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Culture War Roundup for the week of June 24, 2024

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Yet Another Part Of the WPATH Saga

Unsealed Court Documents Show That Admiral Rachel Levine Pressured WPATH To Remove Age Guidelines From The Latest Standards Of Care

You may have heard about the controversy around the latest Standards Of Care removing the age minimums for various transgender care procedures. What I didn't make clear in that post was this wasn't about the difference between SOC7 and SOC8, the removal took place between different versions of the SOC8 itself. Shortly after the original guidelines were published, a correction notice was issued, and WPATH republished the SOC with the minimum ages removed (among other changes). Curiously the current version of the notice says the original version was published by mistake, and contains no details about the text that was changed.

The now unsealed documents show that this was the result of pressure from none other than Admiral Rachel Levine:

The issue of ages and treatment has been quite controversial (mainly for surgery) and it has come up again. We sent the document to Admiral Levine. . . She like [sic] the SOC-8 very much but she was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth and maybe adults too. Apparently the situation in the USA is terrible and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them. We have the WPATH executive committee in this meeting and we explained to her that we could not just remove them at this stage.

Another quote from the article says that "we have made changes as to how the minimal ages are presented in the documents", but this wasn't just a simple change in presentation, all age limits, other than for phalloplasty, are gone, and replaced with procedural steps the patient should go through. They claim this makes the standards more restrictive, but in my opinion that's contradicted by the statements from admiral Levine.

Jesse Singal also points out standards were supposed to be determined by the "Delphi process":

As the document itself explains: “Consensus on the final recommendations was attained using the Delphi process that included all members of the guidelines committee and required that recommendation statements were approved by at least 75% of members.”

This process was violated according to SOC contributors themselves:

I don’t see how we can simply remove something that important from the document—without going through a Delphi—at this final stage of the game [. . . ] I realize that those in favor of the bans are going to go right to the age criteria and ignore the fact that we actually strengthened the strictness of the criteria to help clinicians better discern appropriate surgical candidates from those who are inappropriate [. . . ] It’s all about messaging and marketing.

So between the "correction notice" shenanigans, and outright admission that rules were broken to push through that particular change, it seems like a pretty slam-dunk case for the Biden administration putting political pressure to loosen criteria for transgender care for minors.

This all just feels like moving deck chairs on the titanic. If being trans is real and we can indeed reliably detect it then all of this is pointless. If it's not then deciding what age to do the surgeries is the least of our issues. I don't see how there can be some middle road where we are confident it's real and detectable and yet should move cautiously.

I've started to use religious terms around transgender ideology, since I think they're the most accurate ones to describe what I see as a metaphysical belief system, or a "folk religion." If there can be a more widespread understanding of this ideology as similar to a folk religion, I think the decisions around treatments and surgeries (acts of faith) become easier for pundits/politicians/voters to articulate and decide where the guardrails should be.