{"id":4580,"date":"2023-07-31T22:00:03","date_gmt":"2023-07-31T22:00:03","guid":{"rendered":"https:\/\/wifamily.news\/?p=4580"},"modified":"2023-07-31T22:18:06","modified_gmt":"2023-07-31T22:18:06","slug":"part-3-associations-used-to-justify-transgender-treatments-for-wisconsin-minors-are-riddled-with-bias-conflict-of-interest-questions","status":"publish","type":"post","link":"https:\/\/wifamily.news\/?p=4580","title":{"rendered":"Part 3: Associations Used to Justify Transgender Treatments for Wisconsin Minors Are Riddled With Bias, Conflict of Interest Questions"},"content":{"rendered":"

This post originally appeared at https:\/\/www.wisconsinrightnow.com\/trandgender-treatments-for-wisconsin-minors\/<\/a><\/p>\n

\"Trandgender<\/p>\n

This is part 3 in a multipart series<\/a> exploring gender treatments in Wisconsin hospitals.\u00a0<\/strong><\/em><\/p>\n

Three major hospitals in Wisconsin that perform gender surgeries and\/or treatments on minors justify them by relying on guidelines from three associations with lofty-sounding names. However, those associations are riddled with ideological bias and conflict of interest concerns and once considered recommending castration and hysterectomies for minors, Wisconsin Right Now has found.<\/p>\n

Children\u2019s Hospital\u2019s website notes, \u201cOur approach is guided by widely accepted medical and scientific evidence and follows guidelines endorsed by World Professional Association for Transgender Health, Endocrine Society, and American Psychological Association.\u201d<\/p>\n

UW Health makes similar claims. \u201cWe rely on best practice standards and guidelines from organizations such as the WPATH, Pediatric Endocrine Society and Endocrine Society,\u201d its spokesperson says.
\n<\/em><\/p>\n

Marshfield Clinic: Earlier this year, Marshfield Clinic sponsored a conference that featured Laura Edwards-Leeper, PhD. In an online advertisement<\/a> for the conference, \u201cthe information provided will be consistent with the World Professional Association\u2019s Standards of Care \u2013 Version 8, but the focus will go beyond what is available in the WPATH document.\u201d<\/p>\n

The advertisement describes Edwards-Leeper as a member of \u201cthe American Psychological Association Task Force which developed practice guidelines for working with transgender individuals, the SAMHSA committee that helped develop a consensus statement regarding the danger in using conversion therapy with LGBT youth, and was the chair of the World Professional Association for Transgender Health\u2019s (WPATH) Child\/Adolescent Committee. She was also selected to be on both the child and adolescent WPATH committees that revised the Standards of Care (Version 8, released in September 2022). She has been identified as an international expert in this area.\u201d<\/p>\n

In 2022, a draft of the guidelines, which are used in the U.S. and internationally, were going to reduce the minimum age for a variety of transgender treatments, including allowing castration and hysterectormies of minors. The guidelines were going to recommend prescribing hormones to minors to 14, to 15 for breast removal, 16 for breast augmentation and facial surgeries, 17 for hysterectomy, vaginoplasty or removal of testicles, and 18 for phalloplasty, according to BMJ.<\/a> The article said the change came after news outlets published the planned reduction of the age recommendations, and social media criticism erupted.<\/p>\n

According to a 2022 Economist article, \u201cThe latest standards of care by the World Professional Association for Transgender Health (wpath) on September 15th was a mess. Known as soc8, they originally included a list of minimum ages for treatments\u201414 for cross-sex hormones, 15 for removal of breasts, 17 for testicles. Hours later, a \u2018correction\u2019 eliminated the age limits. The head of the drafting committee, Eli Coleman, said the publisher went ahead \u2018without approval\u2019 before final changes were made.\u201d<\/p>\n

Coleman told The BMJ, \u201cThis whole controversy over treatment of youth was certainly heating up, and we got feedback from
\ndifferent groups who are still worried about anything that would hurt providing access to transgender youth, so we went back and really took a strong look at this last draft and we made some final decisions to make a few of these revisions.\u201d<\/p>\n

\n

Riddled With Controversies<\/h2>\n

However, these associations are riddled with controversies.<\/p>\n

In part 1<\/a>, we reported that more than 260 juveniles received puberty blockers or hormone therapy in recent years from two major Wisconsin hospitals, and at least 21 juveniles underwent breast surgeries \u2013 in most cases mastectomies \u2013 in the state since 2021 because of \u201cgender dysphoria.\u201d<\/p>\n

The American Psychological Association pushes research<\/a> arguing that allowing \u201cgender creative children who eventually identify as cisgender the freedom to explore their gender \u2013 even with puberty blockers \u2013 helped them feel more confident in their ultimate decisions about their gender identity.\u201d<\/p>\n

However, the association has long pushed controversial left-wing political stances.<\/p>\n

According to Capital Research<\/a>, when the American Psychological Association (APA) published its guidelines for Psychological Practice with Boys and Men<\/a><\/u> in August 2018, controversy erupted because the group \u201cinstructed therapists and clinicians to treat traditional masculinity (defined as stoicism, competitiveness, dominance, and aggression) as \u2018on the whole, harmful\u2019 and entirely socially constructed.\u201d<\/p>\n

Capital Research found that \u201cthe psychologists who make up the APA are overwhelmingly left-wing. A 2012 study found that of 800 psychologists surveyed, only 6 percent<\/a><\/em> identified themselves as conservative.\u201d<\/p>\n

Furthermore, the article says, APA has been funded by a series of left-wing foundations, including the Arcus Foundation, which structured \u201cmany of its grants to focus on LGBT issues.\u201d According to Influence Watch<\/a>, that foundation is associated with billionaire medical device heir Jon Stryker.<\/a> One of its two main goals is \u201cto promote LGBT activism,\u201d Influence Watch reported.<\/p>\n

Since the election of President Trump, \u201cthe APA expanded its range of issues to include climate change and immigration, Capital Research reported.<\/p>\n

The other association cited by the hospitals is known as WPATH (World Professional Association for Transgender Health), which recently updated its guidelines.<\/p>\n

According to HR Executive<\/a>, new guidelines issued by WPATH show that \u201cGender-affirming adolescent care remains unclear and controversial.\u201d Although they lowered the age guideline, HR executive noted, \u201cThe implications of long-term puberty blockers are not fully known, but concerns have been raised around issues of bone health for these patients, particularly transgender males.\u201d<\/p>\n

Canadian Gender Report<\/a>, a group of parents and professionals, found \u201cchallenges in guideline development\u201d that \u201cinclude limitations in the scientific evidence on which clinical practice guidelines (CPGs) are based, lack of transparency of development groups\u2019 methodologies, questions about how to reconcile conflicting guidelines, and conflict of interests among guideline development group members and funders.\u201d<\/p>\n

A non-profit patient safety organization, ECRI<\/a> Guidelines Trust, has stepped in to evaluate the groups, the report says.<\/p>\n

\u201cWhen ECRI was contacted by this author and asked why WPATH guidelines were not included, and why the Endocrine Society guidelines did not have a scorecard rating, they responded in an email, saying that the reason the Endocrine Society guidelines did not meet inclusion criteria to be rated was because \u2018Only a few of their recommendations were supported by the systematic review; the majority were not,’\u201d the report says. \u201cThe reason WPATH was not included, ECRI stated, was because the guidelines were over five years old, and \u2018did not use a systematic review to process.’\u201d<\/p>\n

A \u201csystematic review of clinical guideline development in 2011 revealed 56 to 87%<\/a> of the authors had a conflict of interest (COI) in all clinical practice guidelines. Obvious financial COIs such as affiliations with pharmaceutical companies are a given. Research grants, support from foundations,\u201d the site says.<\/p>\n

\u201cWhen looking at the WPATH committee who worked on the current SOC (guideline) document, a cursory examination of the members reveals that every one of the members have significant COIs (conflicts of interest),\u201d says the report.<\/p>\n

\u201cThe majority of the members are from the US, and six of them have affiliations with the same university\u2013the University of Minnesota Program in Sexuality, which is primarily funded<\/a> by a transgender advocacy organization (Tawani<\/a> Foundation),\u201d according to Canadian Gender Report.<\/p>\n

Eli Coleman, \u201cthe committee chair for the WPATH SOC, who IOM guidelines stipulate should be completely free of conflict of interest, has his very position at the University of Minnesota funded by Jennifer Pritzer, a trans person and head of Tawani,\u201d says the report. \u201cThree of the same committee members for the WPATH Guidelines, also served on the Endocrine Society guideline committee, which means intellectual COI (conflict of interest) is at play.\u201d<\/p>\n

The report concluded: \u201cWPATH has a history of being funded and pressured by transgender activists and transgender organizations.\u201d<\/p>\n

A 2018 study<\/a> published by The Journal of Clinical Endocrinology & Metabolis<\/em>m studied \u201cFinancial Conflicts of Interest Among Authors of Endocrine Society Clinical Practice Guidelines.\u201d They found conflicts of interest among many of the authors. \u201cConflicts of interest in which pharmaceutical and device companies manufactured drugs or products pertinent to an author\u2019s specific clinical practice guideline(s) were deemed relevant,\u201d the authors wrote, finding that \u201crelevant nonresearch financial conflicts of interest were self-reported by 42% of authors of clinical practice guidelines.\u201d<\/p>\n

WPATH\u2019s Standard of Care Authors<\/h2>\n

WPATH\u2019s website<\/a> currently lists these \u201cchairs of the SOC8, lead evidence\u201d team:<\/p>\n

1. Eli Coleman, PHD, chair. \u201cProfessor, Director and Academic Chair, Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School (USA) He holds the first and only endowed academic chair in sexual health.\u201d<\/p>\n

The Eli Coleman Institute for Sexual and Gender Health<\/a> at the University of Minnesota has this mission: \u201cRevolutionizing the sexual and gender climate by eliminating barriers and advancing healthy sexuality. Leadership in sexuality research, education, clinical care, and advocacy to promote positive sexual and gender health for all.\u201d The center also sees its role as \u201cAdvocating for sex and gender rights.\u201d<\/p>\n

According to Transgender Map, Coleman spoke of the importance of \u201cexpert testimony in a Florida custody case won by a trans father, and the need to fight renewed efforts by the religious groups which still stigmatize transpeople.\u201d He is the founding editor of International Journal of Transgenderism and International Journal of Sexual Health.<\/p>\n

He also criticized a book by a Northwestern professor who, according to the New York Times, had \u201cargued that some people born male who want to cross genders are driven primarily by an erotic fascination with themselves as women.\u201d<\/p>\n

According to Transgender Map, Jamison Green, a writer and educator, said of Coleman\u2019s speech on that professor\u2019s book: \u201cHe was urging HBIGDA as an organization and the membership as a whole (as individuals) to become more assertive in addressing social and political issues that affect transpeople.\u201d The site says Coleman presented a 10-point plan at the international conference that included \u201cend stigma and discrimination. Change laws and social policies. Change religious views. Promote social tolerance for diversity.\u201d<\/p>\n

The Eli Coleman Institute for Sexual and Gender Health in April promoted this event: \u201cJoin us @BarrelTheory
\non Thu 5\/18 for our next Sex Science Happy Hour w\/ special guest Sarah Auna, a queer birth advocate & author who helps families navigate America\u2019s birth-phobic culture.\u201d<\/p>\n

Last October, the Institute tweeted, \u201cDressing up isn\u2019t only for Halloween. Today we\u2019re debunking the myth that roleplay (including wearing costumes) during sex is abnormal. Swipe for more on how sexual roleplay & other forms of kink are normal, healthy expressions of sexuality.\u201d The site retweeted a tweet that reads, \u201cDon\u2019t condone violence? Distribute that generational wealth attained violently. Support robust reparations. Defund the police. And you should be furious about what\u2019s happening to trans people.\u201d<\/p>\n

The site also tweeted, \u201cThe Department of Health & Human Services (HHS) stands with transgender and gender nonconforming youth and their families\u2014and the significant majority of expert medical associations in unequivocally stating that gender affirming care for minors, when medically appropriate and necessary, improves their physical and mental health.\u201d<\/p>\n

The Economist noted, \u201cWpath, based in Illinois, has been the main transgender-health organisation that is looked to for guidance across the world. Since its views count, critics worry about soc8 saying hormones and surgery should be allowed at even younger ages. They think this medicalises too many teens who need neither, just therapy. Soc8 also says puberty blockers are reversible, a contested claim.\u201d<\/p>\n

Salon reported in June 2022, \u201cThe World Professional Association for Transgender Health has declared that the minimum age for gender transition treatment can now be lowered to 14, which is two years younger than previously advised. Along with that decrease in the age requirement for hormone treatments, the association has also moved to lower the minimum age for some gender reassignment surgeries to between 15 or 17.\u201d Salon reported, \u201cUnder the new guidelines, girls will be able to start puberty blockers between the ages of 8 to 13, and two years later for boys.\u201d<\/p>\n

Salon reported that the new guidelines recommended \u201cmost genital surgeries starting at age 17, including womb and testicle removal, a year earlier than previous guidance\u201d and \u201cBreast removal for trans boys at age 15.\u201d<\/p>\n

The Associated Press quoted Coleman as supporting the age reductions. The AP paraphrased him as saying, \u201cStarting treatment earlier allows transgender teens to experience physical puberty changes around the same time as other teens.\u201d It noted, \u201che stressed that age is just one factor to be weighed. Emotional maturity, parents\u2019 consent, longstanding gender discomfort and a careful psychological evaluation are among the others.\u201d<\/p>\n

2. Asa Radix, MD, PhD, MPH (Co-chair). Senior Director, Research and Education, Callen-Lorde Community Health Center, Clinical Associate Professor of Medicine, New York University, (USA). \u201cDoing research within LGBTQ+ communities, especially when you are part of the community, can bring additional challenges and responsibilities. You are expected to wear multiple hats (investigator, advocate, community leader, among others) and if you do not take care of yourself, you may find that you are quickly overwhelmed and in danger of burn-out,\u201d Radix said.<\/p>\n

St. George\u2019s University wrote, \u201cAsa Radix, MD \u201988, PhD, MPH decided to pursue medicine out of a desire to offer patient-centered healthcare in an often-overlooked community in need. Dr. Radix\u2019s career has focused on LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Ally, plus) health and policy and being able to ensure patients receive quality care that is respectful, non-judgmental, and meets the unique needs of members of the LGBTQIA+ community.\u201d On one panel, Radix said, \u201cmy pronouns are he or they\u201d and attributed COVID deaths to structural racism.<\/p>\n

Radix co-wrote a paper on what happens with parents and transgender children disagree about treatment. \u201cWe discuss three potential avenues for providing gender-affirming care over parental disagreement: legal carve-outs to parental consent, the mature minor doctrine and state intervention for neglect. Our discussion approaches this parent-child disagreement in a manner that prioritises the developing autonomy of transgender youth in the decision-making process surrounding medically assisted gender affirmation,\u201d it says.<\/p>\n

3. Jon Arcelus, MD, PhD (Co-chair). Full Professor of Mental Health and Transgender Health, University of Nottingham, (UK). He is listed as \u201ctransgender health specialist at the Nottingham Centre for Transgender Heath and Emeritus Professor of Mental Health and Wellbeing at the University of Nottingham.\u201d His research has included studying the romantic relationships of transgender people. He edited a \u201ctransgender handbook.\u201d He is an Associate Editor of the International Journal of Transgender Health.<\/p>\n

4. Karen A. Robinson, PhD (Lead, Evidence Review Team). Associate Professor of Medicine, Epidemiology and Health Policy & Management, Johns Hopkins University, (USA)<\/p>\n","protected":false},"excerpt":{"rendered":"

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