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

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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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Alberta

Fraser Institute: Time to fix health care in Alberta

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From the Fraser Institute

By Bacchus Barua and Tegan Hill

Shortly after Danielle Smith was sworn in as premier, she warned Albertans that it would “be a bit bumpy for the next 90 days” on the road to health-care reform. Now, more than two years into her premiership, the province’s health-care system remains in shambles.

According to a new report, this year patients in Alberta faced a median wait of 38.4 weeks between seeing a general practitioner and receiving medically necessary treatment. That’s more than eight weeks longer than the Canadian average (30.0 weeks) and more than triple the 10.5 weeks Albertans waited in 1993 when the Fraser Institute first published nationwide estimates.

In fact, since Premier Smith took office in 2022, wait times have actually increased 15.3 per cent.

To be fair, Premier Smith has made good on her commitment to expand collaboration with the private sector for the delivery of some public surgeries, and focused spending in critical areas such as emergency services and increased staffing. She also divided Alberta Health Services, arguing it currently operates as a monopoly and monopolies don’t face the consequences when delivering poor service.

While the impact of these reforms remain largely unknown, one thing is clear: the province requires immediate and bold health-care reforms based on proven lessons from other countries (e.g. Australia and the Netherlands) and other provinces (e.g. Saskatchewan and Quebec).

These reforms include a rapid expansion of contracts with private clinics to deliver more publicly funded services. The premier should also consider a central referral system to connect patients to physicians with the shortest wait time in their area in public or private clinics (while patients retain the right to wait longer for the physician of their choice). This could be integrated into the province’s Connect Care system for electronic patient records.

Saskatchewan did just this in the early 2010s and moved from the longest wait times in Canada to the second shortest in just four years. (Since then, wait times have crept back up with little to no expansion in the contracts with private clinics, which was so successful in the past. This highlights a key lesson for Alberta—these reforms are only a first step.)

Premier Smith should also change the way hospitals are paid to encourage more care and a more patient-focused approach. Why?

Because Alberta still generally follows an outdated approach to hospital funding where hospitals receive a pre-set budget annually. As a result, patients are seen as “costs” that eat into the hospital budget, and hospitals are not financially incentivized to treat more patients or provide more rapid access to care (in fact, doing so drains the budget more rapidly). By contrast, more successful universal health-care countries around the world pay hospitals for the services they provide. In other words, by making treatment the source of hospital revenue, hospitals provide more care more rapidly to patients and improve the quality of services overall. Quebec is already moving in this direction, with other provinces also experimenting.

The promise of a “new day” for health care in Alberta is increasingly looking like a pipe dream, but there’s still time to meaningfully improve health care for Albertans. To finally provide relief for patients and their families, Premier Smith should increase private-sector collaboration, create a central referral system, and change the way hospitals are funded.

Bacchus Barua

Director, Health Policy Studies, Fraser Institute

Tegan Hill

Director, Alberta Policy, Fraser Institute
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Alberta

Province says Alberta family doctors will be the best-paid and most patient-focused in the country

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Dr. Shelley Duggan, president, Alberta Medical Association

New pay model, better access to family doctors

Alberta’s government is implementing a new primary care physician compensation model to improve access to family physicians across the province.

Alberta’s government recognizes that family physicians are fundamental to strengthening the health care system. Unfortunately, too many Albertans do not currently have access to regular primary care from a family physician. This is why, last year, the government entered into a memorandum of understanding with the Alberta Medical Association (AMA) and committed to developing a new primary care physician compensation model.

Alberta’s government will now be implementing a new compensation model for family doctors to ensure they continue practising in the province and to attract more doctors to choose Alberta, which will also alleviate pressures in other areas of the health care system.

This new model will make Alberta’s family doctors the strongest-paid and most patient-focused in the country.

“Albertans must be able to access a primary care provider. We’ve been working hard with our partners at the Alberta Medical Association to develop a compensation model that will not only support Alberta’s doctors but also improve Albertans’ access to physicians. Ultimately, our deal will make Alberta an even more attractive place to practise family medicine.”

Danielle Smith, Premier

“We have worked with the Alberta Medical Association to address the challenges that primary care physicians are facing. This model will provide the supports physicians need and improve patient access to the care they need.”

Adriana LaGrange, Minister of Health

The new model is structured to encourage physicians to grow the number of patients they care for and encourage full-time practice. Incentives include increases for:

  • Maintaining high panel numbers (minimum of 500 patients), which will incentivize panel growth and improve access to primary care for patients.
  • Providing after-hours care to relieve pressure on emergency departments and urgent care centres.
  • Improving technology to encourage using tools that help streamline work and enhance patient care.
  • Enhancing team-based care, which will encourage developing integrated teams that may include family physicians, nurse practitioners, registered nurses, dietitians and pharmacists to provide patients with the best care possible.
  • Adding efficiencies in clinical operations to simplify processes for both patients and health care providers.

As a market and evidence-based model, it recognizes and pays for the critically important work of physicians, including the number of patients seen and patient complexity, as well as time spent providing direct and indirect care.

“Family medicine is the foundation of our health care system. This model recognizes the extensive training, experience and leadership of primary care physicians, and we hope it will help Alberta to attract and retain more family medicine specialists who provide comprehensive care.”

Dr. Shelley Duggan, president, Alberta Medical Association

Additionally, family physicians who are not compensated through the traditional fee-for-service model will now receive higher pay rates under their payment model, known as the alternative relationship plan. This includes those who provide inpatient care in hospitals and rural generalists. Alberta’s government is increasing this to ensure hospital-based family physicians and rural generalists also receive fair, competitive pay that reflects the importance of these roles.

“This new compensation model will make Alberta more attractive for physicians and will make sure more Albertans can have improved access to a primary care provider no matter where they live. It will also help support efforts to strengthen primary care in Alberta as the foundation of the health care system.”

Kim Simmonds, CEO, Primary Care Alberta

“Family physicians have been anxiously awaiting this announcement about the new compensation model. We anticipate this model will allow many primary care physicians to continue to deliver comprehensive, lifelong care to their patients while keeping their community clinics viable.”

Dr. Sarah Bates, president, family medicine section, Alberta Medical Association

Quick facts

  • Enrolment in the primary care physician compensation model will begin in January with full implementation in spring 2025, provided there are at least 500 physicians enrolled.
  • The alternative relationship plan rate has not been updated since it was initially calculated in 2002.
  • The new compensation model for family doctors is the latest primary health care improvement following actions that include:
    • A $42-million investment to recruit more health providers and expand essential services.
    • A new rural and remote bursary program for family medicine resident physicians.
    • Additional funding of $257 million to stabilize primary care delivery and improve access to family physicians.
    • Implementing the Nurse Practitioner Primary Care Program, which expands the role of nurse practitioners by allowing them to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.

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