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

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18 minute read

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 NorwaySweden, Denmark, and the U.Khave 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 issuesPaula 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.

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2025 Federal Election

Study links B.C.’s drug policies to more overdoses, but researchers urge caution

Published on

By Alexandra Keeler

A study links B.C.’s safer supply and decriminalization to more opioid hospitalizations, but experts note its limitations

A new study says B.C.’s safer supply and decriminalization policies may have failed to reduce overdoses. Furthermore, the very policies designed to help drug users may have actually increased hospitalizations.

“Neither the safer opioid supply policy nor the decriminalization of drug possession appeared to mitigate the opioid crisis, and both were associated with an increase in opioid overdose hospitalizations,” the study says.

The study has sparked debate, with some pointing to it as proof that B.C.’s drug policies failed. Others have questioned the study’s methodology and conclusions.

“The question we want to know the answer to [but cannot] is how many opioid hospitalizations would have occurred had the policy not have been implemented,” said Michael Wallace, a biostatistician and associate professor at the University of Waterloo.

“We can never come up with truly definitive conclusions in cases such as this, no matter what data we have, short of being able to magically duplicate B.C.”

Jumping to conclusions

B.C.’s controversial safer supply policies provide drug users with prescription opioids as an alternative to toxic street drugs. Its decriminalization policy permitted drug users to possess otherwise illegal substances for personal use.

The peer-reviewed study was led by health economist Hai Nguyen and conducted by researchers from Memorial University in Newfoundland, the University of Manitoba and Weill Cornell Medicine, a medical school in New York City. It was published in the medical journal JAMA Health Forum on March 21.

The researchers used a statistical method to create a “synthetic” comparison group, since there is no ideal control group. The researchers then compared B.C. to other provinces to assess the impact of certain drug policies.

Examining data from 2016 to 2023, the study links B.C.’s safer supply policies to a 33 per cent rise in opioid hospitalizations.

The study says the province’s decriminalization policies further drove up hospitalizations by 58 per cent.

“Neither the safer supply policy nor the subsequent decriminalization of drug possession appeared to alleviate the opioid crisis,” the study concludes. “Instead, both were associated with an increase in opioid overdose hospitalizations.”

The B.C. government rolled back decriminalization in April 2024 in response to widespread concerns over public drug use. This February, the province also officially acknowledged that diversion of safer supply drugs does occur.

The study did not conclusively determine whether the increase in hospital visits was due to diverted safer supply opioids, the toxic illicit supply, or other factors.

“There was insufficient evidence to conclusively attribute an increase in opioid overdose deaths to these policy changes,” the study says.

Nguyen’s team had published an earlier, 2024 study in JAMA Internal Medicine that also linked safer supply to increased hospitalizations. However, it failed to control for key confounders such as employment rates and naloxone access. Their 2025 study better accounts for these variables using the synthetic comparison group method.

The study’s authors did not respond to Canadian Affairs’ requests for comment.

 

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Correlation vs. causation

Chris Perlman, a health data and addiction expert at the University of Waterloo, says more studies are needed.

He believes the findings are weak, as they show correlation but not causation.

“The study provides a small signal that the rates of hospitalization have changed, but I wouldn’t conclude that it can be solely attributed to the safer supply and decrim[inalization] policy decisions,” said Perlman.

He also noted the rise in hospitalizations doesn’t necessarily mean more overdoses. Rather, more people may be reaching hospitals in time for treatment.

“Given that the [overdose] rate may have gone down, I wonder if we’re simply seeing an effect where more persons survive an overdose and actually receive treatment in hospital where they would have died in the pre-policy time period,” he said.

The Nguyen study acknowledges this possibility.

“The observed increase in opioid hospitalizations, without a corresponding increase in opioid deaths, may reflect greater willingness to seek medical assistance because decriminalization could reduce the stigma associated with drug use,” it says.

“However, it is also possible that reduced stigma and removal of criminal penalties facilitated the diversion of safer opioids, contributing to increased hospitalizations.”

Karen Urbanoski, an associate professor in the Public Health and Social Policy department at the University of Victoria, is more critical.

“The [study’s] findings do not warrant the conclusion that these policies are causally associated with increased hospitalization or overdose,” said Urbanoski, who also holds the Canada Research Chair in Substance Use, Addictions and Health Services.

Her team published a study in November 2023 that measured safer supply’s impact on mortality and acute care visits. It found safer supply opioids did reduce overdose deaths.

Critics, however, raised concerns that her study misrepresented its underlying data and showed no statistically significant reduction in deaths after accounting for confounding factors.

The Nguyen study differs from Urbanoski’s. While Urbanoski’s team focused on individual-level outcomes, the Nguyen study analyzed broader, population-level effects, including diversion.

Wallace, the biostatistician, agrees more individual-level data could strengthen analysis, but does not believe it undermines the study’s conclusions. Wallace thinks the researchers did their best with the available data they had.

“We do not have a ‘copy’ of B.C. where the policies weren’t implemented to compare with,” said Wallace.

B.C.’s overdose rate of 775 per 100,000 is well above the national average of 533.

Elenore Sturko, a Conservative MLA for Surrey-Cloverdale, has been a vocal critic of B.C.’s decriminalization and safer supply policies.

“If the government doesn’t want to believe this study, well then I invite them to do a similar study,” she told reporters on March 27.

“Show us the evidence that they have failed to show us since 2020,” she added, referring to the year B.C. implemented safer supply.


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.

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Addictions

Addiction experts demand witnessed dosing guidelines after pharmacy scam exposed

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By Alexandra Keeler 

The move follows explosive revelations that more than 60 B.C. pharmacies were allegedly participating in a scheme to overbill the government under its safer supply program. The scheme involved pharmacies incentivizing clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market.

An addiction medicine advocacy group is urging B.C. to promptly issue new guidelines for witnessed dosing of drugs dispensed under the province’s controversial safer supply program.

In a March 24 letter to B.C.’s health minister, Addiction Medicine Canada criticized the BC Centre on Substance Use for dragging its feet on delivering the guidelines and downplaying the harms of prescription opioids.

The centre, a government-funded research hub, was tasked by the B.C. government with developing the guidelines after B.C. pledged in February to return to witnessed dosing. The government’s promise followed revelations that many B.C. pharmacies were exploiting rules permitting patients to take safer supply opioids home with them, leading to abuse of the program.

“I think this is just a delay,” said Dr. Jenny Melamed, a Surrey-based family physician and addiction specialist who signed the Addiction Medicine Canada letter. But she urged the centre to act promptly to release new guidelines.

“We’re doing harm and we cannot just leave people where they are.”

Addiction Medicine Canada’s letter also includes recommendations for moving clients off addictive opioids altogether.

“We should go back to evidence-based medicine, where we have medications that work for people in addiction,” said Melamed.

‘Best for patients’

On Feb. 19, the B.C. government said it would return to a witnessed dosing model. This model — which had been in place prior to the pandemic — will require safer supply participants to take prescribed opioids under the supervision of health-care professionals.

The move follows explosive revelations that more than 60 B.C. pharmacies were allegedly participating in a scheme to overbill the government under its safer supply program. The scheme involved pharmacies incentivizing clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market.

In its Feb. 19 announcement, the province said new participants in the safer supply program would immediately be subject to the witnessed dosing requirement. For existing clients of the program, new guidelines would be forthcoming.

“The Ministry will work with the BC Centre on Substance Use to rapidly develop clinical guidelines to support prescribers that also takes into account what’s best for patients and their safety,” Kendra Wong, a spokesperson for B.C.’s health ministry, told Canadian Affairs in an emailed statement on Feb. 27.

More than a month later, addiction specialists are still waiting.

 

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According to Addiction Medicine Canada’s letter, the BC Centre on Substance Use posed “fundamental questions” to the B.C. government, potentially causing the delay.

“We’re stuck in a place where the government publicly has said it’s told BCCSU to make guidance, and BCCSU has said it’s waiting for government to tell them what to do,” Melamed told Canadian Affairs.

This lag has frustrated addiction specialists, who argue the lack of clear guidance is impeding the transition to witnessed dosing and jeopardizing patient care. They warn that permitting take-home drugs leads to more diversion onto the streets, putting individuals at greater risk.

“Diversion of prescribed alternatives expands the number of people using opioids, and dying from hydromorphone and fentanyl use,” reads the letter, which was also co-signed by Dr. Robert Cooper and Dr. Michael Lester. The doctors are founding board members of Addiction Medicine Canada, a nonprofit that advises on addiction medicine and advocates for research-based treatment options.

“We have had people come in [to our clinic] and say they’ve accessed hydromorphone on the street and now they would like us to continue [prescribing] it,” Melamed told Canadian Affairs.

A spokesperson for the BC Centre on Substance Use declined to comment, referring Canadian Affairs to the Ministry of Health. The ministry was unable to provide comment by the publication deadline.

Big challenges

Under the witnessed dosing model, doctors, nurses and pharmacists will oversee consumption of opioids such as hydromorphone, methadone and morphine in clinics or pharmacies.

The shift back to witnessed dosing will place significant demands on pharmacists and patients. In April 2024, an estimated 4,400 people participated in B.C.’s safer supply program.

Chris Chiew, vice president of pharmacy and health-care innovation at the pharmacy chain London Drugs, told Canadian Affairs that the chain’s pharmacists will supervise consumption in semi-private booths.

Nathan Wong, a B.C.-based pharmacist who left the profession in 2024, fears witnessed dosing will overwhelm already overburdened pharmacists, creating new barriers to care.

“One of the biggest challenges of the retail pharmacy model is that there is a tension between making commercial profit, and being able to spend the necessary time with the patient to do a good and thorough job,” he said.

“Pharmacists often feel rushed to check prescriptions, and may not have the time to perform detailed patient counselling.”

Others say the return to witnessed dosing could create serious challenges for individuals who do not live close to health-care providers.

Shelley Singer, a resident of Cowichan Bay, B.C., on Vancouver Island, says it was difficult to make multiple, daily visits to a pharmacy each day when her daughter was placed on witnessed dosing years ago.

“It was ridiculous,” said Singer, whose local pharmacy is a 15-minute drive from her home. As a retiree, she was able to drive her daughter to the pharmacy twice a day for her doses. But she worries about patients who do not have that kind of support.

“I don’t believe witnessed supply is the way to go,” said Singer, who credits safer supply with saving her daughter’s life.

Melamed notes that not all safer supply medications require witnessed dosing.

“Methadone is under witness dosing because you start low and go slow, and then it’s based on a contingency management program,” she said. “When the urine shows evidence of no other drug, when the person is stable, [they can] take it at home.”

She also noted that Suboxone, a daily medication that prevents opioid highs, reduces cravings and alleviates withdrawal, does not require strict supervision.

Kendra Wong, of the B.C. health ministry, told Canadian Affairs that long-acting medications such as methadone and buprenorphine could be reintroduced to help reduce the strain on health-care professionals and patients.

“There are medications available through the [safer supply] program that have to be taken less often than others — some as far apart as every two to three days,” said Wong.

“Clinicians may choose to transition patients to those medications so that they have to come in less regularly.”

Such an approach would align with Addiction Medicine Canada’s recommendations to the ministry.

The group says it supports supervised dosing of hydromorphone as a short-term solution to prevent diversion. But Melamed said the long-term goal of any addiction treatment program should be to reduce users’ reliance on opioids.

The group recommends combining safer supply hydromorphone with opioid agonist therapies. These therapies use controlled medications to reduce withdrawal symptoms, cravings and some of the risks associated with addiction.

They also recommend limiting unsupervised hydromorphone to a maximum of five 8 mg tablets a day — down from the 30 tablets currently permitted with take-home supplies. And they recommend that doses be tapered over time.

“This protocol is being used with success by clinicians in B.C. and elsewhere,” the letter says.

“Please ensure that the administrative delay of the implementation of your new policy is not used to continue to harm the public.”


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.


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