I’m guessing this interesting set of ‘corrections’ is the reason for WPATH’s strange, last-minute delay releasing releasing the eighth standards of care. Just as I predicted last week, when I noted that it’s a terribly inconvenient time for WPATH to recommend lowering the age limit for “gender-affirming” surgeries.
So the question is, did they do this to appease angry non-WPATH MDs who needed cover for the surgeries they had done/were doing on younger children? Or was this the plan all along, pandering to members who wanted at least some (way too low) age limits and then pulling a fast one at the last minute? In either case, how does this not result in internal strife and bad PR? How would we not see a storm of angry WPATH members complaining to the press? (Ah, the press… never mind on that one.) Or does any of that matter when the gender clinicians are just using the vagaries of the SoC as coverage for whatever they do? It's not like they were of any value before this version.
I keep thinking too rationally about this, expecting that a move like this — a quick "presto change-o" — would somehow draw negative attention and tarnish the entire effort. I forget the world we now inhabit.
I think it's more to prevent headlines like "WPATH endorses hysterectomies at 17." Too specific. Too much exactly what WPATH members have been denying up and down. But they can't actually say "No surgeries under 18" because their membership is performing these surgeries. They only have resort to vagueness.
I've heard some speculation elsewhere that this was the plan all along. But I really doubt it. I think they did not expect the scrutiny on surgeries for youth. Clinics were getting away with it for so long -- then in the last month or two, the issue blows up. This looks like damage control to me, nothing more organized.
So you think in general, widespread internal agreement? I don’t know. The uproar over the age limits has been going on for a few weeks now. Seems like they would have worked this out before releasing anywhere. I get your rationale, but the execution doesn’t quite make sense. There has to be external forces at work. Someone saw this in print and read them the riot act. And either there was fast internal approval or top members made an executive decision, balancing internal and external forces.
The standards to lower ages got approved for final publication within WPATH. Then something happened or the organization panicked and went into damage control mode. That's how it seems to me. If it were an internal dispute primarily, we wouldn't see the standards until that was resolved. It seems like any internal dispute got resolved previously. The standards as regards minimum ages did not change from the draft circulated in January. Last week, they were delayed on the eve of release due to "unforeseen circumstances." And I guess I wonder -- what external forces? Who would read the riot act?
Well that's my point. Maybe internally they thought the standards with the ages WERE approved. This change happened after the "unforeseen circumstances". As for externals, I don't know, but the ones that would get harmed by those ages are the ones who've operated on children below their original age limits.
Ok, I see. It's possible, though the minimums were themselves loose. Seems like at least two possible areas of concern are drs who felt like their asses were hanging out when WPATH didn't lower minimum ages enough or WPATH realizing they didn't want to be on the record with specific underage recs (though membership was comfortable with these recs and no changes on ages had been made after public comment period). My hunch is the first concern would have come up much earlier, after the draft standards circulated last winter (non-WPATH docs would have seen and had a chance to object during public comment period). It seems more likely to me that ages were removed in the last week and that the wrong 'final' version was uploaded, then replaced with the 'right' final version.
But I can only speculate.
(Also have a cold so apologize if misreading you or expressing myself poorly.)
I totally cosign your interpretation, Eliza. The publicity in the wake of the LibsOfTikTok publicizing underage surgeries just got too hot. But expunging the minimum age recommendations, spongy though they were, has opened the floodgates wide to the least-scrupulous health care providers. What lurks behind the gates is shocking even to me, and I'm hardly naive.
I read the short - rather dismissive and distorted - section on detransitioners, and the first part of the adolescence chapter. Then I decided to skip ahead and read the eunuch and nonbinary chapters because they're relatively short. Subsequently I tried to resume the SOC chapter on adolescents but had to stop because I'm still too queasy from the eunuch material.
I couldn't believe that the online eunuch archive they cited in the text (not merely a footnote!!!!) of the SOC was the same one Genevieve Gluck has reported on, so I went to check. Yup. Same archive. The stories are still up, too, though to get more than a sampler you have to register as a member. For anyone who'd prefer to protect their sanity, don't go there. The eunuch stories are brimming with sexual sadism. Truly horrific.
But precisely this site is touted as the font of eunuch knowledge: "While there is a 4000-year history of eunuchs in society, the greatest wealth of information about contemporary eunuch-identified people is found within the large online peer-support community that congregates on sites such as the Eunuch Archive (www.eunuch.org), which was established in 1998." (p. 88) WPATH suggests eunuch-identified people "may also benefit from a eunuch community" (ibid.). No other community is mentioned apart from this archive of extreme sexual sadism and masochism that eroticizes genital mutilation, including of underage boys, and delights in rape of boys and men.
The stories are presented as fiction. But the stories run parallel to discussion forums, blogs, and other resources that aren't accessible at all to non-members. The stories are the only public-facing element of the site. They're the teaser, drawing potential new members into this "community."
The nonbinary chapter is laundering this straight-up chamber of horrors. Please stop reading now if you're squeamish, as the following quotation is graphic. The recommendations for male (AMAB) people advise:
"In the case of vaginoplasty, individuals should be advised lack of testosterone-blocking therapy may cause postopera- tive hair growth in the vagina when hair-bearing skin graft and flaps have been used (Giltay & Gooren, 2000).
"Additional surgical requests for nonbinary people AMAB include penile-preserving vaginoplasty, vaginoplasty with preservation of the testicle(s), and procedures resulting in an absence of external primary sexual characteristics (i.e., penectomy, scrotectomy, orchiectomy, etc.). The surgeon and individual seeking treatment are advised to engage in discussions so as to understand the individual’s goals and expectations as well as the benefits and limitations of the intended (or requested) procedure, to make decisions on an individualized basis and collaborate with other health care providers who are involved (if any)." (p. 87)
This is what lies beneath the glittery promises of gender euphoria, trans joy, authenticity, and "living your best life" sold to our young people. I do know adult trans people who are quite satisfied with changes they've made to their bodies (though I dearly wish they'd never felt the need). But we're now so far beyond alleviating severe dysphoria and deep into mass sociogenic self-harm that it's hard to imagine many of my fellow liberals would support this approach to "medical care" if they knew the truth.
Exactly. It's a mass mediatized delusion that you can just wave a little wand and become another person, a better person, a hero, a star. It is so f-ed up, but it's the American Dream, after all, except for the hospitals and sutures and pain and lifelong meds and botched down theres. I am filled with nausea, despair and fury. I know from the history of anti-smoking campaigns that pictures of diseased lungs and tracheotomies don't seem to inhibit smoking as much as increasing the costs of cigarettes. Insurance coverage for affirmative medicalization must be attacked - Medicare, Medicaid, VA, employment coverage -but it only seems to grow. I spent years trying to do something about the cosmetogynecology industry (newviewcampaign.org), but labiaplasties continue to rise (along with insensate genitals). I dunno - if you have any bright ideas don't keep them to yourself.
Agree. I've heard/read from several men who have detransitioned that they figured out how to get on Medicaid so the surgeries would be free. These surgeries have to become "elective." I guess for that to happen, the myth that they prevent suicide needs to be dispelled and the number of detransitioners needs to be tracked.
Backing down from "medical necessity" is key, though the trend is opposite. e.g., rhinoplasty et al. are medically necessary because of the "harm" and "trauma" from "bullying" if your nose is wrong.
It's likely that the specifics of the actual numbers gave someone cold feet in light of the recent protests at children's hospitals and the pending legislation down south.
Anyone who reads the doubletalk of the entire document comes away reeling, horrified, confused, and nauseated.
The list of gender affirmative surgical nip-and-shave a little here and a little there makes Hollywood plastics-to-the-stars look like amateurs. We need to cap the number of plastic surgeons. Primary care, child psychiatry, gerontology, rehab medicine-that's what's needed. All these plastics docs looking for business is dangerous.
It's the stuff of nightmares. I just wrote a lengthy comment that only begins to express how disturbed I feel, and I am no newcomer to these issues. But omigod I am feeling everything you described, as well as a burning fury.
Is it just me, or has this morphed into a universe of thought completely unhinged from reality? How is it that we've reached a point where the discussion is about the age at which we should try to reconstruct a young person's body? I did a lot of things when I was in my 20s, the long-term repercussions of which I could not appreciate. (We all have.) As a Biological Psychologist, I'm at a complete loss to understand how these procedures can even be considered for a person not yet a thoughtful, psychologically stable adult. In my experience, that's at least mid-20s. At that point, the individual can make a decision for themselves.
So the question is, did they do this to appease angry non-WPATH MDs who needed cover for the surgeries they had done/were doing on younger children? Or was this the plan all along, pandering to members who wanted at least some (way too low) age limits and then pulling a fast one at the last minute? In either case, how does this not result in internal strife and bad PR? How would we not see a storm of angry WPATH members complaining to the press? (Ah, the press… never mind on that one.) Or does any of that matter when the gender clinicians are just using the vagaries of the SoC as coverage for whatever they do? It's not like they were of any value before this version.
I keep thinking too rationally about this, expecting that a move like this — a quick "presto change-o" — would somehow draw negative attention and tarnish the entire effort. I forget the world we now inhabit.
I think it's more to prevent headlines like "WPATH endorses hysterectomies at 17." Too specific. Too much exactly what WPATH members have been denying up and down. But they can't actually say "No surgeries under 18" because their membership is performing these surgeries. They only have resort to vagueness.
I've heard some speculation elsewhere that this was the plan all along. But I really doubt it. I think they did not expect the scrutiny on surgeries for youth. Clinics were getting away with it for so long -- then in the last month or two, the issue blows up. This looks like damage control to me, nothing more organized.
So you think in general, widespread internal agreement? I don’t know. The uproar over the age limits has been going on for a few weeks now. Seems like they would have worked this out before releasing anywhere. I get your rationale, but the execution doesn’t quite make sense. There has to be external forces at work. Someone saw this in print and read them the riot act. And either there was fast internal approval or top members made an executive decision, balancing internal and external forces.
The standards to lower ages got approved for final publication within WPATH. Then something happened or the organization panicked and went into damage control mode. That's how it seems to me. If it were an internal dispute primarily, we wouldn't see the standards until that was resolved. It seems like any internal dispute got resolved previously. The standards as regards minimum ages did not change from the draft circulated in January. Last week, they were delayed on the eve of release due to "unforeseen circumstances." And I guess I wonder -- what external forces? Who would read the riot act?
Well that's my point. Maybe internally they thought the standards with the ages WERE approved. This change happened after the "unforeseen circumstances". As for externals, I don't know, but the ones that would get harmed by those ages are the ones who've operated on children below their original age limits.
Ok, I see. It's possible, though the minimums were themselves loose. Seems like at least two possible areas of concern are drs who felt like their asses were hanging out when WPATH didn't lower minimum ages enough or WPATH realizing they didn't want to be on the record with specific underage recs (though membership was comfortable with these recs and no changes on ages had been made after public comment period). My hunch is the first concern would have come up much earlier, after the draft standards circulated last winter (non-WPATH docs would have seen and had a chance to object during public comment period). It seems more likely to me that ages were removed in the last week and that the wrong 'final' version was uploaded, then replaced with the 'right' final version.
But I can only speculate.
(Also have a cold so apologize if misreading you or expressing myself poorly.)
It looks like the little shop of horrors to me !🤬
https://twitter.com/SwipeWright/status/1571999221401948161 -- interesting. I wasn't in this session but the one I had told a slightly different story about dropping the age minimums: it was a distraction.
I totally cosign your interpretation, Eliza. The publicity in the wake of the LibsOfTikTok publicizing underage surgeries just got too hot. But expunging the minimum age recommendations, spongy though they were, has opened the floodgates wide to the least-scrupulous health care providers. What lurks behind the gates is shocking even to me, and I'm hardly naive.
I read the short - rather dismissive and distorted - section on detransitioners, and the first part of the adolescence chapter. Then I decided to skip ahead and read the eunuch and nonbinary chapters because they're relatively short. Subsequently I tried to resume the SOC chapter on adolescents but had to stop because I'm still too queasy from the eunuch material.
I couldn't believe that the online eunuch archive they cited in the text (not merely a footnote!!!!) of the SOC was the same one Genevieve Gluck has reported on, so I went to check. Yup. Same archive. The stories are still up, too, though to get more than a sampler you have to register as a member. For anyone who'd prefer to protect their sanity, don't go there. The eunuch stories are brimming with sexual sadism. Truly horrific.
But precisely this site is touted as the font of eunuch knowledge: "While there is a 4000-year history of eunuchs in society, the greatest wealth of information about contemporary eunuch-identified people is found within the large online peer-support community that congregates on sites such as the Eunuch Archive (www.eunuch.org), which was established in 1998." (p. 88) WPATH suggests eunuch-identified people "may also benefit from a eunuch community" (ibid.). No other community is mentioned apart from this archive of extreme sexual sadism and masochism that eroticizes genital mutilation, including of underage boys, and delights in rape of boys and men.
The stories are presented as fiction. But the stories run parallel to discussion forums, blogs, and other resources that aren't accessible at all to non-members. The stories are the only public-facing element of the site. They're the teaser, drawing potential new members into this "community."
The nonbinary chapter is laundering this straight-up chamber of horrors. Please stop reading now if you're squeamish, as the following quotation is graphic. The recommendations for male (AMAB) people advise:
"In the case of vaginoplasty, individuals should be advised lack of testosterone-blocking therapy may cause postopera- tive hair growth in the vagina when hair-bearing skin graft and flaps have been used (Giltay & Gooren, 2000).
"Additional surgical requests for nonbinary people AMAB include penile-preserving vaginoplasty, vaginoplasty with preservation of the testicle(s), and procedures resulting in an absence of external primary sexual characteristics (i.e., penectomy, scrotectomy, orchiectomy, etc.). The surgeon and individual seeking treatment are advised to engage in discussions so as to understand the individual’s goals and expectations as well as the benefits and limitations of the intended (or requested) procedure, to make decisions on an individualized basis and collaborate with other health care providers who are involved (if any)." (p. 87)
This is what lies beneath the glittery promises of gender euphoria, trans joy, authenticity, and "living your best life" sold to our young people. I do know adult trans people who are quite satisfied with changes they've made to their bodies (though I dearly wish they'd never felt the need). But we're now so far beyond alleviating severe dysphoria and deep into mass sociogenic self-harm that it's hard to imagine many of my fellow liberals would support this approach to "medical care" if they knew the truth.
"Protect trans kids," indeed.
Exactly. It's a mass mediatized delusion that you can just wave a little wand and become another person, a better person, a hero, a star. It is so f-ed up, but it's the American Dream, after all, except for the hospitals and sutures and pain and lifelong meds and botched down theres. I am filled with nausea, despair and fury. I know from the history of anti-smoking campaigns that pictures of diseased lungs and tracheotomies don't seem to inhibit smoking as much as increasing the costs of cigarettes. Insurance coverage for affirmative medicalization must be attacked - Medicare, Medicaid, VA, employment coverage -but it only seems to grow. I spent years trying to do something about the cosmetogynecology industry (newviewcampaign.org), but labiaplasties continue to rise (along with insensate genitals). I dunno - if you have any bright ideas don't keep them to yourself.
Agree. I've heard/read from several men who have detransitioned that they figured out how to get on Medicaid so the surgeries would be free. These surgeries have to become "elective." I guess for that to happen, the myth that they prevent suicide needs to be dispelled and the number of detransitioners needs to be tracked.
Backing down from "medical necessity" is key, though the trend is opposite. e.g., rhinoplasty et al. are medically necessary because of the "harm" and "trauma" from "bullying" if your nose is wrong.
It's likely that the specifics of the actual numbers gave someone cold feet in light of the recent protests at children's hospitals and the pending legislation down south.
Anyone who reads the doubletalk of the entire document comes away reeling, horrified, confused, and nauseated.
The list of gender affirmative surgical nip-and-shave a little here and a little there makes Hollywood plastics-to-the-stars look like amateurs. We need to cap the number of plastic surgeons. Primary care, child psychiatry, gerontology, rehab medicine-that's what's needed. All these plastics docs looking for business is dangerous.
It's the stuff of nightmares. I just wrote a lengthy comment that only begins to express how disturbed I feel, and I am no newcomer to these issues. But omigod I am feeling everything you described, as well as a burning fury.
Is it just me, or has this morphed into a universe of thought completely unhinged from reality? How is it that we've reached a point where the discussion is about the age at which we should try to reconstruct a young person's body? I did a lot of things when I was in my 20s, the long-term repercussions of which I could not appreciate. (We all have.) As a Biological Psychologist, I'm at a complete loss to understand how these procedures can even be considered for a person not yet a thoughtful, psychologically stable adult. In my experience, that's at least mid-20s. At that point, the individual can make a decision for themselves.
Thanks for pulling all this together. Good goddess - those age limits are YOUNG! No wonder they decided to be vague...
I feel ill reading this….
I would appreciate if somewhere you would explain what "WPATH" refers to. I do have a rough idea, but many readers might not. Thanks.
World Professional Association of Transgender Health.