I’m in Lisbon at the Genspect conference (and tuning in to World Professional Association for Transgender Health conference when I can…), so I’m recirculating this piece I wrote about the last three -PATH conferences I attended and what I’ve learned…
It is hard to shock me these days — but as I moved around the World Professional Association for Transgender Health’s symposium in Montreal in September 2022, I often felt as if I’d slipped sideways into some strange universe that operated in accordance with other laws: where up is down and girls are boys and medicine has left its modest brief — healing — far behind in its breathless pursuit of transcendence.
I wasn’t really supposed to be there. I hadn’t misrepresented myself — I am what I claimed to be: a graduate student researching gender identity — but this was a convocation for believers and I’m a sceptic. When WPATH, the world’s most prestigious and influential gathering in transgender healthcare, came to Montreal, I couldn’t resist the opportunity to see up close the people and ideas I had pursued through so many articles and books.
I wanted to know what gender clinicians were saying behind closed doors. I wanted to see how they understand the work they do, the patients they serve, and the criticism they face. That’s why I began attending WPATH conferences, starting with the symposium in Montreal, followed by the European Professional Association for Transgender Health conference in Killarney, Ireland, in April, and the US Professional Association for Transgender Health conference in Denver, Colorado, just a few weeks ago.
After years of flying under the radar, the field of transgender health care is facing serious questions about whether minors can consent to life-altering interventions; what role factors like autism, sexual orientation, and social influence may play in the explosion of children and young people identifying as trans; and what to make of mounting evidence of medical harm, regret, and detransition. In response, the field of trans healthcare is becoming ever more secretive. There is a sharp demarcation between what gender clinicians say in public and what they say in private.
At these conferences, the big questions confronting transgender health care hardly feature. Instead, these conferences serve a different purpose: to shore up the faithful and cultivate a revolutionary vanguard within medicine. To this end, the proceedings revolve around a strange set of parables: that of the good gender clinician and the bad gender clinician.
In this world, being a good gender clinician means deferring to patients’ self-understandings and having the humility to serve even what one does not understand. The mark of a good gender clinician is her credulity in the face of brave new manifestations of gender.
“People outside this room get hung up on questions like ‘How can we make sure people are really trans and are not going to regret their transition later?’” one gender clinician in Denver mused. “I’m interested in giving the very best possible care to trans young people, the care that they need and deserve… it’s easy to roll down this pathway of ‘how do you know if somebody’s going to change their mind?’ or ‘how do you know if somebody’s really trans or not?’ and that’s not the conversation I’m really participating in.”
I’m assuming you’re aware that earlier this year the Daily Wire obtained and released several hours of video from the 2022 Montreal conference you attended (the conference immediately after the release of SOC8, yes?). These are available on YouTube now for anyone who wants to watch them, which I did. Apparently not very many other people have because as I write this each video has at most a few dozen views. Not sure what that says about me…
The Daily Wire’s goal seemed to be to mine for inflammatory nuggets to release on social media, which, fair enough. They were certainly there to be had. My interest in watching was much closer to yours in attending: How do the people in WPATH think and talk about these things when they assume no one outside the movement is watching?
My takeaway was much the same as yours. They seem to be sincerely living in an alternative reality where the following things are so axiomatic they’re almost never said directly, and will not be surprising to anyone who’s followed this topic for a while. They are 1) everyone has an innate but potentially flexible gender identity, 2) for people whose bodies don’t align with their gender identity, the greatest and highest good is to alter their body with hormones and surgeries to bring the two into alignment, 3) these are safe, effective, and ALWAYS medically necessary, 4) anything interfering with easy access to these is “gatekeeping” and is bad, 5) anything that normalizes them and makes them easier to get is “gender affirming” and is good, 6) the gender affirming community is a small, brave, beleaguered community defending access to these treatments against dark forces who are conspiring to take them away.
So what I saw in the videos is what you would expect a “normal” conference looks like when everyone is in unspoken agreement about those things. Which, of course, is not at all like a normal conference at all.
I’m not surprised, but horrified, that I am newly horrified and not surprised by rereading this because it is all still happening in spite of so many of us seeing it for the horror that it really is.