Connect with us
[bsa_pro_ad_space id=12]

Health

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

Published

9 minute read

From the Daily Caller News Foundation

By MEGAN BROCK AND KATE ANDERSON

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.

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.

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.

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.”

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.”

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

Todayville is a digital media and technology company. We profile unique stories and events in our community. Register and promote your community event for free.

Follow Author

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.

 

Subscribe for free to get BTN’s latest news and analysis – or donate to our investigative journalism fund.

 

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.

Our content is always free – but if you want to help us commission more high-quality journalism,

consider getting a voluntary paid subscription.

Continue Reading

Addictions

Addiction experts demand witnessed dosing guidelines after pharmacy scam exposed

Published on

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.

 

Subscribe for free to get BTN’s latest news and analysis – or donate to our investigative journalism fund.

 

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.


Subscribe to Break The Needle

Launched a year ago Break The Needle provides news and analysis on addiction and crime in Canada.
Continue Reading

Trending

X