The World Professional Association of Transgender Health (WPATH) has long insisted that so-called “sex-change” surgeries on minors are safe, necessary and backed by medical consensus. Yet newly exposed internal discussions obtained by The Daily Wire reveal the association’s own members scrambling for guidance on how to treat patients left with permanently altered bodies after they decide to reverse course—people often referred to as detransitioners.
In private online forum messages discovered through The Daily Wire’s public records request, members of WPATH openly discussed what appeared to be a shift in their overall promotion of transgender ideology. Group members expressed the need for formal “detransition” protocols, which are the clinical pathways for patients who want to attempt reversing hormone therapy or recover from surgeries such as mastectomy, hysterectomy, oophorectomy and vaginoplasty.
In June, the Federal Trade Commission sued WPATH, which is the largest transgender organization in the world, alleging it “misled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness” of interventions for minors. Systematic reviews have repeatedly questioned the evidence base underlying the group’s guidance.
What does the internal conversation look like?
One thread, titled “De-transition Protocols / Policies,” began with a straightforward request from Dr. Christopher Terndrup, associate director of the LGBTQ+ Healthcare Fellowship Program at Vanderbilt Health. He asked whether any institutions had protocols or policies that would address a person’s request to reverse gender-affirming surgeries, or to otherwise put people back to their prior hormonal state.
Responses revealed a shared recognition that this type of guidance is, in fact, lacking.
One psychologist confessed that patients often feel neglected: “We really need the clinical pathways. People will ask how to go off testosterone or how to restart testosterone, and I’ve asked various MDs and gotten different responses. Often, folks who are choosing to detransition feel like they have to do this all on their own.”
Some claim that detransitioners make up a very small portion of the population. Even so, another psychologist argued, “I still think that we should be developing protocols to handle this regardless of how many detransitioners there are. I think it’s important.”
In a separate thread, a physician’s assistant described a patient in her 20s who had undergone removal of her breasts, uterus and ovaries while identifying as a “trans male.” The young woman later experienced a shift and wanted to detransition. Yet, without ovaries, her body could no longer produce estrogen, leaving her in a surgically induced postmenopausal state that requires lifelong hormone replacement to avoid risks like osteoporosis and cardiovascular disease.
Conflicting opinions?
Former WPATH president and prominent transgender surgeon Marci Bowers claimed that “if ever there was a challenge to the WPATH professional community, it is to help patients sort through their gender diverse feelings prior to undergoing irreversible treatment.”
“Though there can always be a silver lining,” she added, detransition “cases like this seem tragic.”
Bowers suggested the organization needed better ways to help patients examine their feelings before irreversible steps, which many have been saying for years. However, she stopped short of calling for greater protections against the experimental procedures as a whole.
On the other hand, one WPATH member directly disagreed that the situation was “tragic,” arguing that “sometimes … people need to go ‘too far’ before they realize where they want to be.”
Holding WPATH Accountable
These revelations also emerge as WPATH faces growing pressure from the broader medical community and society at large.
As The Daily Wire emphasized, these internal admissions stand in sharp contrast to WPATH’s public Standards of Care Version 8—a document that recommends access to irreversible surgeries for minors with no age minimums. In its current form, it advises providers to support adolescents who detransition, but describes detransition as “proportionally rare,” offering no formal clinical protocols for providing help. The standards also acknowledge limited ability to predict how a child’s gender identity may evolve.
Dr. Kurt Miceli, chief medical officer at the conservative medical advocacy group Do No Harm, said the forum discussions expose a fundamental inconsistency. “There is a critical and undeniable need for detransitioner protocols—a reality acknowledged even by WPATH’s own members,” he told The Daily Wire. “Yet this is the same organization that has ignored systematic review upon systematic review as it promotes harmful and irreversible sex-rejecting procedures for minors.”
At the least, The Daily Wire reporting shows that even the world’s leading transgender organization promoting medical gender interventions recognizes, at least behind closed doors, that some patients will later need specialized medical help to live with the permanent consequences. And this despite many critics warning about such consequences from the beginning.
As Miceli concluded, this “contradiction” within WPATH “cannot be brushed aside: it exposes a fundamental inconsistency in which life-altering interventions are championed for minors on the one hand while the reality of those who later seek to reverse them has unfortunately been minimized and gone unaddressed.”
“Dr. Bowers’ comments within the WPATH Member Forum acknowledge a truth the organization does not confront publicly: the profound tragedy faced by individuals who seek to detransition after irreversible sex‑rejecting surgeries,” Miceli added.
The messages, spanning June to November 2024 and totaling nearly 250 pages, form the second installment in the Daily Wire’s ongoing investigation into the group. Neither WPATH nor Vanderbilt Health have responded to requests for comment from The Daily Wire, and Bowers declined.
Relevant Bible passages to ponder: Genesis 1:27, Matthew 19:4, Proverbs 31:8-9
