The Federal Trade Commission (FTC) has sued an influential medical organization, seeking to prevent it from allegedly misleading patients about the benefits of “gender-affirming care” for children.
In a complaint filed on June 17, the Trump administration and four states have asked the U.S. District Court for the Northern District of Texas to issue an injunction against World Professional Association for Transgender Health (WPATH) affiliates.
They allege WPATH violated the FTC Act and similar state laws that protect consumers from unfair or deceptive business practices.
“Children, but especially their parents, must have complete and truthful information when making decisions to purchase medical services,” FTC Chairman Andrew Ferguson said in a statement.
The lawsuit added to mounting international scrutiny for WPATH, which has denied wrongdoing.
Here’s what to know about the lawsuit and ongoing controversy over WPATH.
‘Standards of Care’
Transition doctors founded WPATH to promote the financial interests of the medical transitioning industry after losing support in 1979, according to the lawsuit.
WPATH developed “standards of care” (SOCs) to address insurance coverage losses. That led major health insurance companies to rely on the SOCs’ determination of medical necessity.
The standards limited procedures to adults, but that changed over the years.
The government’s complaint focuses on WPATH’s most recent SOCs, updated in 2022.
The latest WPATH standards removed age restrictions on life-altering gender surgeries for children, including penis and breast removal, with almost no exceptions.
Political pressure, instead of science, pushed WPATH to eliminate age restrictions, the government alleges.
WPATH misled the public by asserting that pediatric medical transition was the “standard of care” and medically necessary for gender dysphoria; that the effects of puberty blockers are reversible; that cross-sex hormones improve mental health; and that breast removal for children is safe, effective, and “consistently results in better health and quality of life,” the FTC alleges.
WPATH also allegedly omitted or minimized important information in its standards. The FTC argues that the group failed to meaningfully disclose the side effects of puberty blockers and cross-sex hormones, such as sexual dysfunction or the inability to breastfeed after a mastectomy.
The group’s standards say children with gender dysphoria are at a higher risk of suicide unless they undergo medical transition, characterizing these interventions as “lifesaving,” despite the absence of evidence that they reduce the risk of suicide, according to the government’s complaint.
Federal, State Laws
The FTC claimed that WPATH intentionally provided medical professionals with information to deceive consumers, which violated 5(a) and 12 of the FTC Act.
That law, enacted in 1914, made it illegal to deceive consumers through “unfair or deceptive acts or practices.” Alaska, Iowa, Nebraska, and Texas enacted similar consumer protection laws.
WPATH practices allegedly violated the FTC Act by seeking to profit from its gender dysphoria treatment recommendations, which “deceived many consumers into believing that its treatment guidelines are based on strong evidence.” WPATH’s use of the term “standards of care” implied they were appropriate and widely accepted, but in reality, their appropriateness and effectiveness were the subject of significant medical debate, allegedly.
Likewise, WPATH allegedly provided “deceptive” transitioning materials to clinicians to pass on to children and their parents.
Attorney Jonathan Hullihan, general counsel at Remnant Law Firm in Texas, told The Epoch Times that the government and states were targeting the organization that wrote the playbook on so-called “gender-affirming care.”
“At the heart of this case is a consumer protection law. The question is simple: Were families told things that were false or unproven, and were the real risks left out that caused harm?” he said.
Hullihan noted that the lawsuit says the procedures were advertised as reversible, effective, and in accordance with the standard of care. Likewise, the complaint says these medical interventions were sold as settled science when they were not.
“If that’s true, it’s textbook deception and a brilliant legal strategy to cut off the source of the so-called standard of care the clinics claim they followed.”
Josh Payne, founding partner at Campbell Miller Payne in Dallas, which represents detransitioners, said his clients are living examples of what happens when people aren’t fully informed.
“This is happening on the ground—doctors, counselors, surgeons are not giving the complete, full, and accurate information when it comes to the hormones and the surgeries that patients are being told are life-saving care,” he told The Epoch Times.
Many detransitioners who suffered with mental health disorders in their youth were told transitioning would ease their distress, he said.
“They have all these things swirling around, and they’re told that their real problem is their gender identity,” he said. “I would say insurance companies are probably already looking at this very hard, and the whole idea of medical necessity.”
WPATH Responds
WPATH shot back with its own statement about the lawsuit, saying the government and state case is factually and legally flawed.
The FTC is not a medical provider and has no place “interfering with the process of individualized medical decision-making,” WPATH said in a June 17 press release.
WPATH defended its standards, saying it was the second time in a year that the Trump administration had targeted the group and interfered with Americans’ right to obtain healthcare.
This wasn’t the first time the group fought back against the FTC, which tried to investigate it earlier this year.
WPATH filed a lawsuit over the investigation, and in May, a federal judge entered a preliminary injunction ordering the FTC not to implement or enforce its investigative demand against the group.
“The first attempt, the FTC’s improper requests to WPATH for protected information, was struck down by a federal judge,” the group said. “As an end-around, the FTC has now purportedly brought a similarly baseless actual complaint and has enlisted the administration’s go-to, obedient state attorneys general to help do its unlawful bidding.”
The group argued that treatment decisions should be made by patients and their doctors.
Transgender patients deserve the “highest level of care” from their medical professionals, and the SOCs put out by the organization are designed to promote this through open dialogue and clear communication, the group said.
Controversy Over WPATH
WPATH has come under increased scrutiny as more countries, especially those in Europe, have turned away from medical intervention for gender dysphoria.
Among other things, WPATH has faced scrutiny over the lead-up to its decision to remove age limits—specifically over whether it was improperly influenced by the Biden administration.
Adm. Rachel Levine, former assistant secretary for health at the U.S.Department of Health and Human Services, was “extremely supportive of the SOC 8” and “very eager for its release, so as to ensure integration in the U.S. health policies of the Biden government,” the FTC’s lawsuit alleged.
Levine’s chief of staff was allegedly concerned that if WPATH put in age limits, it would result in “devastating legislation” against transitioning and give headlines to “the conservative anti-trans agenda.”
WPATH’s age restrictions were “corrected” and removed nine days after being published in 2022, said the Family Research Council, a conservative group that investigated the issue.
Its comments and other criticisms of WPATH came in amicus briefs filed in United States v. Skrmetti, a Supreme Court case questioning Tennessee’s law banning “gender-affirming care” for minors. The court ultimately said the law passed constitutional muster following oral arguments in which justices expressed skepticism of things such as hormone drugs.
The FTC argued that pressure to remove age restrictions also came from the American Academy of Pediatrics (AAP), which threatened to “actively publicly oppose” WPATH’s 2022 standards unless it removed them.
Physicians and medical organizations have taken conflicting stances on the issue, as was seen in filings before the Supreme Court.
For example, both the Endocrine Society and the AAP have backed the use of hormone drugs for gender dysphoria.
In support of WPATH and the Endocrine Society’s guidelines, the AAP said the guidelines were developed “by expert clinicians and researchers who have worked with patients with gender dysphoria for many years.”
The American Psychological Association similarly defended WPATH’s guidelines as “highly individualized” and including “a range of accepted treatment options.”
“The WPATH Standards reflect the consensus in expert opinion among professionals in this field based on their collective clinical experience as well as a large body of research,” the group told the Supreme Court.
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