Industry documents

Study objective

Files reveal discussions among clinicians that demonstrate serious issues about the ethical and scientific basis of their sex-rejecting procedures, highlighting issues with WPATH’s (World Professional Association for Transgender Health) Standards of Care (SOC) which has shaped global transgender healthcare policies.

Findings

• Lack of informed consent: clinicians acknowledging that some patients, including minors and those with severe mental health issues, are receiving irreversible treatments such as puberty blockers, hormones, and surgeries despite not being able to fully understand the consequences, such as infertility or loss of sexual function.
• Awareness of harmful outcomes: WPATH members discuss serious side effects of treatments, including cancer, pelvic floor dysfunction, and sterility, yet often dismiss concerns about long-term patient outcomes, prioritizing access to interventions over caution.
• Unscientific practices: The files reveal an improvisational approach to treatments, with clinicians discussing experimental procedures like “nullification” surgeries and acknowledging a lack of evidence for long-term outcomes, undermining WPATH’s claim of providing evidence-based care.

Findings

• The rule prohibits federal Medicaid dollars for sex-rejecting procedures for individuals under age 18, and federal Children’s Health Insurance Program (CHIP) dollars for individuals under age 19 (CMS-2451-F).
• HHS says the final rule is scheduled to take effect October 13, 2026.

Findings

• HHS reports that more than 225 hospitals and health systems established pediatric gender programs nationwide.
• Nationwide claims data from 2015 through 2025 identified approximately $50 million in insurance claims for puberty blockers billed using endocrine disorder diagnostic code E34.9 (Endocrine Disorder, Unspecified).

Findings

• Nationwide register of all under-23s referred to specialised gender identity services, 1996–2019: 2,083 people vs 16,643 matched controls.
• Specialist psychiatric care was already higher before referral (45.7% vs 15.0%) and still higher two or more years later (61.7% vs 14.6%).
• Among those who received medical gender reassignment, the share in specialist psychiatric care rose — 9.8% to 60.7% after feminising reassignment, 21.6% to 54.5% after masculinising.
• The authors: psychiatric needs do not subside after medical gender reassignment.

Findings

• ASPS advises delaying breast/chest, genital, and facial gender surgery until patients are at least 19.
• The statement cites insufficient evidence of a favorable risk–benefit ratio and low-certainty mental-health evidence.
• It notes concerns about long-term harms and irreversibility in a developmentally vulnerable population.
• This is professional guidance.