Overview

The World Professional Association for Transgender Health (WPATH) writes the Standards of Care (SOC), the most widely cited guideline for medical transition. Between 2024 and 2026 a series of leaks, court disclosures and official reviews raised serious questions about how those guidelines were made. This page covers four of them: the leaked forum posts and panel recording known as the WPATH Files (March 2024), the Johns Hopkins evidence reviews that WPATH commissioned and then restricted, the removal of age minimums from the 2022 eighth edition (SOC8) after outside pressure, and the eunuch chapter on people who identify as eunuchs. It then looks at the fallout, from court rulings to a US Federal Trade Commission (FTC) lawsuit, and sets out WPATH's defence.

Quotes below come from primary documents wherever possible: the screenshots and transcript in the WPATH Files report, the SOC8 text, court filings and the US Supreme Court's opinion in United States v. Skrmetti, the 2025 case that upheld Tennessee's ban on youth gender medicine. Much of the court material comes through filings by the State of Alabama, a litigant. Those filings quote internal documents but are advocacy, and are labelled as such.

What WPATH is

From HBIGDA to SOC8

WPATH was founded in 1979 as the Harry Benjamin International Gender Dysphoria Association (HBIGDA). It describes itself as "a 501(c)(3) non-profit, interdisciplinary professional and educational organization devoted to transgender health" (WPATH). Its guidelines have loosened over time. The 1998 version allowed puberty blockers and hormones for minors in "rar[e]" circumstances. SOC7 (2012) "began permitting cross-sex hormones for children under the age of 16", as the US Supreme Court summarised (United States v. Skrmetti 2025). SOC8, published in September 2022, set no minimum ages for hormones or for any surgery except phalloplasty (Coleman et al. 2022).

Who can join

WPATH is not a body made up only of clinicians. SOC8 describes its membership as "over 3,000 health care professionals, social scientists, and legal professionals, all of whom are engaged in clinical practice, research, education and advocacy". Full voting membership is open to professionals in "medicine, psychology, law, social work, counseling, psychotherapy, nursing, family studies, sociology, anthropology, speech and voice therapy and sexology" (WPATH membership). Non-professionals can join too. WPATH's bylaws state:

Other persons applying for membership in the Association who do not have any relevant professional connection with the field, yet pay dues as prescribed by the Board of Directors, will be regarded as supporting members of the Association without voting rights. — (WPATH Bylaws 2016)

Why its guidelines matter

The SOC are referenced by clinics, insurers, courts and other medical associations. A US employer plan administered by Aetna, for example, tells members: "Coverage is based on the Standards of Care published by the World Professional Association for Transgender Health (WPATH)" (Aetna). The University of York's appraisal for the Cass Review (England's independent review of youth gender services) found that WPATH and the Endocrine Society (the main professional body for US hormone specialists) "formed the basis for most other guidance" worldwide (Taylor et al. 2024). The SOC therefore act as a single point of failure. If WPATH's process is flawed, the flaw is copied into clinic protocols, insurance rules and court arguments around the world.

Timeline

The WPATH Files (2024)

What was leaked

On 4 March 2024 the US think tank Environmental Progress, founded by Michael Shellenberger, published The WPATH Files: Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults. It contains an analysis by journalist Mia Hughes followed by the raw material. According to its press release, this is "screenshots of posts from WPATH's internal messaging forum dating from 2021 to 2024 and a video of an internal panel discussion", with most names redacted except "WPATH members of public significance" (Environmental Progress). The panel was a WPATH Global Education Institute "Identity Evolution Workshop" held on 6 May 2022.

The report is openly polemical, but its appendix reproduces the raw screenshots and transcript, and those can be read on their own terms.

Consent and comprehension in minors

In the recorded panel, Canadian paediatric endocrinologist Daniel Metzger described discussing fertility with young patients:

I think, I think when we're doing informed consent, I know that that's still a big lacuna of, of that we're just, we do it. We try to talk about it, but most of the kids are nowhere in any kind of a brain space to really, really, really talk about it in a serious way. I, that's always bothered me, but you know, we still want the kids to. Be happy, happier in the moment, right? — Daniel Metzger, WPATH Identity Evolution Workshop transcript (The WPATH Files, p. 192)

He also said that "the Dutch researchers… gave some data about, um, young adults who had transitioned and reproductive regret, like regret, and it's there." Child psychologist Dianne Berg, a co-author of SOC8's child chapter, said in the same session that "it's out of their developmental range sometimes to understand the extent to which some of these medical interventions are impacting them" (transcript, p. 185).

These statements go to the heart of the informed consent critique. A treatment that causes infertility is ethically defensible only if the patient can understand and weigh that loss. Here, clinicians who give the treatment said in private that many of their patients could not, and that they continue anyway.

Sexual function: the Bowers post

The most widely cited document is a forum post dated 31 January 2022 by Marci Bowers, a surgeon who became WPATH president. Asked for the sources on orgasm and fertility after puberty blockers, Bowers replied:

The orgasmic response question is thornier and observational based largely upon the growing cohort of puberty blocked individuals seeking gender affirming surgical care years later (i.e. now, with our office providing that care to a large number). To date, I'm unaware of an individual claiming ability to orgasm when they were blocked at Tanner 2. Clearly, this number needs documentation and the longterm sexual health of these individuals needs to be tracked. Again, puberty blockade is in its infancy— observational reports are commonly the nidus for future study, as will likely be the case here. — Marci Bowers, WPATH member forum (The WPATH Files, p. 117)

In the same post Bowers wrote that "puberty onset allows for fertility options while blockers preclude those opportunities." Tanner stage 2 is the very start of puberty, the point at which SOC8 allows blockers to begin. The post is an observation from one surgical practice, not a study, and Bowers says so. That is the point: a treatment pathway given to children had, by its own leading surgeon's account, no outcome data on adult sexual function. Bowers called puberty blockade an intervention "in its infancy" and its effects things that "need to be tracked". That is a fair description of an experiment. See sexual function and puberty blockers.

Mental illness and capacity

Several threads concern adults with serious psychiatric conditions. Dan Karasic, lead author of SOC8's mental health chapter, wrote that "the mere presence of psychiatric illness should not block a person's ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks." A gender therapist described getting consent for hormones from every "alter" of a client with dissociative identity disorder. Critics argue that capacity is hardest to judge in conditions such as dissociation, where the stability of the self is the very thing in question (see mental health).

Complications

Christine McGinn, a surgeon, reported having "performed about 20 vaginoplasties in patients under 18 over the past 17 years", adding: "Not all of these vaginoplasties had perfect outcomes" (p. 73). Other posts describe liver tumours in a 16-year-old on hormones, vaginal atrophy and pain with orgasm on testosterone, and painful erections on estrogen. Single cases cannot show how common such outcomes are. They do show that serious complications were known and discussed among practitioners. The question is whether patients were told.

Detransition

Bowers, replying to a post about a detransition study, wrote that "acknowledgment that de-transition exists even to a minor extent is considered off limits for many in our community". A thread on Lisa Littman's 2021 survey of 100 detransitioners (Littman 2021) drew mixed replies. One member argued that a change of mind should not be "seen as a mistake". A Canadian doctor described a new cohort of "mostly natal females who are expressing regret" and asked for help supporting them (pp. 105–106).

Criticisms of the report

Defenders of WPATH made several criticisms, some of which hold up:

• Editorialising and omitted context. The excerpts document quotes Berg as saying "[It is] out of their developmental range to understand", leaving out the word "sometimes" that appears in the transcript. Metzger's "talking to a blank wall" remark is followed in the transcript by "And the same would happen for a cisgender kid", which the report does not include. These are real distortions, even if they do not change the substance.
• Anecdotes as evidence of risk. STAT News reported experts saying the report presented a false link between hormones and cancer. Carl Streed, a WPATH board member, said: "When you hear of a one-off case, you have to balance that against the tens of thousands of people who've been on testosterone and are doing well" (STAT 2024).
• Source and motive. Writer Erin Reed and others called the report a politically motivated attack. They argued that it cherry-picked forum posts and treated low regret figures as "suspicious" rather than as evidence of good care (Erin in the Morning).

Those criticisms bear on the report's framing. They do not touch the primary documents, which no one has shown to be fake, and the statements by Metzger, Berg and Bowers quoted above come from those documents.

WPATH's response

Bowers issued a statement saying WPATH "is and has always been a science- and evidence-based organization whose recommendations are widely endorsed by major medical organizations around the world" (Gender Clinic News). Members were advised not to respond to the media.

The Johns Hopkins evidence reviews

In 2018 WPATH paid the Johns Hopkins University Evidence-based Practice Center, led by Karen Robinson, to carry out systematic reviews for SOC8; SOC8 says most of its grant "went to pay" the centre (Coleman et al. 2022). Emails disclosed in Boe v. Marshall in 2024 show a long fight over who controlled the results. In December 2017 WPATH's executive director told Robinson the researchers "cannot publish their findings independently". Robinson replied that Hopkins "will not sign something that limits academic freedom in this manner". After seeing two manuscripts in 2020, WPATH imposed a new approval policy. An October 2020 email said research must be "thoroughly scrutinised and reviewed to ensure that publication does not negatively affect the provision of transgender health care in the broadest sense" (The Economist, via SEGM).

According to Alabama's Supreme Court brief, which cites the court exhibits, the policy also required authors to "use the Data for the benefit of advancing transgender health in a positive manner" and to involve "at least one member of the transgender community" in final approval. In August 2020 Robinson wrote to a US federal health research agency that "we found little to no evidence about children and adolescents" and that she was "having issues with this sponsor… trying to restrict our ability to publish". A WPATH leader later wrote: "We were caught on the wrong foot when the Johns Hopkins University Team informed us of wanting to publish 3 papers based on the SOC8 data" (Alabama amicus brief 2024).

Only a small number of the Hopkins reviews were ever published. One of them, a 2021 review of hormone therapy, found low-strength evidence and no difference in adolescents' quality-of-life scores after a year of treatment. The Economist reported that an internal checklist confirmed a WPATH representative's involvement in approving that article, although the article stated that the authors alone were responsible for its content. Meanwhile SOC8's adolescent chapter states that "a systematic review regarding outcomes of treatment in adolescents is not possible." The US government's own expert in the Alabama case testified that "a systematic review is always possible." A 2023 BMJ investigation had already reported that reviews commissioned by WPATH and the Endocrine Society rated the evidence on adolescent hormone treatment as low or very low, and that guidelines often paired strong recommendations with weak evidence (Block 2023). A further BMJ investigation in 2024 examined the dispute over WPATH's role in the WHO's transgender health guideline (BMJ 2024).

One SOC8 contributor explained in an email why some authors resisted formal evidence review. The message was quoted by Judge Lagoa of the Eleventh Circuit and again by Justice Thomas:

Our concerns, echoed by the social justice lawyers we spoke with, is that evidence-based review reveals little or no evidence and puts us in an untenable position in terms of affecting policy or winning lawsuits. — SOC8 contributor, quoted in (United States v. Skrmetti 2025)

Removal of age minimums

A near-final SOC8 draft set minimum ages: 14 for hormones, 15 for mastectomy, 16 for breast augmentation and some facial surgery, 17 for metoidioplasty, orchiectomy, vaginoplasty and hysterectomy, and 18 for phalloplasty. It also allowed exceptions for "significant, compelling reasons". According to documents filed in Boe v. Marshall, the office of then-US Assistant Secretary for Health Rachel Levine reviewed an "Embargoed Copy – For Your Eyes Only" draft in July 2022. It warned that listing "specific minimum ages for treatment… under 18, will result in devastating legislation for trans care", and suggested moving the ages to an "adjunct document" that would be "less visible". A WPATH participant wrote that Levine "was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth" and that "She asked us to remove them" (Alabama amicus brief 2024). The New York Times reported the same documents on 25 June 2024.

Chapter authors objected in internal messages. One wrote: "I don't know how I feel about allowing US politics to dictate international professional clinical guidelines that went through Delphi." The American Academy of Pediatrics also pressed for removal. WPATH first downgraded the ages from a recommendation to a "suggestion", then dropped them; because SOC8 had already gone online with the ages included, it issued a correction. The SOC8 chair, Eli Coleman, testified that the change was made "without being presented any new science", and that "we did not submit that change to Delphi at the end". SOC8 nevertheless states that its recommendations reached consensus through the Delphi process (structured rounds of anonymous expert voting).

WPATH's public explanation was different. Its SOC8 FAQ says ages were "replaced by strengthened criteria" because "one-size-fits-all health care models… are not accurate or appropriate for every individual person". Bowers's draft message to Reuters said the final document "puts the emphasis back on individualized patient care rather than some sort of minimal final hurdle". Both explanations may be sincere. Neither mentions the political request.

The eunuch chapter

SOC8 added a chapter on people who identify as eunuchs, describing them as males who "wish to eliminate masculine physical features, masculine genitals, or genital functioning". It states that "eunuchs may also seek castration to better align their bodies with their gender identity", treats this as "medically necessary gender-affirming care", and says "eunuch individuals may be aware of their identity in childhood or adolescence". It also says that "due to the lack of research into the treatment of children who may identify as eunuchs, we refrain from making specific suggestions." SOC8 names an online forum, the Eunuch Archive, as holding "the greatest wealth of information about contemporary eunuch-identified people" (Coleman et al. 2022).

Critics, including the WPATH Files report and Alabama's brief, pointed out that the site's fiction section hosts violent sexual fantasies involving the castration of children, citing reporting by Reduxx. In deposition Coleman agreed that WPATH's position is that castration may be medically necessary for a physically healthy man who identifies as a eunuch. He also accepted that no diagnostic manual recognises "eunuch" as a diagnosis. Court filings also quote another SOC8 author calling the chapter "very high on speculation and assumptions, whilst a robust evidence base is largely absent".

What WPATH's own documents say about evidence

The strongest evidence that the field's science is weak comes from WPATH itself:

• SOC8: "A key challenge in adolescent transgender care is the quality of evidence", and "the long-term effects of gender-affirming treatments initiated in adolescence are not fully known."
• Coleman, in an internal "12-point strategic plan" after SOC8's publication: "[a]ll of us are painfully aware that there are many gaps in research to back up our recommendations." The same plan listed "academics and scientists who are naturally skeptical", "continuing pressure in health care to provide evidence-based care" and "increasing number of regret cases" among the "attacks on access" (Alabama brief).
• An SOC8 author, in court exhibits: "most of the recommendation statements in SOC8 are not PICO format… but consensus based or based on weak evidence." (PICO is the standard way of framing a clinical question by population, intervention, comparison and outcome.)
• Bowers, as above: puberty blockade "is in its infancy".

A quote widely attributed online to a WPATH leader, that treatment is "all experimental", could not be verified from a primary source and is not used here.

Institutional incentives

Most guideline failures in medicine involve sincere people, so the question here is structural: did WPATH's set-up give it reasons to favour particular conclusions? The evidence below comes from WPATH's own documents and sworn testimony.

Ideological incentives

• A stated advocacy mission. SOC8 states: "WPATH is committed to advocacy for these policy and legal changes", and calls on clinicians "to advocate for improved access". Its mission includes "public policy" alongside care and research.
• Membership open to advocates. As shown above, voting membership extends to law, sociology and anthropology, and non-voting membership to anyone who pays dues. SOC8 authorship was limited to WPATH members. Bowers testified that it was "important for someone to be an advocate for [transitioning] treatments before the guidelines were created" (Alabama brief).
• Guidelines written for litigation. Justice Thomas quoted a contributor: "My hope with these [Guidelines] is that they land in such a way as to have serious effect in . . . law and policy settings." He also cited an older First Circuit case recording that "WPATH aspires to be both a scientific organization and an advocacy group for the transgendered" (Skrmetti 2025). In 2022 WPATH described itself to the Alabama court as a "nonparty advocacy organization".
• Authors judging their own treatments. The York appraisal found that most guidance in this field "lacks an independent and evidence-based approach" (Taylor et al. 2024). The US National Academies standard cited in the Alabama brief says members with conflicts of interest "should represent not more than a minority" of a guideline group. Coleman testified that "most participants in the SOC-8 process had financial and/or nonfinancial conflicts of interest".

Financial incentives

• Conflicts declared as nil. SOC8 states: "No conflicts of interest were deemed significant or consequential." In deposition Bowers reported earning "more than a million dollars" in a year from transition surgeries and called it "absurd" to treat that as a reportable conflict (Alabama brief). Robinson wrote to WPATH that disclosure and management of conflicts "should take place prior to the selection of guideline members", adding: "this was not done here."
• Funding. WPATH says it is "funded primarily through the support of our membership, and through donations and grants sponsored by non-commercial sources", and SOC8 was "partly funded from a grant of the Tawani Foundation". Its conferences do seek commercial sponsors. The 2025 prospectus for USPATH, WPATH's US affiliate, opens "Dear Industry Colleagues and Supporters" (USPATH 2025), and the 2026 symposium invites exhibitors to "showcase your products and services" (WPATH 2026). This page could not verify a public list of named commercial sponsors or amounts.
• Insurance coverage. SOC8 "urges health care systems to provide these medically necessary treatments and eliminate any exclusions" from coverage. Because insurers base coverage on the SOC, the term "medically necessary" decides whether providers are paid. One internal message in the court record says "the main argument for ages is access/insurance". The FTC's 2026 complaint alleges that WPATH labelled nearly all transition services medically necessary to maximise insurance coverage. That is an allegation and has not been proven (FTC 2026).

None of this proves that any recommendation was made for money or ideology. It does show that the body judging the evidence was committed to advocacy, was made up largely of people who provide or campaign for the treatments, and wrote the rules that decide whether those treatments are paid for. Evidence-based medicine builds independence into guideline development for exactly this reason.

Fallout, 2024–2026

Courts

In Eknes-Tucker (2024), another challenge to Alabama's ban, Eleventh Circuit judge Barbara Lagoa wrote that "WPATH's lodestar is ideology, not science." In United States v. Skrmetti (June 2025) the Supreme Court upheld Tennessee's ban on medical transition for minors. Justice Thomas's concurrence said "recent revelations suggest that WPATH… bases its guidance on insufficient evidence and allows politics to influence its medical conclusions". It quoted Metzger's "blank wall" remark and the Levine episode. After the age-minimum story broke, the Biden administration said it opposed surgery for minors (Skrmetti 2025). Detransitioners' own cases are covered under lawsuits.

Professional bodies

In August 2024 the American Society of Plastic Surgeons said it "has not endorsed any organization's practice recommendations for the treatment of adolescents with gender dysphoria" (Fox News). On 3 February 2026 it recommended that surgeons "delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old" (SEGM). The next day the American Medical Association said that "in the absence of clear evidence, the AMA agrees with ASPS that surgical interventions in minors should be generally deferred to adulthood" (WTTW/AP; The Atlantic). In 2024 Coleman had testified that he knew of only two organisations that had formally endorsed SOC8; the AMA had told WPATH it "does not endorse or support standards of care".

Official and independent reviews

The Cass Review noted that most guidelines "described insufficient evidence" but "went on to cite this same evidence to recommend medical treatments" (quoted in Skrmetti; see Cass 2024). The US HHS review (2025) listed "suppression of systematic evidence reviews" and "inadequate management of conflicts of interest" among WPATH's guideline failings (HHS). A 2026 appraisal using AGREE II (a standard tool for rating guideline quality) of six SOC8 chapters by eight international assessors found rigour-of-development scores of only 39–47% and editorial-independence scores of 43–44%. Three assessors recommended not using the chapters, three recommended use with modifications, and two recommended use (Zhang et al. 2026).

The FTC

On 15 January 2026 the FTC sent WPATH a civil investigative demand. WPATH's petition to quash it was denied. On 17 June 2026 the FTC and four states sued WPATH in the Northern District of Texas. They allege deceptive claims about consensus, medical necessity, safety and suicide prevention, and failure to disclose side effects including sexual dysfunction. WPATH's separate attempt to block the case in Washington, DC failed in July 2026. In its motion to dismiss, WPATH argued that the challenged SOC8 statements "are non-actionable opinions about subjects on which there is 'medical and scientific uncertainty'" (WPATH motion to dismiss). As of October 2026 the case is pending. Critics noted the irony: a guideline promoted as the evidence-based "standard of care" was being defended in court as opinion on an uncertain subject.

WPATH's defence and the strongest counter-arguments

A fair account has to set out the best case for WPATH:

• Adult decision-making. Much of the Files concerns adults, and letting adults with psychiatric conditions consent when they have capacity is a mainstream principle.
• The Files' framing. The report trimmed quotes and leaned on anecdotes, and low reported regret in older studies is real, if incomplete, data.
• Individualised care. Fixed ages can be arbitrary, and SOC8 kept assessment criteria.
• Political targeting. The FTC action and parts of the HHS review come from an administration hostile to transition at any age, and the Alabama material comes from a litigant.
• Hard-to-study treatments. Randomised trials are difficult, and a lack of high-certainty evidence does not prove harm.

These points have some force, but they do not answer the central findings. The age minimums were removed for non-scientific reasons, by WPATH's own chair's account. The commissioned reviews were brought under an approval policy tied to whether results would "negatively affect" care. SOC8 made strong recommendations while saying a systematic review was "not possible". And WPATH's own leaders said in private that young patients often could not grasp fertility and sexual loss. Weak evidence explains why youth medical transition is uncertain. It does not explain why a guideline body would hide that uncertainty.

What detransitioners say

What detransitioners report

For many detransitioners on /r/detrans, the WPATH Files confirmed what they had experienced. Some had been treated on the assumption that the guidelines rested on solid science:

I would try my best as a teenager to research the studies behind HRT but what chance did i have when they didnt exist. I had no idea the standard of care was completely made up. I put my trust entirely into my doctors. Wow. —tyxxxty, desisted female

I can't believe I was so wrapped up in this completely experimental process, without ANY form of psychotherapy whatsoever. I was on blockers and testosterone for five years … I'm grateful beyond belief that I had already begun puberty. —bluenile02, detrans female

A detrans male who was blocked before puberty described the outcome Bowers's post points to:

Because of puberty blockers(started before natural Puberty) my penis and testicles never developed the proper growth … I was told that I simply didn't have the anatomy needed to create a neovagina because my puberty was stopped … I also have never and will NEVER achieve orgasm. —Crafty-Damage2808, detrans male

Others stress that consent forms signed as children cannot carry the weight placed on them:

as a teenager who also went through informed consent it's so messed up. i signed off on a paper that stated that these were experimental drugs and had no long term research at THIRTEEN. —shloogmo, detrans female

Some commenters argue that the SOC were never true medical standards:

The WPATH "standards of care" are not true standards. They're guidelines (i.e., doctors aren't legally required to follow them), and yes, they are activist-led and have been since WPATH was HBIGDA. —somenuanceplease, detrans female

Trans perspectives

Some trans commenters, particularly adults content with their transition, see WPATH as a protector of access and the Files as propaganda. One trans man sharing rebuttals called them a "right wing conspiacy" and added: "WPATH itself is a great trans friendly org" (Hyracotherium, trans man (FTM)). Others describe how central the SOC are to their care and coverage:

WPATH is the standard of care for trans people. It's referenced in all documents I get related to trans care from my clinic and health insurance. —DeadlyRBF, trans man (FTM)

Most insurance is using WPATH 7 standards unless you really fight with them so it's 2 letters for bottom surgery and 1 letter for top surgery. —intergalactagogue, trans woman (MTF)

These comments illustrate the point made above about insurance: the SOC decide what gets paid for. Fears that restrictions on minors will spread to adults are understandable. But scrutinising how a guideline was made is not an attack on people who are content with their transition. The real harm comes from permanent interventions given without fully informed consent, and the WPATH documents show that its own members doubted such consent was possible for many young patients.

Related pages

• Evidence reviews: Cass Review and youth gender medicine
• Tavistock GIDS
• Informed consent critique
• Sexual function after transition
• Puberty blockers
• Detransition lawsuits
• Study archive · Detransition statistics · Support directory

References

• Hughes, M. (2024). The WPATH Files: Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults. Environmental Progress. source (full report with forum screenshots and Identity Evolution Workshop transcript; executive summary and excerpts).
• Coleman, E. et al. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health 23(S1). source.
• WPATH. Mission and Vision; Membership Information; Bylaws (approved 2016). mission, membership, bylaws.
• USPATH (2025). 2025 Scientific Symposium Partnership Prospectus. source; WPATH (2026). 29th Scientific Symposium: Partnerships. source.
• Aetna. Amazon transgender benefits. source.
• State of Alabama et al. (2024). Brief of Alabama as Amicus Curiae in Support of Respondents, United States v. Skrmetti, No. 23-477. source (quotes exhibits from Boe v. Marshall, M.D. Ala. No. 2:22-cv-184).
• Supreme Court of the United States (2025). United States v. Skrmetti, 605 U.S. ___ (opinion of the Court and Thomas, J., concurring). source.
• The Economist (2024). Research into trans medicine has been manipulated, 29 June 2024 (reproduced with permission by SEGM). source.
• BMJ (2024). Dispute arises over World Professional Association for Transgender Health's involvement in WHO's trans health guideline. BMJ 387:q2227. source.
• Block, J. (2023). Gender dysphoria in young people is rising—and so is professional disagreement. BMJ. study page, source.
• Littman, L. (2021). Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Archives of Sexual Behavior. study page, source.
• Cass, H. (2024). Independent review of gender identity services for children and young people: Final report. study page.
• Taylor, J., Hall, R., Heathcote, C., Hewitt, C. E., Langton, T., Fraser, L. (2024). Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1). Archives of Disease in Childhood. source.
• Zhang, Y., Januś, D., Kaltiala, R., Karvonen, M., Ptak, J. J., Yepes-Nuñez, J. J. (2026). Quality of the World Professional Association for Transgender Health Guideline Standards of Care 8: An Appraisal Using the AGREE II Instrument. Archives of Sexual Behavior. source.
• US Department of Health and Human Services (2025). Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices — summary message. source.
• Federal Trade Commission (2026). FTC, States Sue World Professional Association for Transgender Health Over Deceptive Claims Regarding the Treatment of Children, 17 June 2026. source; complaint; order denying petition to quash.
• WPATH (2026). Motion to Dismiss, FTC et al. v. WPATH, N.D. Tex. No. 4:26-cv-00748. source; Law Dork (2026). Judge denies WPATH request to block FTC from proceeding in Texas. source.
• American Society of Plastic Surgeons statements (2024, 2026). Fox News (2024), SEGM (2026), WTTW/AP (2026); The Atlantic (2026). The Tide Goes Out on Youth Gender Medicine. source.
• STAT News (2024). Experts say leaked messages present false link between gender-affirming care and cancer. source.
• Reed, E. (2024). "WPATH Files" Authors Upset Over How "Suspiciously" Happy Trans People Are. Erin in the Morning. source.
• Lane, B. (2024). Fear and doubt. Gender Clinic News. source.