‘Social Justice Lawyers’ Told WPATH to Avoid ‘Evidence-Based Review’ of Sex-Change Guidelines for Minors, Docs Reveal

Pediatrician with child patient
by Harold Hutchison


  • WPATH avoided “evidence-based” reviews of child sex-change procedures on the advice of unidentified “social justice lawyers,” according to a motion for summary judgment filed Wednesday.
  • Republican Attorney General Steve Marshall of Alabama accused WPATH of allowing “advocacy concerns” to influence standards of care for the procedures.
  • “WPATH’s scuttling of the evidence reviews was consistent with advocacy concerns that animated the drafting of SOC-8,” the motion states.

The World Professional Association of Transgender Health (WPATH) avoided “evidence-based” reviews of child sex-change procedures on the advice of “social justice lawyers,” a court filing states.

Republican Attorney General Steve Marshall of Alabama filed a motion for summary judgment in the United States District Court for the Middle District of Alabama Wednesday, seeking to beat back a challenge to Alabama’s law restricting the procedures. The Alabama attorney general’s office accused WPATH of placing “advocacy concerns” at the forefront of the creation of the organization’s “Standards of Care for the Health of Transgender and Gender Diverse People, Version 8” (SOC-8), which was based in part on the advice of the “social justice” attorneys who advised the organization to avoid seeking evidence-based recommendations.


“Though the SOC-8 authors didn’t seem to have much use for them, the Johns Hopkins evidence review team did create systematic evidence reviews—’dozens!’—for SOC-8,” the motion says. “The results were concerning. The head of the team, Dr. Robinson, wrote to the Agency for Healthcare Research and Quality at HHS: ‘[W]e found little to no evidence about children and adolescents.’ On September 1, 2020, HHS wrote back: ‘Knowing that there is little/no evidence about children and adolescents is helpful.’”

After President Joe Biden took office, the Justice Department took a different approach, joining a lawsuit against Alabama that sought to block the law.

“That did not stop the United States from representing to the Supreme Court on November 6, 2023, that “overwhelming evidence establishes that … puberty blockers and hormones directly and substantially improve[] the physical and psychological wellbeing of transgender adolescents with gender dysphoria,” Alabama’s motion says.

WPATH also blocked publication of results of “evidence reviews” that they felt would “negatively affect the provision of transgender healthcare in the broadest sense,” Marshall’s office said in the filing.

“Dr. Robinson also told HHS that she was ‘having issues with this sponsor’—WPATH—’trying to restrict our ability to publish.’ Days earlier, WPATH had rejected the team’s request to publish two manuscripts based on the reviews because the team failed to comply with WPATH’s policy for using SOC-8 data,” the Alabama attorney general’s office wrote. “Among other things, that policy required Johns Hopkins to seek ‘final approval’ of the proposed article from an SOC-8 leader and ‘at least one member of the transgender community.’”

“We sent the document to Admiral Levine . . . She like[d] the SOC-8 very much but she was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth and maybe adults too. Apparently the situation in the USA is terrible and she and the Biden administration worried that having ages in the document will make matters worse,” an email quoted in the appendix of a supplemental report by Dr. James Cantor says. “She asked us to remove them.”

The motion also said that “social justice” attorneys were pressing WPATH to draft SOC-8 with an eye toward prevailing in litigation like that faced by Alabama.

“WPATH’s scuttling of the evidence reviews was consistent with advocacy concerns that animated the drafting of SOC-8,” the motion states. “Some authors chose not to seek evidence reviews from the Johns Hopkins team precisely so they wouldn’t have to report the results: ‘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.’”

“Discovery has revealed that WPATH: violated multiple international standards for the creation of clinical guidelines that WPATH itself claimed to follow in Standards of Care 8 (“SOC-8”); restricted the ability of SOC-8’s evidence review team to publish the systematic evidence reviews finding scant evidence for transitioning treatments; intentionally used SOC-8 as a political and legal document to increase coverage for transitioning treatments and advance WPATH’s political goals; caved to outside political pressure by Admiral Rachel Levine and others to remove age minimums for hormones and surgeries in SOC-8; and ‘muzzle[d]’ WPATH members who tried to inform the public of their concerns over pediatric transitioning treatments,” the Alabama attorney general’s office wrote in Wednesday’s filing.

Marshall’s office also accused WPATH of creating “misleading” critiques of Alabama’s law.

“WPATH’s public positions were likewise influenced by its ideological and political goals. Asked to endorse a critique of Alabama’s law—authored by Plaintiffs’ ‘misinformation’ expert Dr. McNamara and relied on by Plaintiffs at the PI hearing93—WPATH initially noted its disagreement with the document’s strong implication that genital surgeries were not provided to minors,” the motion says. “The sponsor replied: ‘After consultation with those involved in the Alabama lawsuit, the consensus appeared to be that quoting the standards of care’—and omitting facts about the actual provision of surgeries to minors—‘would be most helpful for the case.’ WPATH endorsed the critique it knew was misleading.”

The Daily Caller News Foundation obtained footage from WPATH’s September 2022 Global Education Institute (GEI) and over 100 pages of documents which included some members of the group questioning SOC-8.

The videos included some of the instructors urging doctors to disregard a standard of care requiring that mental health issues be addressed before the start of any sex-change procedures, even for patients suffering from schizophrenia. Other videos discussed potentially grisly complications from some of the surgical procedures.

“In short, neither the Court nor Alabama need treat WPATH as anything other than the activist interest group it has shown itself to be,” the motion said.

WPATH did not immediately respond to a request for comment from the DCNF.

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Harold Hutchison is a reporter at Daily Caller News Foundation.
Photo “Pediatrician with Child Patient” by Pavel Danilyuk.

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