment option.”

“So the question is, are they allowing people that are rigorous investigators to do this?” Goldfarb told The Daily Caller. “Or are they simply taking people who have set up gender clinics, and they said, yeah, you’re an expert because you’re on our side. And that’s what needs to be clarified.”

AUTHOR

SARAH WEAVER

Social issues reporter.

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EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

White House To Host ‘Roundtable On Affirming Transgender Kids’

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The White House will host a “Roundtable on Affirming Transgender Kids” Friday as part of its observance of “Transgender Day of Visibility,” according to a fact sheet.

The roundtable is part of a push from the administration to support transgenderism, including childhood medical transitions, in the wake of numerous red states restricting the procedures. The discussion will focus on the experiences of children who identify as transgender and their parents in states that have restricted child sex changes, according to the White House.

“Over half of transgender youth say they have seriously considered suicide in the last year because of the discrimination and rejection they face. In the face of these challenges, research shows that, when transgender youth are affirmed and supported, they thrive,” the fact sheet wrote, citing no evidence for either claim.

The suicidality rates of transgender individuals are vastly exaggerated, according to experts in the field, some of whom believe that overemphasis on the suicide narrative can become a self-fulfilling prophecy that encourages young people with gender identity issues to contemplate suicide. Additionally, studies suggesting that cross-sex medical procedures improve mental health are riddled with bias, confounding variables and methodological errors, according to multiple Daily Caller News Foundation reviews.

The White House also issued what it called a “landmark report” on ways to support LGBT youth and issued new guidance for “gender identity inclusion” for public servants.

The White House did not respond to the DCNF’s request for comment.

AUTHOR

LAUREL DUGGAN

Social issues and culture reporter.

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EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.

All content created by the Daily Caller News Foundation, an independent and nonpartisan newswire service, is available without charge to any legitimate news publisher that can provide a large audience. All republished articles must include our logo, our reporter’s byline and their DCNF affiliation. For any questions about our guidelines or partnering with us, please contact licensing@dailycallernewsfoundation.org.

‘Groomed And Preyed Upon’: Young Woman Was Pressured Into Mastectomy, Testosterone As A Child — Now She Regrets It

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  • Luka, a 20-year-old woman who began identifying as transgender in adolescence, now regrets taking cross-sex hormones and having a double mastectomy at 16; she says doctors pressured her into medically transitioning. 
  • Her story is a microcosm of what’s happening across the U.S.: thousands of teen girls are undergoing irreversible biomedical interventions to resolve gender identity issues they would likely outgrow on their own, experts say, and doctors are encouraging the medicalization of these minors despite health risks the treatments present. 
  • “My parents were told the same thing so many other parents in these situations are told, ‘Would you rather have a dead daughter or a living son?’ despite the fact that, no matter all my mental health struggles, I had never been suicidal,” Luka told the Daily Caller News Foundation.

Luka was 15 when she was first encouraged by her therapist to come out as transgender while she was hospitalized for mental health issues. A surgeon removed her breasts when she was 16 in a “gender-affirming” double mastectomy, and she went on cross-sex hormones soon after, which permanently changed her face, body and voice.

At 20 years old, Luka now regrets listening to doctors and medical professionals, whom she says misled and manipulated her into undergoing irreversible medical procedures.

“There was no stopping to question if this was the right way to deal with the discomfort I was feeling around my body,” Luka told the Daily Caller News Foundation.

At no point did doctors inform Luka that there were ways to resolve her mental health problems besides transitioning, which she now believes would have been enough to prevent her from going through with the procedures, she told the DCNF. Her doctors appear to have adopted the “gender affirmation approach” promoted by transgender activists: they encourage gender transitions rather than helping patients come to terms with their biological sex.

“The only acceptable answer to any medical professional was to ‘affirm’ what I said instead of offering any alternative ways of dealing with the issues I was suffering from. Those constant affirmations really did push me down the path of further medicalization,” said Luka, whose last name has been withheld to protect her privacy.

Luka is one of a handful of “detransitioners” speaking out against what they see as a medical establishment run amok, committed more to transgender ideology than patient well-being; their fears are backed up by a growing body of experts who believe the medical community is pushing minors onto the gender medicalization path to alleviate normal adolescent woes they would likely outgrow. Luka is sharing her story now in the hope that girls who find themselves thrust into the transgender medical world will slow down and reconsider before socially or medically transitioning.

“According to all the studies ever carried out on gender-distressed children, 80% of these kids grow out of it,” said Stella O’Malley, psychotherapist and founder of Genspect, an organization that is skeptical of the efficacy of the “gender affirmation” approach to gender dysphoria.

Numerous studies have shown similar figures.

“It’s very authoritarian of clinicians to pretend to know which child will persist in their trans identity and which will desist,” O’Malley said. “The rising numbers of detransitioners who transitioned when they were children shows that these clinicians are no less fallible than every other human.”

“We have no way of knowing what sort of adult the child will become and we shouldn’t allow clinicians with an inflated sense of their abilities to have this authority,” she told the DCNF.

The DCNF confirmed the details of Luka’s transition through a review of medical documents and photographs. The names of the clinics and medical professionals involved in her transition have been withheld at her request due to her fear of possible retaliation.

A therapist first encouraged Luka to come out as transgender while she was partially hospitalized for unrelated mental health issues at age 15, as a freshman in high school, she said; this meant she was sleeping at home but spending most days at the hospital. She had expressed general discomfort with her body and said she might be questioning her gender identity, and her therapist told her to come out as transgender to her parents, claiming it was the best way the get the help she needed, Luka told the DCNF.

Luka had only met with that therapist once or twice on a one-on-one basis prior to that meeting, she said. During that therapy session, Luka said she was overwhelmed, shaking with anxiety and nearly blacked out. Afterwards, her parents were told that she was at high risk for suicide if she didn’t transition — a common talking point among transgender activists, politicians and some health care professionals.

“I cannot stress enough how I was not in a good place mentally at that point in time,” she said. “I’d say that first visit to the partial hospital definitely solidified that identity of transgender in me and started that process of social (and later medical) transition, since up until that point I was questioning but hadn’t put any label on myself yet.”

“It was only rather recently after I really was able to take a large step back from having direct interactions with those medical professionals that I was able to process everything and really work through the actual causes of my dysphoria and general discomfort,” she told the DCNF.

Soon after adopting a transgender identity, Luka moved from her all-girls school to a public school, where she began wearing chest binders and going by a new name. Transgender activists refer to this process as “social transition.”

While activists claim the practice is easily reversed, critics say that social transition further confuses children and cements transgender identification.

“Social transition has a critical effect on [transgender identification’s] persistence,” wrote Dr. Stephen B. Levine, a Distinguished Life Fellow of the American Psychiatric Association, in his expert witness statement in a court case over transgender participation in school sports. “It is evident from the scientific literature that engaging in therapy that encourages social transition before or during puberty … is a psychotherapeutic intervention that dramatically changes outcomes.”

“Studies conducted before the widespread use of social transition for young children reported desistance rates in the range of 80-98%, [while] a more recent study reported that fewer than 20% of boys who engaged in a partial or complete social transition before puberty had desisted when surveyed at age 15 or older,” he wrote.

After Luka’s social transition came the more invasive, irreversible treatments.

A therapist she was seeing at her gender clinic recommended she visit a plastic surgery center, she said. Luka did, and underwent a double mastectomy at 16 years old, about a year and a half after “coming out” as transgender. No one at the clinic seemed to have any hesitations about Luka’s age, she said, and the purpose of her appointments prior to surgery were simply to get familiar with the clinic, not to determine if surgery was actually right for her.

“The doctors themselves seemed to have no hesitation about the surgery,” Luka said, noting that the surgery was delayed a few months due to concerns about her mental health and recovery timing. “The initial consultation at the gender identity clinic was around two hours just asking how I felt about things related to gender.”

Double mastectomies, often referred to by doctors and transgender activists as “top surgery,” are frequently recommended to underage girls with gender identity issues; numerous hospitals in the U.S. openly perform them on minors, and some surgeons advertise the procedure on youth-dominated social media platforms like TikTok.

Mastectomies can result in loss of nipple sensation, and some patients choose to have the nipples removed entirely, according to Miami-based plastic surgeon Sidhbh Gallagher, who promoted double mastectomies on TikTok.

There’s no comprehensive data on how many minors have received mastectomies in pursuit of gender transitions in the U.S., but Boston Children’s Hospital performed 65 top surgeries on minors from 2017 to 2020, according to data published by the Journal of Clinical Medicine. The average top surgery patient was 18, and the youngest was 15, according to the review.

At least 1,130 chest surgeries were performed on adolescents (98.6% of whom were female) in the U.S. from 2016 to 2019, according to one study conducted by researchers at Vanderbilt University, but this data only includes hospital settings; it doesn’t account for the patients who had surgeries at private practices or the likely higher number of minors who underwent the procedure from 2020 to 2022.

Doctors often recommend patients take testosterone, referred to as “hormone therapy,” before undergoing mastectomies to promote chest muscle growth, according to the Mayo Clinic. However, Luka said she wasn’t prescribed testosterone until after her surgery.

“After getting surgery at 16, getting on hormones later that fall went very quickly,” she said. “I met with my doctor at the gender clinic, had blood work done and got a prescription for testosterone.”

She continued to take testosterone until earlier this year, at the age of 20, when she realized it hadn’t resolved her underlying problems. It had, however, resulted in a long list of health issues, Luka told the DCNF: she stopped getting her period, her voice grew deeper, she began growing facial hair, her jaw became more square, her figure changed from hourglass to rectangular and she developed a deeper voice.

She also said she was unable to cry while taking testosterone, adding that it affected her thought processes in a way that she struggled to describe.

Gender transitions are an off-label use of testosterone that has not been approved by the Food and Drug Administration, and the side effects still aren’t fully known, according to Kaiser Permanente. The drug can result in permanent infertility and carries the risks of high blood pressure, strokes, heart attacks, cancer, liver damage, weight gain and diabetes.

Medical professionals convinced Luka’s parents to allow her to have the procedures, she said, by telling them their daughter might commit suicide if she didn’t medically transition. She doesn’t blame her parents for what happened, and says they were just trusting a medical system that was supposed to help her.

“My mom was very concerned and opposed to the idea of me getting surgery, but was bullied by my dad and pressured by the doctors and therapists into being ok with it,” she said. “My parents were told the same thing so many other parents in these situations are told, ‘Would you rather have a dead daughter or a living son?’ despite the fact that, no matter all my mental health struggles, I had never been suicidal.”

Other detransitioners have come forward with similar stories; one young woman, Chloe Cole, is suing Kaiser Permanente for fraud after the hospital allegedly told her parents that her gender issues would never go away and that she was at high risk for suicide if she didn’t medically transition. After undergoing puberty blockers, hormones and a double mastectomy beginning at age 13, her gender dysphoria did go away; she is no longer transgender and, like Luka, she regrets the procedures.

“Chloe’s doctors coerced her into a life-altering and highly invasive medical treatment by concealing from her less invasive treatment options and by lying to her about her condition,” Harmeet Dhillon, one of Cole’s attorneys, told the DCNF. “This predatory and barbaric behavior from medical professionals needs to stop. ”

Dr. Joseph Burgo, a clinical psychologist, said some medical professionals ignore the various mental health issues young patients may have and instead focus solely on gender dysphoria, viewing their other problems as mere extensions of gender identity issues and the result of discrimination and mistreatment they may face.

“The current term used to describe this very real phenomenon is ‘diagnostic overshadowing,’ where a diagnosis of transgender identity takes precedence over all other mental health issues and becomes the sole focus of treatment,” Burgo told the DCNF. “Some practitioners hold that those other mental issues are caused by so-called ‘minority stress’ (non-acceptance of trans identities by society) and will actually be resolved through medical transition.”

World Professional Association for Transgender Health (WPATH) and the American Academy of Pediatrics support cross-sex medical procedures for minors, which are legal in most states and widely defended by Democratic politicians. However, a growing number of health care professionals are coming out against the procedures, citing health risks and a lack of evidence of their safety and efficacy.

More than 1,700 medical professionals and concerned parents recently signed a declaration condemning WPATH’s guidelines over concerns about ethics, child safeguarding and the group’s alleged mischaracterization of scientific data. WPATH had removed age minimums for many cross-sex procedures, invalidated the experiences of detrantitioners and ignored scientific skepticism of cross-sex procedures to adhere to ideological positions, the declaration argued.

By ceasing her transition and speaking out, Luka joins a growing cohort of young people who adopted transgender identities, underwent cross-sex medical procedures in adolescence and eventually regretted it. These so-called detransitioners are largely female, and they often attribute their gender identity issues to social contagion or to pressure from transgender activists on social media.

“I would definitely say social media played a role in keeping the process of everything going, as well as some issues with being groomed and preyed upon by people online,” she said. “That probably played a much bigger role than any social contagion aspect.”

Transgender activists claim transition regret is rare, but the systematic review they often cite only counted patients who had undergone surgeries and omitted patients who had only taken puberty blockers and/or hormones. Likewise, the study’s data stretched back to 1989, long before medical transitions became common and readily available. It will likely take years to get more complete data on how many young women who transitioned recently will come to regret their decision.

Luka no longer identifies as transgender, and she avoids interacting with the transgender community. When she began questioning components of gender ideology, including childhood medical transitions, she said members of the transgender community shunned and shamed her.

As for her future, she wants a normal life and is waiting to see how she can recover from her transition.

“I want to get through university, find a job and hopefully in the future find someone, get married and have a family, some of which is definitely dependent on finding out if the damage done from transitioning can be undone,” she said.

AUTHOR

LAUREL DUGGAN

Social issues and culture reporter.

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Massive Florida Medical Center Boasted Of Helping Child Get ‘Gender-Affirming’ Surgery, Hormones

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  • UF Health’s Youth Gender Program offers medical treatments to minors to help them present as the opposite sex; the program boasted about helping a minor undergo hormones and feminizing facial surgery and obtain a referral for “gender affirmation surgery,” according to the institution’s website.
  • UF Health did not respond to dozens of requests for comment from the Daily Caller News Foundation and ignored many requests for their age guidelines.
  • “Your parents may not understand and may fight your transition, but this is the way you were born,” one patient said in a UF Health testimonial prominently featured on their website. “Your authentic life is worth fighting for.”

UF Health, a medical network affiliated with the University of Florida located in Gainesville and Jacksonville, boasted about helping a child with gender dysphoria undergo hormone blockers and surgeries in a testimonial on their website.

UF Health’s Youth Gender Program boasts of nationally recognized endocrinologists who specialize in administering pubertal suppression and cross-sex hormone medications to minors and connects children and their families with a host of resources that unquestioningly encourage medical transition for children. One testimonial on their website highlights a minor who, with the help of UF Health, received facial surgery, hormone blockers and a referral for an unspecified cross-sex surgery before turning 18.

The patient, referred to as “Hunter,” underwent hormone blocker injections and sperm cryopreservation as a minor upon adopting a transgender identity at age 15 after watching “I Am Jazz,” a show about a transgender child, according to a testimonial featured prominently on the Youth Gender Program’s website. Hunter received facial feminization surgery, which can include altering the hairline, shaving down the chin and jawbone or augmenting the lips and nose, upon turning 16 with the help of then-UF Health clinical psychologist Anyaliese Hancock-Smith, and was slated to undergo “gender affirmation surgery” in the summer of 2017.

“At the age of 15, Hunter was watching TLC’s transgender reality series, I am Jazz, when she realized she could no longer continue living uncomfortably in the wrong body. Hunter immediately ran into her mother’s room and told her she needed to be on puberty blocking medication,” the testimonial reads.

Hunter was 17 in April 2017, and it is unclear whether the adolescent turned 18 before the surgery; it’s also unclear precisely which surgery Hunter had and whether UF Health performed it or wrote a referral, though Hunter vaguely gives credit to UF Health.

“After meeting with Dr. Silverstein and being diagnosed with Gender Dysphoria, Hunter was prescribed hormone blocker injections and later underwent sperm cryopreservation, a procedure which would eventually allow her to produce biologic children if she wishes,” the post read. “Hunter now believes she looks on the outside like the gender she has always been on the inside, and she credits much of it to her team at UF Health.”

“Hunter now meets with clinical psychologist Anyaliese Hancock-Smith, Ph.D., who assisted Hunter in healthy development of gender identity and expression congruency. This included Hunter getting some facial feminization surgery for her 16th birthday,” the post continued. “Now seventeen years old, Hunter is preparing to have gender affirmation surgery in the summer of 2017, which will allow her to finally feel comfortable in her own skin. She hopes her story will inspire others to embrace their true selves.”

UF Health also included a quote from the patient encouraging others to go against their parents’ wishes when pursuing medical transitions.

“Your parents may not understand and may fight your transition, but this is the way you were born,” Hunter said in the testimonial. “Your authentic life is worth fighting for.”

UF’s Youth Gender Program was following about 50 children receiving puberty blockers and had about 200 patients total on hormones, according to data supplied to the Tampa Bay Times. Fewer than 50 patients in the practice had mastectomies, which are not performed on children under 16, according to the Tampa Bay Times.

The program collaborated with transgender activist group Equality Florida, a group that supports childhood gender transitions and has staunchly opposed efforts to limit those procedures for minors in Florida.

UF Health did not respond to dozens of requests for comment from the Daily Caller News Foundation, including numerous requests over phone, voicemail and email for the institution’s age guidelines for gender-related procedures. UF Health also has yet to share records requested through Florida’s freedom of information law regarding its Youth Gender Program.

Many medical professionals criticize administering puberty blockers and performing sex change surgeries on minors, arguing that children can’t consent to the irreversible procedures and questioning their purported benefits. However, prominent medical organizations like the American Academy of Pediatrics support affirming transgender identities through medical procedures, even for minors, and view the procedures as a way to improve adolescents’ mental health.

“All the up-to-date evidence shows that puberty blockers are neither safe nor reversible. The evidence shows that 98% of children who take puberty blockers go on to cross-sex hormones,” Stella O’Malley, an Irish psychotherapist and founder of the gender-critical organization Genspect, told the Daily Caller News Foundation. “We are roughly 10 years into this large-scale experiment and already we have reports on issues with cognitive development, bone mineral density and fertility. It is only with class action suits, like that taken in the UK, will we see a full exploration of this issue.”

Detransitioners, people who regret undergoing medical gender transitions, are also speaking out against the procedures. Helena Kirshner, a young woman who took cross-sex hormones and socially transitioned to a male identity as a teenager, attributed her temporary trans identity to emotional struggles, peer influence and social media.

“The adolescent brain is in a developmental stage primed to incorporate experiences into the process of identity formation,” she wrote in a February Substack post. “At my first appointment, I was prescribed testosterone, and I would remain on this regimen for a year and a half. It had an extremely negative effect on my mental health, and I finally admitted what a disaster it had been when I was 19 … It has not been easy, and the whole experience seriously derailed my life in ways I could never have foreseen when I was that fifteen-year-old kid playing with pronouns on Tumblr.”

The Youth Gender Program offers consultation, psychotherapy and assessment of medical readiness for cross-sex hormone therapy, according to its website; though it does not list surgical procedures it provides for minors, the first item on its resource page is financing advice for “gender confirmation surgery.” Resources for transgender youth also include a guide to “tucking,” or using tape to hide one’s penis, along with various activist groups including GLAAD which are vocal proponents of childhood medical transitions.

The Youth Gender Program claims its services are consistent with World Professional Association For Transgender Health (WPATH) guidelines; WPATH’s most recent standards of care do not list any age restrictions for minors to be eligible for cross-sex procedures including surgeries, and the organization is generally supportive of adolescent medical transition.

Dr. Michael Haller, chief of pediatric endocrinology at the University of Florida, publicly criticized detransitioner Chloe Cole on Twitter in August after she voiced regret about undergoing a medical transition as a minor and criticized the interventionist approach to gender dysphoria that Haller endorses. Cole, who underwent a “gender-affirming” double-mastectomy at age 15 along with cross-sex hormones that permanently altered her voice, no longer identifies as transgender and advocates against sex change procedures for minors.

“She states she was ‘rushed’ through care but notes her first endocrinologist actually said ‘no’ to rapid transition,” Haller wrote. “She sought alternative avenues for treatment. She then speaks as if her case should justify full scale elimination access for all trans patients.”

“You chose internet notoriety over anything that will ever help patients,” he wrote in another tweet.

“At this point, Dr. Haller has a creepy obsession with me. He’s a corrupt Dr. and Prof. who recommends children for double mastectomies and cross sex hormones. Dr. Haller exhibits abusive habits towards outspoken victims of gender care,” Cole wrote. 

Haller initially agreed to an interview with the DCNF before cancelling and instructing the DCNF to direct questions to an outside organization, the American Academy of Pediatrics, which also did not respond to a request for comment.

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AUTHOR

LAUREL DUGGAN

Social issues and culture reporter.

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EDITORS NOTE: This Daily Caller column is republished with permission. ©All rights reserved.