WPATH's Annus Horribilis

A year on from the release of the WPATH files, the blows keep falling, by Mia Hughes

As 2024 ended, the World Professional Association for Transgender Health could have described the past year with the same Latin phrase Queen Elizabeth II famously used in 1992: annus horribilis or ‘horrible year.’

For the Royal Family, 1992 was marred by a fire at Windsor Castle, the separation of Prince Charles and Prince Andrew from their wives, and Princess Anne’s divorce. For WPATH, 2024 was a year of endless revelations, scandalous leaks, and, one can certainly hope, irreparable damage to its carefully crafted facade as a credible medical organization. As this week marks one year since the release of The WPATH Files, it seems fitting to take this opportunity to recap WPATH’s annus horribilis.

On March 4th, 2024, The WPATH Files report—based on leaked internal communications from the organization’s messaging forum—revealed what those in the gender debate had long known: that WPATH is a fringe group of trans activists, masquerading as a professional medical association, prioritizing politics over patient health while advocating for a reckless experiment to be performed on some of the most vulnerable people in society.

While the story received international attention and appeared in several mainstream outlets, it was ignored by the BBC, the CBC, and most top US outlets. Then, the day after the release of WPATH Files, WPATH President Marci Bowers issued a statement to members containing the laughable claim that WPATH is a “science- and evidence-based organization,” along with the curious insights that “the world is not flat,” and gender, “like genitalia, is represented by diversity.”

Bowers also claimed that WPATH’s recommendations “are endorsed by major medical organizations around the world,” which leads us to the next major blow to the group’s reputation in 2024. Just one month after The WPATH Files were released, England’s Cass Report exposed the astonishing level of fraud and collusion that enabled this very claim.

Cass Adds to WPATH’s Woes

As part of its investigation, the Cass Review commissioned a systematic review of the guidelines in gender medicine, which revealed that WPATH, along with the Endocrine Society, manufactured a false consensus on so-called gender-affirming care. 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. “The circularity of this approach may explain why there has been an apparent consensus on key areas of practice despite the evidence being poor,” wrote Cass in her characteristically measured tone.

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. These shocking revelations once again received almost no mainstream media coverage, with only a passing mention in a New York Times op-ed.

The “citation cartel”

Remarkably, it took WPATH more than a month to respond to the Cass Report, and when it finally did, the statement was highly revealing. Dismissing the validity of the four-year independent investigation, which is not only the most comprehensive in gender medicine but one of the most thorough reviews of any medical practice, WPATH claimed that its SOC8 was “based on far more systematic reviews than the Cass Review.” As it turned out, the most damning revelations of 2024 were still to come, and they would expose that claim as completely false.

The Man Behind the Curtain

In June 2024 came the eagerly anticipated unsealed documents in the legal case surrounding Alabama’s ban on gender-affirming care for minors. Internal WPATH emails obtained as part of the discovery process revealed, among other things, that top WPATH members interfered with supposedly 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 align with WPATH’s political agenda, the organization blocked their publication.

The discovery revelations did not stop there. Emails show Admiral Rachel Levine, Biden’s Assistant Secretary for Health and Human Services, pressuring WPATH to remove minimum age recommendations from SOC8, arguing that such limits could undermine the Biden administration’s political agenda. Additionally, some SOC8 authors, acting on the advice of "social justice" lawyers, deliberately avoided systematic reviews altogether, because they knew the results would expose the lack of scientific support for gender-affirming interventions, and this would in turn harm litigation efforts. An amicus brief submitted to the US Supreme Court rightly called the revelations “a medical, legal, and political scandal that will be studied for decades to come.”

In short, the events of 2024 made clear that WPATH is not a serious medical organization guided by strong ethical principles or a genuine commitment to the health and well-being of people who identify as transgender. Instead, it is an extremist trans activist group driven by ideology, determined to reframe radical, unproven body modification procedures as evidence-based and medically necessary to suit its political goals.

What’s Next for WPATH?

Now, in 2025, a year after the release of The WPATH Files, the question remains: Will WPATH change course? At this point, it seems highly unlikely. A far more probable outcome is that WPATH will follow the path of its counterpart in psychiatry’s last major debacle—multiple personality disorder. That fiasco had its own version of WPATH, the International Society for the Study of Multiple Personality and Dissociation (ISSMP&D), which held annual conferences where MPD charlatans gathered to promote outrageous pseudoscientific theories before dispersing to destroy countless innocent lives.

The ISSMP&D may have rebranded as the International Society for the Study of Trauma and Dissociation (ISSTD) after the MPD crisis collapsed under an avalanche of lawsuits, but it has yet to fully reckon with the harm it caused. A telling sign of this came in 2016 when psychiatrist Colin Ross received the ISSTD’s Cornelia B. Wilbur Award for outstanding clinical contributions to the assessment and treatment of dissociative disorders.

For those unfamiliar with these key figures in the scandal, Cornelia Wilbur was the psychiatrist who triggered the entire MPD epidemic with her fraudulent account of treating “Sybil,” the central figure in the bestselling book and popular film that were the sparks that ignited the wildfire. Colin Ross was one of the most prominent, and most extreme, voices in the movement, who claimed that the CIA was creating multiples and programming them to commit horrific crimes, much like the plot of The Manchurian Candidate, a well-known film of the time.

It is far easier to envision a future version of WPATH, decades after this scandal has been buried under the inevitable tsunami of lawsuits, honouring Jack Turban with the Diane Ehrensaft Award for contributions to child and adolescent development than to picture the organization admitting its catastrophic wrongdoing, apologizing, and changing course. Some mistakes, after all, are simply too devastating to face.

In her 1992 speech, Queen Elizabeth II called for moderation and sympathy from the press, asking for privacy as her family navigated the trials and tribulations of their messy lives. WPATH is entitled to no such courtesy. Now is the time for relentless media scrutiny. 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.

Mia Hughes is the author of The WPATH Files, and director of Genspect Canada.

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Check out these videos for more on the WPATH Files and parallels with other medical scandals

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