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Health

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

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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

Alberta

Early Success: 33 Nurse Practitioners already working independently across Alberta

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Nurse practitioners expand primary care access

The Alberta government’s Nurse Practitioner Primary Care program is showing early signs of success, with 33 nurse practitioners already practising independently in communities across the province.

Alberta’s government is committed to strengthening Alberta’s primary health care system, recognizing that innovative approaches are essential to improving access. To further this commitment, the Nurse Practitioner Primary Care Program was launched in April, allowing nurse practitioners to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.

Since being announced, the program has garnered a promising response. A total of 67 applications have been submitted, with 56 approved. Of those, 33 nurse practitioners are now practising autonomously in communities throughout Alberta, including in rural locations such as Beaverlodge, Coaldale, Cold Lake, Consort, Morley, Picture Butte, Three Hills, Two Hills, Vegreville and Vermilion.

“I am thrilled about the interest in this program, as nurse practitioners are a key part of the solution to provide Albertans with greater access to the primary health care services they need.”

Adriana LaGrange, Minister of Health

To participate in the program, nurse practitioners are required to commit to providing a set number of hours of medically necessary primary care services, maintain a panel size of at least 900 patients, offer after-hours access on weekends, evenings or holidays, and accept walk-in appointments until a panel size reaches 900 patients.

With 33 nurse practitioners practising independently, about 30,000 more Albertans will have access to the primary health care they need. Once the remaining 23 approved applicants begin practising, primary health care access will expand to almost 21,000 more Albertans.

“Enabling nurse practitioners to practise independently is great news for rural Alberta. This is one more way our government is ensuring communities will have access to the care they need, closer to home.”

Martin Long, parliamentary secretary for rural health

“Nurse practitioners are highly skilled health care professionals and an invaluable part of our health care system. The Nurse Practitioner Primary Care Program is the right step to ensuring all Albertans can receive care where and when they need it.”

Chelsae Petrovic, parliamentary secretary for health workforce engagement

“The NPAA wishes to thank the Alberta government for recognizing the vital role NPs play in the health care system. Nurse practitioners have long advocated to operate their own practices and are ready to meet the growing health care needs of Albertans. This initiative will ensure that more people receive the timely and comprehensive care they deserve.”

Jennifer Mador, president, Nurse Practitioner Association of Alberta

The Nurse Practitioner Primary Care program not only expands access to primary care services across the province but also enables nurse practitioners to practise to their full scope, providing another vital access point for Albertans to receive timely, high-quality care when and where they need it most.

Quick facts

  • Through the Nurse Practitioner Primary Care Program, nurse practitioners receive about 80 per cent of the compensation that fee-for-service family physicians earn for providing comprehensive primary care.
    • Compensation for nurse practitioners is determined based on panel size (the number of patients under their care) and the number of patient care hours provided.
  • Nurse practitioners have completed graduate studies and are regulated by the College of Registered Nurses of Alberta.
  • For the second consecutive year, a record number of registrants renewed their permits with the College of Registered Nurses of Alberta (CRNA) to continue practising nursing in Alberta.
    • There were more than 44,798 registrants and a 15 per cent increase in nurse practitioners.
  • Data from the Nurse Practitioner Primary Care Program show:
    • Nine applicants plan to work on First Nations reserves or Metis Settlements.
    • Parts of the province where nurse practitioners are practising: Calgary (12), Edmonton (five), central (six), north (three) and south (seven).
  • Participating nurse practitioners who practise in eligible communities for the Rural, Remote and Northern Program will be provided funding as an incentive to practise in rural or remote areas.
  • Participating nurse practitioners are also eligible for the Panel Management Support Program, which helps offset costs for physicians and nurse practitioners to provide comprehensive care as their patient panels grow.

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Addictions

BC Addictions Expert Questions Ties Between Safer Supply Advocates and For-Profit Companies

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By Liam Hunt

Canada’s safer supply programs are “selling people down the river,” says a leading medical expert in British Columbia. Dr. Julian Somers, director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University, says that despite the thin evidence in support of these experimental programs, the BC government has aggressively expanded them—and retaliated against dissenting researchers.

Somers also, controversially, raises questions about doctors and former health officials who appear to have gravitated toward businesses involved in these programs. He notes that these connections warrant closer scrutiny to ensure public policies remain free from undue industry influence.

Safer supply programs claim to reduce overdoses and deaths by distributing free addictive drugs—typically 8-milligram tablets of hydromorphone, an opioid as potent as heroin—to dissuade addicts from accessing riskier street substances. Yet, a growing number of doctors say these programs are deeply misguided—and widely defrauded.

Ultimately, Somers argues, safer supply is exacerbating the country’s addiction crisis.

Somers opposed safer supply at its inception and openly criticized its nationwide expansion in 2020. He believes these programs perpetuate drug use and societal disconnection and fail to encourage users to make the mental and social changes needed to beat addiction. Worse yet, the safer supply movement seems rife with double standards that devalue the lives of poorer drug users. While working professionals are provided generous supports that prioritize recovery, disadvantaged Canadians are given “ineffective yet profitable” interventions, such as safer supply, that “convey no expectation that stopping substance use or overcoming addiction is a desirable or important goal.”

To better understand addiction, Somers created the Inter-Ministry Evaluation Database (IMED) in 2004, which, for the first time in BC’s history, connected disparate information—i.e. hospitalizations, incarceration rates—about vulnerable populations.

Throughout its existence, health experts used IMED’s data to create dozens of research projects and papers. It allowed Somers to conduct a multi-million-dollar randomized control trial (the “Vancouver at Home” study) that showed that scattering vulnerable people into regular apartments throughout the city, rather than warehousing them in a few buildings, leads to better outcomes at no additional cost.

In early 2021, Somers presented recommendations drawn from his analysis of the IMED to several leading officials in the B.C. government. He says that these officials gave a frosty reception to his ideas, which prioritized employment, rehabilitation, and social integration over easy access to drugs. Shortly afterwards, the government ordered him to immediately and permanently delete the IMED’s ministerial data.

Somers describes the order as a “devastating act of retaliation” and says that losing access to the IMED effectively ended his career as a researcher. “My lab can no longer do the research we were doing,” he noted, adding that public funding now goes exclusively toward projects sympathetic to safer supply. The B.C. government has since denied that its order was politically motivated.

In early 2022, the government of Alberta commissioned a team of researchers, led by Somers, to investigate the evidence base behind safer supply. They found that there was no empirical proof that the experiment works, and that harm reduction researchers often advocated for safer supply within their studies even if their data did not support such recommendations.

Somers says that, after these findings were published, his team was subjected to a smear campaign that was partially organized by the British Columbia Centre on Substance Use (BCCSU), a powerful pro-safer supply research organization with close ties to the B.C. government. The BCCSU has been instrumental in the expansion of safer supply and has produced studies and protocols in support of it, sometimes at the behest of the provincial government.

Somers is also concerned about the connections between some of safer supply’s key proponents and for-profit drug companies.

He notes that the BCCSU’s founding executive director, Dr. Evan Wood, became Chief Medical Officer at Numinus Wellness, a publicly traded psychedelic company, in 2020. Similarly, Dr. Perry Kendall, who also served as a BCCSU executive director, went on to found Fair Price Pharma, a now-defunct for-profit company that specializes in providing pharmaceutical heroin to high-risk drug users, the following year.

While these connections are not necessarily unethical, they do raise important questions about whether there is enough industry regulation to minimize potential conflicts of interest, whether they be real or perceived.

The BCCSU was also recently criticized in an editorial by Canadian Affairs, which noted that the organization had received funding from companies such as Shoppers Drug Mart and Tilray (a cannabis company). The editorial argued that influential addiction research organizations should not receive drug industry funding and reported that Alberta founded its own counterpart to the BCCSU in August, known as the Canadian Centre of Recovery Excellence, which is legally prohibited from accepting such sponsorships.

Already, private interests are betting on the likely expansion of safer supply programs. For instance, Safe Supply Streaming Co., a publicly traded venture capital firm, has advertised to potential investors that B.C.’s safer supply system could create a multi-billion-dollar annual market.

Somers believes that Canada needs more transparency regarding how for-profit companies may be directly or indirectly influencing policy makers: “We need to know exactly, to the dollar, how much of [harm reduction researchers’] operating budget is flowing from industry sources.”

Editor’s note: This story is published in syndication with Break The Needle and Western Standard.

The Bureau is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

Dr. Julian M. Somers is director of the Centre for Applied Research in Mental Health and Addiction at Simon Fraser University. He was Director of the UBC Psychology Clinic, and past president of the BC Psychological Association. Liam Hunt is a contributing author to the Centre For Responsible Drug Policy in partnership with the Macdonald-Laurier Institute.

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