Health
Private Footage Reveals Leading Medical Org’s Efforts To ‘Normalize’ Gender Ideology

From the Daily Caller News Foundation
By MEGAN BROCK AND KATE ANDERSON
I have developed a part of my brain that’s very fluid around with some of my folks asking them each week, what name are you going by? What pronouns are we using today? So it keeps us flexible to be doing this work.
This is the seventh article in the “WPATH Tapes” series on the World Professional Association for Transgender Health and the gender medical industry. Read the overview of our investigation here.
Members of the world’s most prominent transgender medical organization encouraged fellow doctors to push transgender ideology beyond the healthcare field into schools and their communities, according to internal recordings obtained by the Daily Caller News Foundation.
In September 2022, the World Professional Association of Transgender Health (WPATH) Global Education Institute (GEI) hosted an event that included a series of education sessions for certification in transgender medicine. The event coincided with the release of WPATH’s updated medical guidance, called the Standards of Care Version 8 (SOC 8), and provided additional insights on its clinical applications.
During the sessions WPATH members were encouraged to “normalize” preferred pronoun use as a way to “create societal change” and behave in a way that “affirms” their patients’ gender identity, such as by asking female patients if they have a penis.
Psychologist Ren Massey, the co-chair of WPATH GEI, said clinicians should be ready to act as advocates for “gender diversity” in school settings. Massey earned a Ph.D. in clinical psychology from University of South Florida and is not a physician.
“We want to have the skills to negotiate multiple roles,” Massey said. “Because I have both had to be the therapist and then go talk to the school and be an advocate, or do a talk to the whole community of a school. So, I’m in multiple hats that we get to navigate, if we are advocating and helping and supporting our trans and gender diverse folks we are working with.”
Massey did not respond to requests for comment, and neither did Massey’s psychology practice.
Transgender ideology includes the belief that a person’s sex can be different from their “gender identity,” which SOC 8 defines as “a person’s deeply felt, internal, intrinsic sense of their own gender.” It’s a rejection of long-established scientific understanding of biology that there are only two sexes based on the fact there are only two types of reproductive cells — sperm and ova.
The term “gender identity” was popularized in the 1960s by controversial sexologist John Money, who’s most high-profile experiment involved advising parents of a boy whose penis was damaged in a botched circumcision to cut the rest of it off and raise him as a girl. At age 15, the boy — who was raised as “Brenda” — discovered the truth and rejected further hormone treatments. He eventually committed suicide at age 38.
The very concept of “gender identity” creates the possibility of changing one’s sex — a biological impossibility — through medical interventions, therefore creating a demand for medical sex reassignment interventions.
SOC 8 recommends that gender dysphoric minors be given the opportunity to “change” their sex through medical interventions. The guidance has been used to inform government regulations, insurance policies, and recommendations by numerous medical organizations, increasing minors access to sex reassignment procedures.
‘We Will Facilitate Changes’
The call for clinicians to be involved in local schools was echoed by WPATH-affiliated psychologist Dr. Wallace Wong in a presentation titled “Foundations in Gender Affirming Mental Health Care in Childhood and Adolescence.” Wong explained how therapists can play a pivotal role in facilitating change by helping schools embrace transgenderism and explained that schools need to embrace the use of preferred pronouns.
“A lot of time we will facilitate changes. It’s not unusual that you will go to the school with the parents together and educate the school what to do,” said Wong. “A lot of the times, some school they say, ‘we don’t know what to do.’ You say, ‘that doesn’t fly, I will teach you how to do,’” Wong said.
Wong did not respond to requests for comment, and the Diversity and Emotional Wellness Centre, where Wong works, provided additional contact information but did not provide comment.
SOC 8 recommends that “health care professionals work with families, schools, and other relevant settings to promote acceptance of gender diverse expressions of behavior and identities of the adolescent.”
“Using different pronouns for children is a step towards their social transition. It is now well established that social transition leads to the medicalization of their care,” Dr. Stanley Goldfarb of Do No Harm, a watchdog organization focused on keeping identity politics out of healthcare and medical schools, told the DCNF.
“It is inappropriate for anyone to advocate gender transition in gender dysphoric children unless they have had extensive psychological counseling and are part of some formal research protocol,” Goldfarb said. “This is the new policy in the United Kingdom and in multiple European countries.”
Without naming a specific doctor, Goldfarb said that “for a physician to speak to untrained personnel given the psychological difficulties that these children often experience along with their gender dysphoria, is bordering on malpractice.”
‘The Face Of The Enemy’
As European nations such as Norway, Sweden, Denmark, and the U.K. have restricted or halted the use of cross-sex hormones and puberty blockers in minors, WPATH has rallied against similar bans in the United States.
The WPATH GEI educational event dedicated an entire session to transgender legal and policy issues. Paula Neira, a biological man who identifies as a woman and is program director of LGBTQ Equity & Education at Johns Hopkins Medicine, gave a presentation titled “Legal Issues & Policy.” During the talk, Neira criticized legislative efforts aimed at stopping child sex changes and protecting women’s sports.
“Numerous states have either engaged in having litigation and legislation proposed or the government has taken actions that are targeting the LGBTQ+ community broadly, and then at least half of these bills are specifically targeting transgender people, particularly transgender youth. The way that these bills are being played out is, one is attempts to ban gender affirming care,” Neira said.
“In Alabama they’re trying to criminalize, by making it a felony, to provide gender-affirming care to transgender youth. The bill is called the “Alabama Child Compassion and Protection Act” so the height of cynicism and hypocrisy,” Neira said.
Neira ended the session by calling on WPATH members to band together and stand firm against “attacks” on the transgender community.
“Being defiant in the face of the enemy is not something that’s unfamiliar to me,” Neria said. “It’s going to take a lot of resolve. It’s going take a lot of resilience. It’s going take a lot of mutual support, to stand firm under these attacks. And that’s what we have to do. And we have to do it with a clear strategic eye. And that means banding together. It means being strategic in how we challenge policy, how we advocate and make persuasive arguments.”
“And together we’re gonna get back to making progress no matter how bleak it looks now, as long as we never give in. And we never surrender,” Neira told the audience, prompting applause.
Neira did not respond to requests for comment. Johns Hopkins Medicine, where Neira works, responded but did not provide comment.
‘Helps All Humans’
Throughout the 30 hours of WPATH GEI recordings reviewed by the DCNF, speakers cast a vision of moving gender ideology beyond sex change procedures and promoting it in other domains such as schools, communities and public policy.
Dr. Scott Leibowitz, a WPATH board member and SOC 8 co-author, said it “helps all humans” to promote the acceptance of transgender ideology in a diversity of settings.
“We recommend health care professionals who work with families. They should work with families, schools, and other relevant settings to promote acceptance of gender diverse expressions of behavior and identities of the adolescent,” Leibowitz said.
“Notice, we don’t say: ‘work with these settings to promote acceptance of transgender people,’” Leibowitz told the audience. “We actually think it’s broader than that because by helping promote acceptance of gender diversity as a whole, we believe that helps all humans, including trans people. It doesn’t reinforce the notion of boxes, which is what we’re trying to move away from.”
Leibowitz declined an interview request through a Nationwide Children’s Hospitals spokesperson.
WPATH’s commitment to social change is captured in its own guidelines.
“WPATH recognizes that health is not only dependent upon high-quality clinical care but also relies on social and political climates that ensure social tolerance, equality, and the full rights of citizenship,” the guidelines read. “Health is promoted through public policies and legal reforms that advance tolerance and equity for gender diversity and that eliminate prejudice, discrimination, and stigma. WPATH is committed to advocacy for these policy and legal changes.”
‘Creating Change By Using Different Language’
WPATH members were also encouraged to use preferred pronouns in healthcare practices, with Massey describing the use of preferred pronouns as a way to create social change.
“I would encourage you in your practices to have universal approaches to correct pronouns. So, training your staff so they’re aware and have good interaction skills. Maybe even have role plays with them,” Massey said.
“We are creating change by using different language,” said Massey.
Massey, who maintains an active psychology practice, said it’s “good clinical practice” to let clients dictate terminology used to describe their sex and gender.
“I’ve had folks that within the same day or within the same week may shift from feeling masculine, feminine, both, neither,” Massey said.
“And so that’s a thing like I have developed a part of my brain that’s very fluid around with some of my folks asking them each week, what name are you going by? What pronouns are we using today? So it keeps us flexible to be doing this work. There is so much evolution and so much exciting work developing.”
SOC 8 recommends that healthcare professionals use the “language or terminology” preferred by the patient.
‘Normalize It’
Dr. Jennifer Slovis, the medical director of the Oakland Kaiser Permanente Gender Clinic, promoted the use of an electronic medical database that collects sexual orientation and gender identity information for all patients. On the form, healthcare providers were expected to indicate a patient’s preferred pronouns and gender identity, as well as take an “organ inventory” for the patient.
The organ inventory asks both men and women to indicate their reproductive organs on a list that includes the cervix, breasts, uterus, vagina, testes, prostate and penis. Clinicians were also asked to indicate which organs were present at birth, had been surgically constructed, or developed by hormones.
Slovis explained that to “normalize” the organ inventory, this data needs to be collected for all patients, including “cisgender” patients.
“Cisgender people too, we should be doing this for everybody. That’s the only way we’re going to normalize it, if we do it for everybody,” said Slovis.
Slovis did not respond to requests for comment, and neither did Kaiser Permanente, where Slovis works.
In a presentation titled “Foundations in Primary Care,” Dr. Erika Sullivan said organ inventories needed to be constantly taken because patients’ organs “change.”
“One of the things I always like to illustrate with this is that you don’t just ask this question once, right? Because this changes. And so sexual practices change, pronouns change, organs change,” said Sullivan.
“You kind of have to constantly take that inventory to find out like, what’s what, what’s where, what are we doing?” Sullivan said.
WPATH’s SOC 8 supports the use of organ inventories.
“In electronic health records, organ/anatomical inventories can be standardly used to inform appropriate clinical care, rather than relying solely on assigned sex at birth and/ or gender identity designations,” the guidelines read.
Sullivan also explained the importance of using preferred pronouns and not assuming a patient’s pronouns based on outward appearance.
“I should be asking this of everybody and introducing myself this way, ‘Hi, I’m Erica, I use she/her pronouns,’” Sullivan said. “Because I think if we are going by sort of presentation, we are taking so much bias and so much judgment into that space. It’s really important to just wipe that away. So asking everyone’s pronouns is important because really, ultimately, you have to question your assumptions.”
Sullivan did not respond to requests for comment, and neither did the University of Utah, where Sullivan works.
Goldfarb said doctors should focus on patient care, not promoting gender ideology.
“It is not the job of physicians to create a culture of gender ideology. The job of physicians is to care for ill people,” Goldfarb said. “The proper care for children with gender dysphoria is intensive psychological treatment. The idea that all this should be normalized represents pure ideology and is not based on hard science or valid clinical research.”
WPATH did not respond to multiple requests for comment.
Addictions
‘Over and over until they die’: Drug crisis pushes first responders to the brink

First responders say it is not overdoses that leave them feeling burned out—it is the endless cycle of calls they cannot meaningfully resolve
The soap bottle just missed his head.
Standing in the doorway of a cluttered Halifax apartment, Derek, a primary care paramedic, watched it smash against the wall.
Derek was there because the woman who threw it had called 911 again — she did so nearly every day. She said she had chest pain. But when she saw the green patch on his uniform, she erupted. Green meant he could not give her what she wanted: fentanyl.
She screamed at him to call “the red tags” — advanced care paramedics authorized to administer opioids. With none available, Derek declared the scene unsafe and left. Later that night, she called again. This time, a red-patched unit was available. She got her dose.
Derek says he was not angry at the woman, but at the system that left her trapped in addiction — and him powerless to help.
First responders across Canada say it is not overdoses that leave them feeling burned out — it is the endless cycle of calls they cannot meaningfully resolve. Understaffed, overburdened and dispatched into crises they are not equipped to fix, many feel morally and emotionally drained.
“We’re sending our first responders to try and manage what should otherwise be dealt with at structural and systemic levels,” said Nicholas Carleton, a University of Regina researcher who studies the mental health of public safety personnel.
Canadian Affairs agreed to use pseudonyms for the two frontline workers referenced in this story. Canadian Affairs also spoke with nine other first responders who agreed to speak only on background. All of these sources cited concerns about workplace retaliation for speaking out.
Moral injury
Canada’s opioid crisis is pushing frontline workers such as paramedics to the brink.
A 2024 study of 350 Quebec paramedics shows one in three have seriously considered suicide. Globally, ambulance workers have among the highest suicide rates of public service personnel.
Between 2017 and 2024, Canadian paramedics responded to nearly 240,000 suspected opioid overdoses. More than 50,000 of those were fatal.
Yet many paramedics say overdose calls are not the hardest part of the job.
“When they do come up, they’re pretty easy calls,” said Derek. Naloxone, a drug that reverses overdoses, is readily available. “I can actually fix the problem,” he said. “[It’s a] bit of instant gratification, honestly.”
What drains him are the calls they cannot fix: mental health crises, child neglect and abuse, homelessness.
“The ER has a [cardiac catheterization] lab that can do surgery in minutes to fix a heart attack. But there’s nowhere I can bring the mental health patients.
“So they call. And they call. And they call.”
Thomas, a primary care paramedic in Eastern Ontario, echoes that frustration.
“The ER isn’t a good place to treat addiction,” he said. “They need intensive, long-term psychological inpatient treatment and a healthy environment and support system — first responders cannot offer that.”
That powerlessness erodes trust. Paramedics say patients with addictions often become aggressive, or stop seeking help altogether.
“We have a terrible relationship with the people in our community struggling with addiction,” Thomas said. “They know they will sit in an ER bed for a few hours while being in withdrawals and then be discharged with a waitlist or no follow-up.”
Carleton, of the University of Regina, says that reviving people repeatedly without improvement decreases morale.
“You’re resuscitating someone time and time again,” said Carleton, who is also director of the Psychological Trauma and Stress Systems Lab, a federal unit dedicated to mental health research for public safety personnel. “That can lead to compassion fatigue … and moral injury.”
Katy Kamkar, a clinical psychologist focused on first responder mental health, says moral injury arises when workers are trapped in ethically impossible situations — saving a life while knowing that person will be back in the same state tomorrow.
“Burnout is … emotional exhaustion, depersonalization, and reduced personal accomplishment,” she said in an emailed statement. “High call volumes, lack of support or follow-up care for patients, and/or bureaucratic constraints … can increase the risk of reduced empathy, absenteeism and increased turnover.”
Kamkar says moral injury affects all branches of public safety, not just paramedics. Firefighters, who are often the first to arrive on the scene, face trauma from overdose deaths. Police report distress enforcing laws that criminalize suffering.
Understaffed and overburdened
Staffing shortages are another major stressor.
“First responders were amazing during the pandemic, but it also caused a lot of fatigue, and a lot of people left our business because of stress and violence,” said Marc-André Périard, vice president of the Paramedic Chiefs of Canada.
Nearly half of emergency medical services workers experience daily “Code Blacks,” where there are no ambulances available. Vacancy rates are climbing across emergency services. The federal government predicts paramedic shortages will persist over the coming decade, alongside moderate shortages of police and firefighters.
Unsafe work conditions are another concern. Responders enter chaotic scenes where bystanders — often fellow drug users — mistake them for police. Paramedics can face hostility from patients they just saved, says Périard.
“People are upset that they’ve been taken out of their high [when Naloxone is administered] and not realizing how close to dying they were,” he said.
Thomas says safety is undermined by vague, inconsistently enforced policies. And efforts to collect meaningful data can be hampered by a work culture that punishes reporting workplace dangers.
“If you report violence, it can come back to haunt you in performance reviews” he said.
Some hesitate to wait for police before entering volatile scenes, fearing delayed response times.
“[What] would help mitigate violence is to have management support their staff directly in … waiting for police before arriving at the scene, support paramedics in leaving an unsafe scene … and for police and the Crown to pursue cases of violence against health-care workers,” Thomas said.
“Right now, the onus is on us … [but once you enter], leaving a scene is considered patient abandonment,” he said.
Upstream solutions
Carleton says paramedics’ ability to refer patients to addiction and mental health referral networks varies widely based on their location. These networks rely on inconsistent local staffing, creating a patchwork system where people easily fall through the cracks.
“[Any] referral system butts up really quickly against the challenges our health-care system is facing,” he said. “Those infrastructures simply don’t exist at the size and scale that we need.”
Périard agrees. “There’s a lot of investment in safe injection sites, but not as much [resources] put into help[ing] these people deal with their addictions,” he said.
Until that changes, the cycle will continue.
On May 8, Alberta renewed a $1.5 million grant to support first responders’ mental health. Carleton welcomes the funding, but says it risks being futile without also addressing understaffing, excessive workloads and unsafe conditions.
“I applaud Alberta’s investment. But there need to be guardrails and protections in place, because some programs should be quickly dismissed as ineffective — but they aren’t always,” he said.
Carleton’s research found that fewer than 10 mental health programs marketed to Canadian governments — out of 300 in total — are backed up by evidence showing their effectiveness.
In his view, the answer is not complicated — but enormous.
“We’ve got to get way further upstream,” he said.
“We’re rapidly approaching more and more crisis-level challenges… with fewer and fewer [first responders], and we’re asking them to do more and more.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
Business
Prime minister can make good on campaign promise by reforming Canada Health Act

From the Fraser Institute
While running for the job of leading the country, Prime Minister Carney promised to defend the Canada Health Act (CHA) and build a health-care system Canadians can be proud of. Unfortunately, to have any hope of accomplishing the latter promise, he must break the former and reform the CHA.
As long as Ottawa upholds and maintains the CHA in its current form, Canadians will not have a timely, accessible and high-quality universal health-care system they can be proud of.
Consider for a moment the remarkably poor state of health care in Canada today. According to international comparisons of universal health-care systems, Canadians endure some of the lowest access to physicians, medical technologies and hospital beds in the developed world, and wait in queues for health care that routinely rank among the longest in the developed world. This is all happening despite Canadians paying for one of the developed world’s most expensive universal-access health-care systems.
None of this is new. Canada’s poor ranking in the availability of services—despite high spending—reaches back at least two decades. And wait times for health care have nearly tripled since the early 1990s. Back then, in 1993, Canadians could expect to wait 9.3 weeks for medical treatment after GP referral compared to 30 weeks in 2024.
But fortunately, we can find the solutions to our health-care woes in other countries such as Germany, Switzerland, the Netherlands and Australia, which all provide more timely access to quality universal care. Every one of these countries requires patient cost-sharing for physician and hospital services, and allows private competition in the delivery of universally accessible services with money following patients to hospitals and surgical clinics. And all these countries allow private purchases of health care, as this reduces the burden on the publicly-funded system and creates a valuable pressure valve for it.
And this brings us back to the CHA, which contains the federal government’s requirements for provincial policymaking. To receive their full federal cash transfers for health care from Ottawa (totalling nearly $55 billion in 2025/26) provinces must abide by CHA rules and regulations.
And therein lies the rub—the CHA expressly disallows requiring patients to share the cost of treatment while the CHA’s often vaguely defined terms and conditions have been used by federal governments to discourage a larger role for the private sector in the delivery of health-care services.
Clearly, it’s time for Ottawa’s approach to reflect a more contemporary understanding of how to structure a truly world-class universal health-care system.
Prime Minister Carney can begin by learning from the federal government’s own welfare reforms in the 1990s, which reduced federal transfers and allowed provinces more flexibility with policymaking. The resulting period of provincial policy innovation reduced welfare dependency and government spending on social assistance (i.e. savings for taxpayers). When Ottawa stepped back and allowed the provinces to vary policy to their unique circumstances, Canadians got improved outcomes for fewer dollars.
We need that same approach for health care today, and it begins with the federal government reforming the CHA to expressly allow provinces the ability to explore alternate policy approaches, while maintaining the foundational principles of universality.
Next, the Carney government should either hold cash transfers for health care constant (in nominal terms), reduce them or eliminate them entirely with a concordant reduction in federal taxes. By reducing (or eliminating) the pool of cash tied to the strings of the CHA, provinces would have greater freedom to pursue reform policies they consider to be in the best interests of their residents without federal intervention.
After more than four decades of effectively mandating failing health policy, it’s high time to remove ambiguity and minimize uncertainty—and the potential for politically motivated interpretations—in the CHA. If Prime Minister Carney wants Canadians to finally have a world-class health-care system then can be proud of, he should allow the provinces to choose their own set of universal health-care policies. The first step is to fix, rather than defend, the 40-year-old legislation holding the provinces back.
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