WHO quietly announces controversial
gender guidance
The organisation used the Christmas period to slip out the news
A few days before
Christmas, the World Health Organization (WHO) announced that it
would be developing guidelines on “the health of trans and gender diverse
people”, with a focus on access to hormones and surgeries (what it calls
“gender-inclusive care”) and legal recognition of gender
self-identification.
The WHO also
announced the formation of a
guideline development group. This panel of experts is heavily stocked with
apparatchiks from the World Professional Association of Transgender Health
(WPATH), including two former presidents;
trans activists employed by the Global Action for Trans Equality network, or
GATE; the parent of a trans-identifying child; and at least one member with
strong ties to the pharmaceutical industry.
A few of the
panellists have especially colourful public profiles, none more so than
Florence Ashley, a “transfeminine jurist and bioethicist” whose preferred
pronouns are “They/Them/That Bitch”. Ashley believes that
“puberty blockers ought to be treated as the default option” for all youth, as
opposed to “letting puberty runs its course”. The activist argues that letting
this stage of human development progress uninterrupted “strongly favours cis
embodiment by raising the psychological and medical toll of transitioning”.
Thus:
… Puberty blockers structurally place transgender and cisgender hormonal
futures in approximate symmetry. Youth who take puberty blockers have their
options wide open, their bodies unaltered by either testosterone or oestrogen.
Although much remains unknown about the long-term effects of puberty blockers,
limited empirical evidence and clinical experience make us more than justified
in assuming that whatever risks puberty blockers have do not foreclose future
life paths as much as undergoing puberty does.
Besides being
absurd, this proposal discounts the possible effects of puberty blockers on
adolescent brain development. We don’t yet know how suppressing the sex
hormones that spur cognitive development during puberty affects factors like
impulse control, emotional regulation, critical thinking, and decision-making.
What’s more, evidence suggests that
blocking puberty may “lock” children into a trans identity, rather than buying
time and space to think.
Ashley has argued elsewhere that clinical assessment
does not predict or prevent regret (so why bother?) and dismissed concerns about the rapid
increase in adolescent and young adult females seeking transition. Ashley
concludes on an odd note, first denying, then embracing the possible role of
social influence: “If the rise in transgender identities evidences social
contagion — a claim I have shown to be unsubstantiated — it may yet be a
healthy contagion.” This comes from the philosopher who once mused: “What is
your main motivation in life, and why is it getting railed in a sundress by a
hot dyke?”
Another panellist,
Teddy Cook, described the
“actual side effects of gender-affirming medical care” as “a significantly
improved quality of life, significantly better health and wellbeing outcomes, a
dramatic decrease in distress, depression and anxiety and a substantial
increase of gender euphoria and trans joy”, concluding that “we are not at risk
of harm by affirming our gender.”
Panellists with
WPATH-heavy résumés oversaw the controversial inclusion of eunuchs, as well as
the exclusion of a draft chapter on medical ethics, from that
organisation’s most recent standards of care. In
short, many of them have significant personal, intellectual, and
professional conflicts of interest that may interfere with their ability to
evaluate and follow the evidence when that evidence leads to uncomfortable
places.
Conflicts of
interest are unavoidable, but balance matters. One won’t find any critics,
concerned clinicians, experts in child and adolescent development, specialists
in neurodevelopment, or desisters and detransitioners in the WHO’s guideline
development group.
The organisation
also opened a brief window for public comment over the Christmas holidays — a
window that closes just two days after Epiphany. If Friday afternoons are the
best time of the week to dump bad news, the quiet stretch around
Christmas and New Year is the ideal time to solicit public comment — if one
wants as few people as possible to weigh in, that is.
The World Health
Organization has a responsibility to facilitate — not preempt — an open,
transparent, and scientific dialogue about the risks, benefits, and unknowns
surrounding the most effective and ethical treatments for gender-dysphoric
patients. At this point, such a process would require starting from scratch.
WHO
quietly announces controversial gender guidance - The Post (unherd.com)