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The WPATH Files
PSEUDOSCIENTIFIC SURGICAL AND HORMONAL
ADOLESCENTS, AND VULNERABLE ADULTS
EXPERIMENTS ON CHILDREN,
By Mia Hughes
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H E W PAT H F I L E S
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TA B L E O F C O N T E N T S
EXECUTIVE SUMMARY ..........................................................................................................................................3
PREFACE TO THE WPATH FILES .............................................................................................................................4
INTRODUCTION ....................................................................................................................................................5
ACKNOWLEDGMENTS ...........................................................................................................................................5
A BRIEF HISTORY OF TRANSGENDER MEDICINE AND THE EARLY DAYS OF WPATH ...............................................6
WPATH HAS MISLED THE PUBLIC ......................................................................................................................... 10
WPATH Knows Children Do Not Understand the Ef fects of Hormone Therapy ......................................... 10
WPATH Knows Children Cannot Consent to Iatrogenic Fertility Loss ........................................................11
WPATH IS NOT A SCIENTIFIC GROUP ................................................................................................................... 16
The Weak Evidence Base for Puberty Suppression ...................................................................................... 16
Evidence in the Files of WPATH’s Lack of Respect for the Scientific Process .............................................. 18
WPATH IS NOT A MEDICAL GROUP ..................................................................................................................... 22
WPATH Has Abandoned the Hippocratic Oath ......................................................................................... 22
Evidence Showing the Harmful Ef fects of Wrong-Sex Hormones ................................................................ 22
Doctors Improvising and Experimenting .................................................................................................... 25
WPATH Members Causing Surgical Harm ................................................................................................ 27
Dismantling Guardrails ............................................................................................................................. 30
WPATH Members Trivializing Detransitioner Stories of Harm .................................................................. 31
Suspiciously Low Regret Rates ................................................................................................................... 32
Permanently Medicalizing Transient Identities ........................................................................................... 33
WPATH Has Broken the Chain of Trust in Medicine ................................................................................. 35
WPATH HAS NO RESPECT FOR MEDICAL ETHICS ................................................................................................. 37
The Ethics of Informed Consent ................................................................................................................. 37
Minors Cannot Consent to Sex Trait Modification Procedures ................................................................... 38
Misinformed Parents Cannot Give Informed Consent ................................................................................. 39
The Transition-or-Suicide Myth................................................................................................................. 41
A llowing Severely Mentally Ill Patients to Consent to Life-A ltering Medical Interventions ......................... 44
Minority Stress .......................................................................................................................................... 47
Realistic Expectations ................................................................................................................................ 47
Consumer-Driven Gender Embodiment ...................................................................................................... 49
Valuing Patient Autonomy Over Risk Aversion ........................................................................................... 50
A Brave New World .................................................................................................................................... 50
PAST CASES OF PSEUDOSCIENTIFIC HORMONAL AND SURGICAL EXPERIMENTS
ON CHILDREN AND VULNERABLE ADULTS .......................................................................................................... 53
Lobotomy .................................................................................................................................................. 53
Ovariotomy ............................................................................................................................................... 57
Apotemnophilia ......................................................................................................................................... 61
Engineering Children’s Height With Hormones ...........................................................................................65
CONCLUSION ...................................................................................................................................................... 70
THE WPATH FILES — COMPLETE AND LIGHTLY REDACTED .................................................................................. 72
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H E W PAT H F I L E S
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E X E C U T I V E S U M M A RY
The World Professional Association for Transgender
Health (WPATH) enjoys the reputation of being the
leading scientific and medical organization devoted to
transgender healthcare. WPATH is globally recognized as
being at the forefront of gender medicine.
However, throughout this report, we will show that the
opposite is true. Newly released files from WPATH’s
internal messaging forum, as well as a leaked internal
panel discussion, demonstrate that the world-leading
transgender healthcare group is neither scientific nor
advocating for ethical medical care. These internal
communications reveal that WPATH advocates for many
arbitrary medical practices, including hormonal and
surgical experimentation on minors and vulnerable adults.
Its approach to medicine is consumer-driven and
pseudoscientific, and its members appear to be engaged in
political activism, not science.
While there is a place in medicine for risky
experiments, these can only be justified if there is a
reliable, objective diagnosis; no other treatment options are
available, and if the outcome for a patient or patient group
is dire.
1
However, contrary to WPATH’s claims, gender
medicine does not fall into this category. The psychiatric
condition of gender dysphoria is not a fatal illness, and the
best available studies show that in the case of minors, with
watchful waiting and compassionate support, most will
either grow out of it or learn to manage their distress in
ways less detrimental to their health.
2,3,4
As such, this report will prove that sex-trait
modification procedures on minors and people with mental
health disorders, known as “gender-affirming care,” are
unethical medical experiments. This experiment causes
harm without justification, and its victims are some of
society’s most vulnerable people. Their injuries are painful
and life-altering. WPATH-affiliated healthcare providers
advocate for the destruction of healthy reproductive
systems, the amputation of healthy breasts, and the surgical
removal of healthy genitals as the first and only line of
treatment for minors and mentally ill people with gender
dysphoria, eschewing any attempt to reconcile the patient
with his or her birth sex. This report will show that this is a
violation of medical ethics and, as is revealed by its own
internal communications, WPATH does not meet the
standards of evidence-based medicine. It will further show
that the ethical requirement to obtain informed consent is
being violated, with members admitting that children and
adolescents cannot comprehend the lifelong consequences
of sex-trait modification interventions, and in some cases,
due to poor health literacy, neither can their parents.
Given the extent of the medical malpractice WPATH
endorses, our report will conclude by calling on the U.S.
government to oversee a bipartisan national inquiry to
investigate how activists with little respect for the
Hippocratic Oath could have risen to such prominence as
to set the Standards of Care for an entire field of medicine,
leading to the medical abuse of minors and vulnerable
adults.
1
2
3
4
Earl, J. “Innovative Practice, Clinical Research, and the Ethical Advancement of Medicine.” [In eng]. Am J Bioeth 19, no. 6 ( Jun 2019): 7-18. https://doi.
org/10.1080/15265161.2019.1602175.
Singh, D., Bradley, S. J., & Zucker, K. J. (2021). A Follow-Up Study of Boys With Gender Identity Disorder [Original Research]. Frontiers in Psychiatry,
12, 287. https://doi.org/10.3389/fpsyt.2021.632784
Steensma, T., & Cohen-Kettenis, P. “Gender Transitioning before Puberty?”. Archives of sexual behavior 40 (03/01 2011): 649-50. https://doi.
org/10.1007/s10508-011-9752-2.
Green, R. The Sissy Boy Syndrome the Development of Homosexuality. Yale University Press, 1987. doi:10.2307/j.ctt1ww3v4c. http://www.jstor.org/
stable/j.ctt1ww3v4c.
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H E W PAT H F I L E S
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P R E FA C E T O T H E W PAT H F I L E S
By Michael Shellenberger, Founder and President, Environmental Progress
Readers may rightly wonder why an environmental
organization is publishing a report on what is known as
“gender medicine.” The short answer is that we are
pro-human environmentalists, and our mission is to
incubate ideas, leaders, and movements for nature, peace,
and freedom for all. We thus work on a wide range of
issues, from climate change to homelessness to freedom of
speech, all of which constitute important aspects of our
“environment.”
The longer answer is that I felt the WPATH Files
needed to be analyzed and put in a broader historical
context than possible through a series of news articles. I
received the WPATH Files from a source or sources who
contacted me because they had seen my work on the
Twitter Files.
We are releasing all of the unedited files precisely as I
received them. Nothing has been removed or added by our
team, but we have organized the files to improve
accessibility. We have included dates where available in the
files. All discussions in the files occurred within the last
four years. We are leaving only the names of the president
of WPATH, most surgeons, and other prominent members
unredacted. While everyone aware of the information
revealed by the WPATH Files is, to some extent,
responsible, we did not feel that everyone in the
conversations needed to be named. The files are preceded
by a report that summarizes, analyzes, and draws
implications from the information they contain.
The WPATH Files are semi-private conversations
inside WPATH’s internal online forum for discussing
specific medical cases. This forum runs on software
provided by DocMatter. I made clear to the source or
sources that while I welcomed all or any information they
chose to share, I would not and did not solicit or encourage
anyone to retrieve any information from WPATH or any
other organization. All information came to me
unsolicited.
We are well within our legal rights to publish the
WPATH Files. Like any publisher, Environmental
Progress is governed by what’s known as the Pentagon
Papers Principle, established by the Supreme Court in
1971. Under the Court’s ruling, interpreting the First
Amendment to the United States Constitution, Americans
can publish information, even if it was obtained illegally, so
long as we do not encourage anyone to break the law in
obtaining the information.
At a moral level, we feel duty-bound to publish the
WPATH Files and do everything within our power to
encourage as wide an audience as possible to access them.
We believe they show that WPATH is neither a scientific
nor medical organization and should not be treated as one.
ACKNOWLEDGMENTS
The author would like to acknowledge, first and foremost, the source or sources of the WPATH Files. They behaved
nobly in their effort to protect children and vulnerable adults from harm.
Second, she would like to acknowledge Alex Gutentag and Michael Shellenberger; their contributions to this report went
far beyond editing.
Third, she would like to thank Lily Markle and Phoebe Smith for their fact-checking, proofing, and general assistance.
Finally, the author would like to thank the Environmental Progress Board of Directors and financial supporters.
Thank you for thinking outside the box of “the environment” to extend your concern to vulnerable people everywhere.
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H E W PAT H F I L E S
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INTRODUCTION
Over the past decade, there has been a huge surge in
the number of young people identifying as transgender and
being referred to pediatric and adult gender clinics. A
thorough analysis of all the possible explanations for this
change is beyond the scope of this report, but there are two
opposing viewpoints worth describing briefly. On one side,
activists argue that the sudden increase is due to shifting
societal attitudes and greater acceptance of the transgender
community, making it easier for transgender people to
come out of the closet and live as their true, authentic
selves. On the other side, critics of gender-affirming care
for minors favor the rapid-onset gender dysphoria
hypothesis, which argues that there is strong peer and
online influence as well as maladaptive coping mechanisms
involved in the adoption of a transgender identity.
This “social genesis” or “social contagion” argument is
supported by the fact that adolescent girls and young
women now make up most of the referrals to gender clinics
when, in the past, it was predominantly young boys and
adult men. Teenage girls and young women have been at
the forefront of almost every social contagion in recorded
history, including contagions of hysteria, eating disorders,
cutting, and dissociative identity disorder. The social
contagion argument is also supported by the high
prevalence of mental health and neurocognitive disorders
among trans-identified youth, and the fact that these
problems typically precede the onset of gender issues.
Despite receiving criticism from activists, the rapid onset
gender dysphoria theory has been endorsed by gender
clinicians across the West.
5,6,7
However, this report does not delve into the cultural
factors responsible for the rising numbers. Instead, our
focus narrows in on the conduct of WPATH members and
the type of medical care the leading transgender health
group endorses. The scope of this report is the potential
harm inflicted upon adolescents and vulnerable adults
within gender-affirming clinics.
WPATH is considered the leading authority on the
care and treatment of individuals who have gender
dysphoria and/or identify as transgender. WPATH
publishes internationally respected Standards of Care,
which it claims represent a professional consensus about
the psychiatric, psychological, medical, and surgical
management of gender dysphoria. Medical and mental
health professionals worldwide look to these guidelines as
the best available resource to guide them in caring for
transgender and gender-diverse patients.
But the WPATH Files show something entirely
different. Before discussing what they show, we recommend
the reader turn to the files and read them in their entirety.
They are complete from what a source or sources provided
to us.
Now, we will put the WPATH Files in a wider
historical and ethical context.
5
6
7
Hutchinson, A., Midgen, M., & Spiliadis, A. (2019). In Support of Research Into Rapid-Onset Gender Dysphoria. Archives of Sexual Behavior, 49.
https://doi.org/10.1007/s10508-019-01517-9
Kaltiala, R. (2023). ‘Gender-Affirming Care Is Dangerous. I Know Because I Helped Pioneer It.’. The Free Press. https://www.thefp.com/p/gender-
affirming-care-dangerous-finland-doctor
Levine, S. B. (2019). Informed Consent for Transgendered Patients. J Sex Marital Ther, 45(3), 218-229. https://doi.org/10.1080/0092623x.2018.1518885

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