WPATH leaks

[PriOn1]

There are a number of articles appearing on Twitter about some leaked files from WPATH. The impending scandal is taking far too long to break, but there are more and more signs that journalists are no longer ignoring the situation.

https://unherd.com/newsroom/leaked-wpath-files-show-gender-clinician-abuses/

I have to turn off my wifi and go onto data mobile to access it. otherwise my phone will not show it.

“WPATH is and has always been a science- and evidence-based organization whose recommendations are widely endorsed by major medical organizations around the world."

This is what is conventionally known (and in the case of this Side of History, rather appropriately) as a "circle jerk".

@Kucinghitam

Helleofabore · Today 08:35

Bowers, just a hint. Just repeating that you are science and evidence based doesn’t mean you or your organisation is science and evidence based.

Oh come on! They IDENTIFY as a science and evidence based organisation, therefore, they are. We must accept it without question.

I find it interesting that Erin's 24 tweet rebuttal only gets to the actual leaks on tweet 23. And then this is all Erin has to say. 🤔

"23. The leaks themselves are benign. They represent exactly what we want our medical entities doing: remaining engaged with care discussions in professional collaborations with one another, discussing edge cases, and exchanging recommendations from clinical experience."

I find that quite revealing. Erin clearly wants to gloss over the actual leaks.

I don't call it benign and professional to be getting consent from an individuals many alters for irreversible medical treatment! It's utterly insane.

Tweet 24 is the usual begging bowl btw.

I agree with Arabella. All rebuttals are to be encouraged.

Including this gem in Read's document....

'When addressing supposedly "scientific" citations, the report's performance is equally lacking. For example, in the editorialized section, the report asserts that transgender individuals who undergo gender reassignment surgery "do not show positive outcomes," citing four references to support its claim. These citations include a 2004 article from The Guardian, an article from a conservative site called "The New Atlantis," which self-describes not as an academic journal but as a "public journal of ideas," the frequently misquoted "Swedish Study" whose author has expressly corrected misinterpretations by anti-trans organizations, and a quality of life study that is 15 years old, evaluating surgeries performed 30 years ago, when social discrimination likely significantly influenced the outcomes. This contrasts sharply with much newer research from peer-reviewed articles that demonstrate a substantial improvement in the quality of life for transgender individuals.'

And this is the 'much newer research'.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440516/

Quality of life improves early after gender reassignment surgery in transgender women

from 29 October 2016

Conclusion:

To our knowledge, this is the largest prospective study to follow a group of transgender patients with regards to QoL over continuous temporal measure points. Our results show that transgender women generally have a lower QoL compared to the general population. GRS leads to an improvement in general well-being as a trend but over the long-term, QoL decreases slightly in line with that of the comparison group.

Maybe Read should have spent more time with their own research....

You really could not make this up.

Also reading Erin's response.

The editorial section serves as a prime example of a "Gish gallop"—a tactic where numerous errors are thrown at once to overwhelm those attempting to critically respond.

A Gish Gallop only works in spoken debate where formulating a coherent response in the moment can be challenging.

What Erin is really saying is that there is a substantial amount of information to review, which may well be overwhelming to Erin but isn't indicative of poor argumentation, just dense information.

Rainbow

You are quite correct.

The very first thing that Read delves into was to discuss Gish Gallop followed by:

'The editorialized report relies heavily on citations that are misrepresented, either in terms of what the citations actually claim, their quality, or whether the arguments in the citations support the point being made by the author. For example, one section claims that the WPATH Standards of Care 8th revision “sent shockwaves through the medical profession,” and “provided the catalyst for the Beyond WPATH declaration, now signed by over 2,000 concerned individuals, many of whom are clinicians working with gender diverse young people.” A closer examination of the “Beyond WPATH” letter itself reveals signatories such as “John Howard - DJ” and “Collin Wynter, yoga instructor.” The vast majority of the signatories appear to be from “concerned grandparent” or “parent.” While the report presents the “declaration” as a document of primarily medical professionals, it omits that it is essentially a freely available online petition form.'

Surely, the first thing that you would lead with would be the most important finding. Or is this an example of that tactic of trying to keep eyes to the end by making people trawl through dross to keep stats looking good?

We are the professionals who best know the medical needs of trans and gender diverse individuals

Well I can't wait for the papers to start quoting WPATH professionals endorsing the eunuch fetishisation website which has pornographic stories of forcing castration onto little boys.

And as for this:

The small percentage of the population that is trans or gender diverse deserves healthcare and will never be a threat to the global gender binary."

Awful. Don't worry, we're only doing it to those children in whom we created a need.

But as they might be running out, we're extending it to children who we are categorising as 'gender diverse'. because we're sure we can create even more needs in children who aren't Barbie and Ken cut outs.

You know, girls with short hair. Gay boys. Those sorts of children.

I only skimmed it but Reed's 'fact check' isn't denying any of those exchanges amongst WPATH members took place, but rather that others have made the wrong inferences from reading them?

What are the correct responses to conversations between doctors discussing performing elective surgery on minors who are developmentally delayed such that they will never be able to give informed consent? Or removing the gonads of homeless people? Or consulting all of a mentally ill persons alternate personalities before prescribing them medically unnecessary medication? Are we meant to read this stuff and say 'yeah sounds legit'?

I know MN FWR has some of the best educated and most knowledgeable
women on the Internet... So does anyone know this paper cited in the report?

Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons A Cohort Study. Darios Getahun, Rebecca Nash, W. Dana Flanders, et al. Annals of Internal Medicine. https://doi.org/10.7326/M17-2785n

The report says "natal males on estrogen had a 5.2% risk of a blood clot in the lungs or legs, a heart attack, or a stroke within a mean of 4 years after initiating estrogen" but I think (well I hope!) that only means a risk that's 5.2% higher than the risk for some other group? The report cites the paper above and I looked up the DOI but I can't figure it out from the abstract and I don't have access to the full text. And I can do basic statistics but relative risk is very tricky to figure out.

This is what the abstract says:
"Transfeminine participants had a higher incidence of VTE, with 2- and 8-year risk differences of 4.1 (95% CI, 1.6 to 6.7) and 16.7 (CI, 6.4 to 27.5) per 1000 persons relative to cisgender men and 3.4 (CI, 1.1 to 5.6) and 13.7 (CI, 4.1 to 22.7) relative to cisgender women. The overall analyses for ischemic stroke and myocardial infarction demonstrated similar incidence across groups."

So does anyone know either way? Because a 5.2% increase in risk is not good but a 1 in 20 risk of blood clots etc would be very scary indeed!

(I did look in case Read had already fact-checked it but guess what, I couldn't find a mention....)

Our results show that transgender women generally have a lower QoL compared to the general population. GRS leads to an improvement in general well-being as a trend but over the long-term, QoL decreases slightly in line with that of the comparison group.

So it's all a complete, pointless waste of time.

And people's money, of course

I think Erin Reed may have 'skin in the game' as they say.
🤔

I might be missing something because I have not accessed the full study. But is Read using this as some evidence to counter the orgasm discussion?

'For instance, they follow the incorrect claim that citations “do not show positive outcomes” with a discussion between WPATH members centering best practices on the ability transgender people to orgasm after puberty blockers, presumably to highlight the aforementioned “no positive outcomes.” To ensure factual accuracy, studies have shown that those who took puberty blockers are capable of orgasm, with 84% reporting orgasm capability and 12% not trying, similar to cisgender rates of anorgasmia.'

And this was one of the links embedded under the 'capable of orgasm' link where I assume the statistics come from.

https://academic.oup.com/jsm/article-abstract/13/9/1438/6940484?redirectedFrom=fulltext&login=false

Patient-Reported Esthetic and Functional Outcomes of Primary Total Laparoscopic Intestinal Vaginoplasty in Transgender Women with Penoscrotal Hypoplasia

Results
Patients graded their life satisfaction a median of 8.0 (range = 4.0–10.0) on Cantril's Ladder of Life Scale. Patients scored a mean total score of 27.7 ± 5.8 on the Satisfaction With Life Scale, which indicated high satisfaction with life, and a mean total score of 5.6 ± 1.4 on the Subjective Happiness Scale. Functionality was graded a median score of 8.0 of 10 (range = 1.0–10.0) and esthetics a score of 8.0 out of 10 (range = 3.0–10.0). The mean Female Sexual Function Index total score of sexually active transgender women was 26.0 ± 6.8.
Conclusion
This group of relatively young transgender women reported satisfactory functional and esthetic results of the neovagina and a good quality of life, despite low Female Sexual Function Index scores.

despite low Female Sexual Function Index scores.

If anyone has access to this study, did the study then check 'male sexual function'? Are these male people having anal sex and orgasming or what is happening?

But to then misuse these anorgasmic stats of women to justify male people who have had their ability to orgasm removed due to surgery is a false comparison too. This paper discusses multiple reasons that build that number. And only some of the reasons are about a medically induced condition. And let's be clear, extreme modification of a healthy body part is medically induced.

https://archive.is/CUS5H

I hope Doyle addresses the castration fetishisation and awful paedophilia aspect.

Many people seem to think it's only legitimate to focus on the risks involved in the surgery, and lack of consent, kids' understanding of the implications, etc.

That the possibility it's all driven by sex is just too difficult to contemplate. Money? yes, absolutely. Sex? Oh, that's a bit much.

Read says this:

'For instance, it incorrectly conflates gender identity and sexuality, claiming that gender-affirming care is “a new form of conversion therapy” that “sterilizes lesbians and gays.” Gender identity and sexuality are fundamentally distinct. Regarding the claim of transition being a form of “conversion therapy,” evidence indicates that the vast majority of transgender individuals do not identify as straight after transitioning. Therefore, if transition were meant to serve as “conversion therapy,” it is notably ineffective in such an endeavor.'

Oh dear. I think that my head exploded.

I don't think Read actually understands with any depth the logic path about conversion therapy 'sterilising lesbian and gays'.

One of the things that massively pisses me off is when medical researchers compare transwomen (natal men)'s health to natal women and not to other natal men. Because if you have a healthy male body and you're consdering medical transition then what you need to know is how much of an increased risk are you at if you take the hormones or have the surgery compared to if you don't. And figures for women don't tell you that. They just confuse things.

Ditto the other way round for transmen (natal women) being compared to natal men and not to other natal women.

That's difficult to believe 😱

"You're not working hard enough to understand", with a sub-text of "perhaps you're too thick to understand" is a way of wielding power.

I would have expected a list of the 216 factual errors. But maybe Read covered them. I don't think that identifying yourself as having found 216 factual errors means that you actually have found 216 factual errors.

These people who make such declarations about being science and evidence based, need to start providing that evidence.

Doc Stock sums it all up in the Telegraph

https://www.telegraph.co.uk/news/2024/03/06/trans-activist-house-of-cards-ought-to-be-collapsing/

https://archive.ph/bo9Cp

Yes, example below.

Publications seem to confuse and heighten the risk of error rather than educate and contribute to patient safety. I'd originally seen the first line of this (mis)reported elsewhere but it wasn't until MedPage and reading the study that all became clear. (The risk of developing Type 2 diabetes is greater for transwomen than it is for women. However, as you might expect, the risk of transwomen developing Type 2 diabetes is is comparable to that for men.)

Diabetes Risk Higher for Transwomen vs Cisgender Females
— But risk wasn't any higher compared with cisgender men

…
Transwomen may face a higher risk for developing type 2 diabetes than cisgender women, a new study suggested.

Among those already diagnosed with type 2 diabetes at baseline, a total of 32% of transwomen were on gender-affirming hormone therapy, the group reported in the Journal of Clinical Endocrinology & Metabolism.
Transwomen also saw a 40% higher risk of developing incident type 2 diabetes during the average 3.1 years of follow-up compared with cisgender females (HR 1.4, 95% CI 1.1-1.8).
However, transwomen didn't have any excess risk for developing diabetes when compared with cisgender men (HR 1.2, 95% CI 0.9-1.5), which the researchers said "likely reflects the known gender disparity in [type 2 diabetes] risk in the general population."
And in an analysis restricted only to transgender and gender-diverse people receiving gender-affirming hormone therapy, transwomen didn't see a significantly higher prevalence of type 2 diabetes (OR 1.0, 95% 0.7-1.3) nor risk for incident diabetes (HR 1.4, 95% CI 0.8-2.4) versus cisgender females. This suggests that the excess diabetes risk for this population wasn't driven by hormonal therapy, the researchers said.

www.medpagetoday.com/endocrinology/diabetes/95937

Although transfeminine people may be at higher risk for T2DM compared with cisgender females, the corresponding difference relative to cisgender males is not discernable. Moreover, there is little evidence that T2DM occurrence in either transfeminine or transmasculine persons is attributable to GAHT use.

Study: Noreen Islam, Rebecca Nash, Qi Zhang, Leonidas Panagiotakopoulos, Tanicia Daley, Shalender Bhasin, Darios Getahun, J Sonya Haw, Courtney McCracken, Michael J Silverberg, Vin Tangpricha, Suma Vupputuri, Michael Goodman, Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data From the STRONG Cohort, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 4, April 2022, Pages e1549–e1557, https://doi.org/10.1210/clinem/dgab832

You need better friends.

@AmaryllisNightAndDay
Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons - PMC (nih.gov)
should give you access to the entire paper, for free, through Pubmed Central.
5.4 is the incidence calculated as number of cases per 1000 person-years (so you could say it's 0.54%/year). The increased risk is 4.1 and all the other numbers in the abstract (that means four times more likely that the cisgender comparison groups -interestingly it compares to both population, cismen and ciswomen).
I hope the link gets pasted correctly.

Edited to clarify the comparison

Thank you for the paper and the explanation @LostInScience ! I ❤MumsNet.