GENDER DYSPHORIA - FACTS AND INFORMATION

WPATH Standards of Care

Not recommended as clinical practice

The WPATH (World Professional Association for Transgender Health) calls itself a science and evidence-based, international medical organisation. But this is only a facade. The facts below make it clear that it is an advocacy organisation that puts politics before the health of patients, and advocates a reckless experiment.

A brief history

It began with WPATH’s Standards of Care 6 (SOC6) in 2001, a set of guidelines steeped in ideology but lacking scientific rigor. Eight years later, the Endocrine Society issued its own guidelines, relying on SOC6 despite its weak evidence base; many Endocrine Society authors were also WPATH members, and WPATH co-sponsored the production of these guidelines. Then, in 2012, WPATH produced its Standards of Care 7 (SOC7), based on the recommendations of the Endocrine Society, which were in turn based on WPATH’s own unsubstantiated SOC6.

This level of collusion and deception is already staggering, but the story gets yet more unbelievable. The Cass Review revealed that WPATH’s SOC7 set off a chain reaction, with medical associations worldwide being duped by WPATH into producing equally flimsy guidelines based on WPATH’s unsupported recommendations.

Then, in 2022, WPATH took this citation cartel to a new extreme with its outrageously ideological Standards of Care 8 (SOC8), infamous for its Eunuch chapter. To legitimize its recommendations, SOC8 cites many of those same international guidelines—guidelines that were themselves built on WPATH’s earlier, unscientific claims. In essence, what this means is that at the heart of this tangled web of circular citations lies an empty shell, devoid of real science.

Sceptics reacted to these new standards of care with bewilderment and dismay. Briefly, we list their main objections:

Despite growing skepticism, standards of care continue to promote the affirmative care model with medical treatments.
Early medicalisation is fundamentally recommended. Age limits were removed, distancing them from their responsibility for basic child protection standards.
Independent systematic reviews, which judged the evidence for gender affirming treatments in adolescents to be of very low quality, were ignored.
A chapter on ethics was dropped.
Eunuch was included as a new gender identity, without convincing evidence of its existence.
Detransition is not acknowledged as the traumatic experience it is.

2024 – Annus Horribilis van de WPATH

On 4 March, there was the publication of the WPATH files, which revealed leaked internal communications from the organisation’s message forum. It made it clear that what the WPATH calls gender care is neither science nor medicine, but a widespread malpractice of pseudoscientific surgical and hormonal experimentation on adolescents and vulnerable adults. Despite WPATH members being aware of an underlying problem at the root of gender dysphoria, and of the long-term consequences of the debilitating and potentially fatal side effects of cross-sex hormones and other treatments, this is ignored.
In April, the Cass Report was published, the result of a four-year independent, in-depth review of gender care for children and young people in the UK, led by Dr Hilary Cass and commissioned by NHS England (National Health Service). This is the most extensive study conducted to date. It includes approximately 9,000 patients who were treated at the Gender Identity Development Services in Tavistock in London.
As part of the study, the Cass Review commissioned a systematic review of the guidelines in gender medicine, which showed that WPATH, together with the Endocrine Society, created a false consensus on so-called gender-affirming care.A scathing assessment of poor quality and lack of independence for the guidelines by WPATH, The American Academy of Pediatrics (AAP), and the Endocrine Society (ES).
As part of the Cass review, an independent team of research methodologists assessed all the current treatment guidelines and recommendations for quality in a systematic review, using the internationally recognized AGREE II methodology for evaluating guideline quality. The AAP 2018 treatment recommendations scored amongst those at the bottom of the 23 reviewed guidelines. The WPATH and the ES treatment recommendations did not fare much better. The review noted a marked lack of independence in guideline authorship, noting circular referencing: one non-evidence-based guideline was used to justify another non-evidence-based guideline’s recommendation. The marked overlap in authorship between the guidelines (especially between WPATH and ES) was noted as a significant cause for concern, as was WPATH’s refusal to acknowledge the results of their own systematic review in its adolescent section.
A month later in June 2024, internal WPATH emails – unsealed documents in the lawsuit over Alabama’s gender-affirming health care ban – revealed that WPATH interfered with independent systematic reviews. In 2018, WPATH commissioned a series of systematic reviews from Johns Hopkins University to support the development of SOC8. However, when the findings did not match WPATH’s political agenda, the organisation blocked their publication. But there was more. Emails show that Admiral Rachel Levine, Biden’s assistant secretary for Health and Human Services, pressured WPATH to remove minimum age recommendations from SOC8, arguing that such restrictions could undermine the Biden administration’s political agenda.

Although these events received international attention, it was largely ignored by the mainstream media. The WPATH has not yet apologised or changed course. Some mistakes are probably too devastating to face.

What does Belgium have to do with the WPATH?

The gender clinic at UZ Gent still invokes the Standards of Care 8 of the WPATH. UZ Gent was assigned an expertise role to guide new Belgian gender centres that want to be recognised for convention transgender care (Belgian health insurance that reimburses costs). A condition for convention is: more emphasis on ICD-11 and the use of the diagnostic term ‘gender incongruence’ in line with the SOC8 recommendations.
The EPATH (European Professional Association for Transgender Health), the European branch of the WPATH was founded in 2013. There were remarkably many Belgians among the initiators (Griet De Cuypere, Guy T’Sjoen, Joz Motmans, Karlien Dhondt, Stan Monstrey), all from the Ghent Gender Clinic.
From 2000-2005, Stan Monstrey was a board member and then president (2005-2007) of the HBIGDA (Harry Benjamin International Gender Dysphoria Association), now the WPATH. He is also a co-author of the SOC8.
Griet De Cuypere, former board member of the WPATH and co-author of the SOC8.
Guy T’Sjoen, former president EPATH (2021) and co-author of the SOC8, Gender Team UZ Gent, former head of Centre for Sexology and Gender UZ Gent.
Joz Motmans, WPATH board member, former president EPATH (2023) and co-author of the SOC8 chapter non-binarity with Walter P. Bauman (UK), gender team coordinator UZ Gent.
As of 8 March 2025, WPATH has 2696 members worldwide, of which Belgium has 15 members (on 21/8/2024, Belgium still had 27 members), the Netherlands 36 members, France 4 members, UK 57 members, Germany 25 members.

Epilogue

This fraudulent and unethical organization also deserves no sympathy. For far too long, it has pursued political goals under the guise of medicine, dismantling safeguards around extreme medical interventions and shifting blame onto victims when the harm becomes undeniable. This cannot be allowed to continue for another moment. Every action and decision WPATH has ever made must be ruthlessly investigated, and its central role in this medical scandal fully exposed. The truth must not only be brought to light; it must bring with it real and severe consequences.