Mostly Cloudy pointed us to The Economist on the WPATH files.

Leaked discussions reveal uncertainty about transgender care

Already we’re in the woods, because calling it “care” is tendentious.

The files shed light on a controversial area of medicine that has largely retreated into the shadows

A big stride farther into the woods, because it’s not really medicine as commonly understood. It’s more like tampering.

Few areas of medicine arouse as strong emotions in America as transgender care.

Not really medicine and not really care. Experimentation perhaps, stripped of most of the usual cautions.

It’s strange that such a reckless ideological pseudo-medical trend has even conservative publications like The Economist mouthing the jargon.

The publication this week of hundreds of posts from an internal messaging forum will add fuel to this fire. The files show members of the World Professional Association for Transgender Health (wpath), an interdisciplinary professional and educational association devoted to the field, discussing how to treat patients.

The non-profit group that obtained and published the files, Environmental Progress, which pushes strong views on more than just the environment, claims that the documents reveal “widespread medical malpractice on children and vulnerable adults”. That claim is questionable. 

Well sure it is, but so is the claim that giving people cross-sex hormones and neo-genitalia is medical care.

But wpath standards of care have previously been cited by other medical organisations, particularly in America. The discussions of its members show that the provision of so-called gender-affirming care is riddled with far more doubt than wpath’s outward message that such interventions are “not considered experimental”.

And why is that? Because so many lunatics are so determined to make these horrifyingly drastic interventions seem normal and beneficial.

Based on the files, wpath has members who are worryingly dogmatic. But mostly the exchanges reveal a group of surgeons, social workers and therapists struggling with how best to serve patients. They debate the challenges of gaining informed consent for medical treatments from children and people with mental-health disorders.

Except, yet again, that the “medical treatments” are not medical treatments as commonly understood. They’re new and experimental and drastic. This fact matters.

Concerns about making irreversible changes to children’s bodies, and the impossibility of gaining their informed consent for this, have been at the heart of controversy over transgender medicine. In America 23 states have now restricted or banned such care for minors, even though almost all medical associations in America support it…

Which itself is bizarre.

The surgeon from California shares his website, which includes a menu of surgical options, and adds that he’s “quite comfortable tailoring my operations to serve the needs of each patient”. This attitude to surgical shopping is uniquely American. Pandering to it will not help gender medicine with its argument that it is medically necessary and non-experimental.

There you go. This is what I’m saying. It applies to the whole thing, not just to the surgeon from California.

wpath, and those arguing for gender-affirming care more broadly, have felt the need to present a level of certainty in an area of medicine full of uncertainty. Bringing frank discussion into the open will surely be healthy. 

And not assuming that it is a genuine “area of medicine” will also surely be healthy.