Eunuchs, indeed. Both figurative and self-identified. That’s the shocking scandal of WPATH—the World Professional Association of Transgender Health—that the state of Alabama exposes in its powerful amicus brief in United States v. Skrmetti (and that I have addressed in previous posts).
The legal question that the Supreme Court will decide in Skrmetti is whether a Tennessee law that bars health-care providers from administering puberty blockers and cross-sex hormones to children as treatment for gender dysphoria violates the Equal Protection Clause. In leading the crusade against Tennessee’s law, the Biden administration relies squarely on WPATH’s supposed “evidence-based guidelines for the treatment of gender dysphoria,” guidelines it says that the “Nation’s leading medical and mental health organizations recognize … as reflecting the accepted standard of care for treating gender dysphoria.”
In separate litigation in defense of its similar law, the state of Alabama has uncovered the “medical, legal, and political scandal” of WPATH’s guidelines. It lays out that scandal in its amicus brief.
Let’s start with the figurative eunuchs, the men and women in the world of science who were supposed to have the courage and integrity to speak accurately about the evidence bearing on transgender interventions on minors but who instead made or acquiesced in changes to WPATH’s proposed guidelines for political reasons.
As Alabama documents in its brief (pp. 10-23), WPATH developed its guidelines (SOC-8) as a political and legal weapon rather than as medical advice. Its goal, as one WPATH author put it, was to provide “a tool for our attorneys to use in defending access to care.” HHS assistant secretary (and transgender ideologue) Rachel Levine “met regularly with WPATH leaders.” Levine’s office objected strenuously to a draft that listed “specific minimum ages for treatment” on the ground that it would “result in devastating legislation for trans care.” Levine asked WPATH leaders to remove the age recommendations. WPATH initially told Levine that it could not do so because those recommendations had already been approved by its vaunted consensus process. But after the American Academy of Pediatrics threatened to oppose the guidelines if the age recommendations remained in, WPATH caved. And it did so without running that major change through the process that it falsely claimed to have used for the entire guidelines. It then tried to cover up what it had done.
In plenty of other respects as well (see pp. 24-34), WPATH did not abide by the principles of evidence-based medicine that it claimed to follow. Ignoring standards governing conflicts of interest, it limited participation in writing the new guidelines to individuals who were already enthusiastic about transitioning treatments, including one doctor who acknowledged making “more than a million dollars” from transitioning surgeries in the previous year. It obscured significant differences in the supposed strength of its various recommendations, and it prevented its own evidence-review teams from publishing unwelcome findings—e.g., that the researchers into the effectiveness of various types of interventions “found little to no evidence about children and adolescents.” WPATH instead mandated that any publications “use the Data for the benefit of advancing transgender health in a positive manner.”
As Alabama points out (pp. 34-36), an entire chapter in WPATH’s new guidelines on those who identify as “eunuchs” illustrates “how unscientific the SOC-8 enterprise was”: “Because eunuchs ‘wish for a body that is compatible with their eunuch identity,’ WPATH recommends ‘castration to better align their bodies with their gender identity.”
And how, Alabama asks rhetorically, did WPATH determine that castration is “medically necessary gender-affirming care”? The answer is astonishing and completely discrediting:
From the internet—specifically a “large online peer-support community” called the “Eunuch Archive.” According to SOC-8 itself, the “Archive” contains “the greatest wealth of information about contemporary eunuch-identified people.” The guideline does not disclose that part of the “wealth” comes in the form of the Archive’s fiction repository, which hosts thousands of stories that “focus on the eroticization of child castration” and “involve the sadistic sexual abuse of children.” “The fictional pornography” “includes themes such as Nazi doctors castrating children, baby boys being fed milk with estrogen in order to be violently sex trafficked as adolescents, and pedophilic fantasies of children who have been castrated to halt their puberty.” [Emphasis added.]