The Horror Show of “Medically Necessary Gender-Affirming Interventions”--Part 3 of “A Layperson Reads the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8”

In this, the third installment of our series, “A Layperson Reads the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8,” we are going to discuss examples of harm to the bodies of troubled people that the transgenderist movement is attempting to normalize and codify.

This is important because the World Professional Association for Transgender Health (WPATH) presents itself as a professional medical organization and is lobbying aggressively worldwide for its Standards of Care to become the go-to manual for the treatment of patients who are convinced that they are in the “wrong body.” These standards are not medicine at all, but the codification of a radical gender ideology gone wild that is doing immediate physical, irreversible harm to untold numbers of people.

The use of the term “medically necessary gender-affirming interventions” is oxymoronic and deceptive. It is not “medically necessary” to slice the healthy breasts off of a healthy woman. It is not “medically necessary” to try to provide a human male with an artificial “vagina.” It is not “medically necessary” to tack artificial testicles onto a healthy woman. Such practices are an assault on human flesh and on the very idea of womanhood. They render the normal female body “abnormal” and allot to troubled men the right to determine what the word “woman” means—if they use it all without sticking “trans” in front of it.

Just a quick recap: in Part 1 of our series on the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, we took a look at the introduction to the standards document which laid out the aims of the standards. In Part 2, we examined some of the terminology that the transgenderist movement uses to try to persuade us that it is not only acceptable to, for example, castrate young boys for no medically justifiable reason but that it is “best practice” to do so.

These practices are the modern equivalent of lobotomies. Just as innocent people were lobotomized by seemingly respectable medical practitioners acting on medical literature produced by “experts,” so today are young girls and boys and troubled adults being surgically butchered and fed hormones by transgenderist-influenced medical providers. This is not just a disgrace; it is criminal.

In today's installment, we will work our way through Chapter 2 Global Applicability of the standards.

First of all, we should note that the involvement of a sizable number of Americans from some of our leading medical schools and medical institutions in the World Professional Association for Transgender Health (WPATH) is damaging to the image of the United States as a country where science is valued and human rights respected. This is an alarming, depressing development. Imposing transgenderist “best practices” on other parts of the world is not only immoral, it will only generate a backlash against the U.S.

Let us now examine, Chapter 2 of the standards document.

Just a reminder about terminology—we read:

the English language umbrella term transgender and gender diverse (TGD) describes a huge variety of gender identities and expressions

There are, of course, only two sexes and “gender identity” is a term invented by the transgenderist movement. But the term, “TGD” is used a lot in the document, so bear that in mind as we proceed with our discussion.

The fact that WPATH is a transgenderist advocacy organization rather than a medical one is clear enough here:

Together, TGD people represent important aspects of human diversity the World Professional Association for Transgender Health (WPATH) asserts should be valued and celebrated.

Note the pressure on everyone to validate the delusion of a man who thinks he is a woman and to treat a woman who thinks she is a man as a man, at the expense of the integrity and self-respect of the people forced to go along with this charade. And not just “value” such delusions, but to celebrate them. To do otherwise, would be “transphobic.”

Interestingly, even as the US starts to impose the transgenderist agenda abroad American medical professionals who oppose transgenderist practices in medicine face pressure to abide by the diktats of medical globalists:

In the International Classification of Diseases, Version 11 (ICD-11), the diagnostic manual of the World Health Organization (WHO, 2019b), the Gender Incongruence diagnosis is placed in a chapter on sexual health and focuses on the person’s experienced identity and any need for gender-affirming treatment that might stem from that identity.

Think about that. A troubled woman insists that she is “really” a man and her “experienced identity” (i.e., her subjective wishful thinking) means that medical providers are expected to offer her “gender-affirming treatment that might stem from that identity.” We will get to what such “treatments” entail in a moment.

The authors foresee a time when surgery and heavy hormone use will not be required of the person who thinks he or she is actually of the opposite sex (or some strange, intermediate “identity” like “nonbinary) who is demanding that the historical record and public records be altered at that person’s whim. Perhaps a man’s mere say-so that he is a woman will do (so much for the “lived experience” of actual women):

It is reasonable to suppose these developments may also promote more socially inclusive policies such as legislative reform regarding gender recognition that facilitates a rights-based approach, without imposing requirements for diagnosis, hormone therapy and/or surgery. TGD people who have changed gender markers on key documents enjoy better mental health…

I have a “right” to say “I’m a man” even though I am woman and the state is required to, say, alter my birth certificate that says I was a female infant because that change will make me happy? This is the “science” that the Standards of Care is promoting.

Note the waving away in the standards of such issues as truth and accuracy in government documents and medical records:

A more rights-based approach in this area may contribute greatly to the overall health and well-being of TGD people

Think of the archival, technological, legal and medical chaos that would ensue if such demands were met. This is selfishness and lunacy on a vast scale.

And what about those who realize what a disaster undergoing “gender-affirming” procedures was for them and choose to “detransition?” The history of their actual sex would have been wiped away.

The incoherence of transgender “medicine” is rendered clear here. On the one hand, the standards applaud the:

depathologization (or more precisely a de-psychopathologization) of transgender identities

while saying that that public records must be altered so as to prevent psychological damage to those who “identify” as “trans” because reflecting biological reality impairs their already fragile mental health.

Additionally, the woke left and the traditional left has always deplored cultural imperialism and the imposition of Western values on the developing world. But such leftist concerns are ignored when it comes to imposing transgenderist ideology on poor countries:

Health care providers have found the relevant literature is largely North American and European, which present particular challenges for persons working in health care systems that are especially poorly resourced. Recent initiatives that often involve TGD stakeholders as partners are changing this situation somewhat by providing a body of knowledge about good practice in other regions, including how to provide effective, culturally-competent TGD health care in low- and middle-income countries outside the global north.

Note that one of the recommendations of the standards employs that misleading term, “medically necessary gender-affirming health care”:

We recommend health care systems should provide medically necessary gender-affirming health care for transgender and gender diverse people.

And as government at the state and local levels adopts these standards, there will be pressure on medical facilities to offer such care and staff up accordingly. This will, of course, drain resources away from other patients and empower the transgenderist movement.

It bears repeating—there is never, never anything “medically necessary” about removing healthy body parts from healthy people on the basis of “gender-affirming health care.” That is not health care and it is denying and renouncing one’s sex not affirming it for a woman, for example, to demand that she be provided with an artificial penis. And to demand that poor countries allocate scarce resources to such quackery is brute imperialism for the sake of radical gender ideology.

Consider the pressure the standards puts on medical providers who might have qualms about toeing the transgenderist line—and remember: it is almost as unethical to refer troubled patients to pro-transgenderist practitioners as it is to perform ghastly procedures oneself:

Provide health care (or refer to knowledgeable colleagues) that affirms gender identities and expressions

Why should a female physician be forced to affirm a man in his false assertion that he is a woman? What about the doctor's rights and her ability to do her job?

Everyone who believes in the provision of options to troubled people and in the free speech rights of those in health care should be alarmed by this recommendation:

Reject approaches that have the goal or effect of conversion and avoid providing any direct or indirect support for such approaches or services.

In other words, WPATH believe that it is “medically necessary” to remove the healthy uterus from a healthy young woman but suggesting to her that destroying part of herself and any chance to have a baby might not be a wise move, should be prohibited. The authors of the standards even make this ludicrous claim:

These efforts may be viewed as a form of violence.

And applaud restrictions of free speech worldwide:

An increasing number of jurisdictions are outlawing such work

This is where we stand with “transgender medicine.” This is insanity.

And this is clearly crossing the line between medical care and the intrusion of radical gender ideology into realms where it does not belong and is an abuse of the concept of expertise:

Support and advocate for clients within their families and communities (schools, workplaces, and other settings) where appropriate

It is not the place of a medical provider to try to undermine the relationship, say, between a parent and a child by thrusting transgenderist ideology into the bosom of the family.

The aforementioned incoherence that the WPATH standards are riddled with is evidenced repeatedly. For instance, we are told that “trans” people are not actually ill and yet they are to be treated clinically as if they are—which is medical malpractice and when paid for by others (like taxpayers) medical fraud and, therefore, an economic crime:

It should be recognized gender diversity is common to all human beings and is not pathological. However, gender incongruence that causes clinically significant distress and impairment often requires medically necessary clinical interventions.

And what evidence do the authors of the standards give for their recommendations: they cite their own standards. That is, of course, absurd:

There is strong evidence demonstrating the benefits in quality of life and well-being of gender-affirming treatments, including endocrine and surgical procedures, properly indicated and performed as outlined by the Standards of Care (Version 8), in TGD people in need of these treatments

The document goes on to list the incredible number of medical services that the patients it keeps assuring us are perfectly healthy should be provided with in addition to endocrine and surgical procedures—again, all in the name of “affirming” people in a sex not their own:

Gender-affirming interventions may also include hair removal/transplant procedures, voice therapy/surgery, counseling, and other medical procedures required to effectively affirm an individual’s gender identity and reduce gender incongruence and dysphoria.

And recall that any such “counseling” cannot include any suggestions to patients that maybe it would be safest, less painful, less expensive, less invasive and certainly less life-changing not to buy into transgenderist pressure from providers who are gung-ho on gender “affirmation.” Not a lot of room for any naysaying in the standards about the wonders of genital surgery on healthy organs here:

Gender-affirming interventions are based on decades of clinical experience and research; therefore, they are not considered experimental, cosmetic, or for the mere convenience of a patient. They are safe and effective at reducing gender incongruence and gender dysphoria

This is crucial: this supposedly medical organization is advocating surgery removing healthy body parts and, in some cases, replacing them with artificial ones on the basis of psychobabble about “gender incongruence.”

As promised, we will get to the grisly nuts and bolts of some of the procedures the standards argue should be performed on healthy people who have no injury or disease that would warrant such procedures. But before we do, just note what a sweeping revamping of health care provision and financing these zealots are demanding:

WPATH urges health care systems to provide these medically necessary treatments and eliminate any exclusions from their policy documents and medical guidelines that preclude coverage for any medically necessary procedures or treatments for the health and well-being of TGD individuals. In other words, governments should ensure health care services for TGD people are established, extended or enhanced (as appropriate) as elements in any Universal Health Care, public health, government-subsidized systems, or government-regulated private systems that may exist. Health care systems should ensure ongoing health care, both routine and specialized, is readily accessible and affordable to all citizens on an equitable basis.

Okay, we will now break down what many of these “medically necessary treatments” are and that medical providers are increasingly being required to provide to people who are not ill or injured:

Medically necessary gender-affirming interventions are discussed in SOC-8. These include but are not limited to hysterectomy +/- bilateral salpingo-oophorectomy; bilateral mastectomy, chest reconstruction or feminizing mammoplasty, nipple resizing or placement of breast prostheses; genital reconstruction, for example, phalloplasty and metoidioplasty, scrotoplasty, and penile and testicular prostheses, penectomy, orchiectomy, vaginoplasty, and vulvoplasty; hair removal from the face, body, and genital areas for gender affirmation or as part of a preoperative preparation process; gender-affirming facial surgery and body contouring; voice therapy and/or surgery; as well as puberty blocking medication and gender-affirming hormones; counseling or psychotherapeutic treatment as appropriate for the patient and based on a review of the patient’s individual circumstances and needs.

To spare you from having to google many of those terms, here is a quick guide to what these standards think will help troubled people become happy. And many of them are performed on children. “Gender-affirming” procedures are designed to make women “feel” like men and the reverse. Sometimes, in the popular press some of these surgeries are referred to flippantly as “top surgery” and “bottom surgery” and presented as almost hip and excitingly transgressive, instead of mutilating.

Hysterectomy: Surgical procedure to remove the womb (uterus)

Bilateral Salpingo-Oophorectomy: Surgical removal of both ovaries and both fallopian tubes

Bilateral Mastectomy: Surgical removal of both breasts

Feminizing Mammoplasty: Surgery to make men look like well-busted women (all very sexist and creepy)

Phalloplasty and Metoidioplasty: Surgical creation of a penis

Scrotoplasty: Surgery that corrects or creates a scrotum (in this case to make a woman look like a man in her genital area)

Penectomy: Surgical removal of the penis

Orchiectomy: Surgical procedure to remove one or both testicles

Vaginoplasty: Creation of a vagina

Vulvoplasty: Surgery that creates the vulva and removal of penis, scrotum, and testes

Puberty Blockers: Drugs that prevent normal human development (used by transgenderist medical providers on troubled children who are unsure what sex they “want to be”)

And so forth. As you can, this is all a chamber of horrors that no medical person should have anything to with. The attack on the human reproductive and genitourinary systems of these unfortunate people will trouble them for the rest of their lives and be a constant drain on the medical system. And for what—to humor healthy people who are convinced that they inhabit the “wrong body.”

And, as have seen and will see throughout this series, the “treatment” of girls and women for the “disease” of being female is part and parcel of the misogynistic ethos that permeates transgenderist ideology. The weird fixation of providing men with sizable breasts speaks for itself. Men with vaginas—seriously?

One of the creepiest features of the standards is the way the authors employ bland-sounding language to suggest that “trans” people are being discriminated against by mean-spirited “cisgender” (i.e. normal) people and are therefore appropriate subjects of our sympathy. Take this passage:

Standard patient management procedures at clinics and hospitals often fail to recognize the gender identities of their TGD patients (including where outside of the binary their patients identify). Patients may be housed in wards that are gender inappropriate for them, putting them at risk of sexual harassment.

A quick bit of deciphering of this coded language reveals that in this case a man who thinks he is a woman is demanding that he be put into a ward with actual women, which is a gross violation of their privacy.

Thus, in just this single chapter of the standards we have seen threats to free speech, advocacy of misogynistic practices and arguments for behavior that borders on fraud, medical malpractice and unethical conduct. And there are 18 chapters in this document. We have a lot more to cover. These standards pose a direct threat to the ethical practice of medicine and to the bodies of troubled people and of innocent children throughout the world. It’s all there in black and white. Read the standards for yourself.

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