WPATH, the MOU and gender ideology in the UK

A guest post by Peter Jenkins, a member of Thoughtful Therapists, whose scoping survey for the UK government consultation on conversion therapy can be found here:  https://thoughtfultherapists.org/scoping-survey-pdf/

The media response to the release of The WPATH Files has rightly focused on its shocking revelations of potentially unethical practice and concern over parallels with past medical negligence scandals in the US, such as the unevidenced use of lobotomy and ovariectomy on vulnerable patients (Hughes, 2024). Within the UK, exposure of the World Professional Association for Transgender Health (WPATH) runs up against the problem that the organisation is not widely known here, outside of specialist medical and therapy circles.

This is perhaps a form of back-handed tribute to WPATH’s evident success in quietly insinuating its influence and its vaunted Standards of Care into UK medical institutions and professional policies at every level. This influence is now being much more clearly recognised. However, it is important to turn to WPATH’s arguably greater success in framing (and blocking) debate about conversion therapy, gender identity affirmative therapy and exploratory therapy through the powerful vector provided by its mouthpiece, the Memorandum of Understanding on Conversion Therapy.

WPATH, as we now know, claims to be the leading global authority on promoting transgender health, perhaps illustrating the power of confident self-promotion in defining others’ expectations. However, its impressive title is based on persuasive definition, rather than on settled reality. WPATH claims to be a World organisation, but, in reality, two thirds of its membership are from the US. The claim to be a Professional Association is in serious doubt, given that around a third of its members are trans activists or allies, rather than qualified medical professionals.

The WPATH Files also challenge its claim to effectively promote Transgender Health, given its apparent reluctance to ‘gatekeep’ access to medication and surgery, and perceived resistance to carry out systematic audit, evaluation and follow-up to its interventions. The vaunted WPATH Standards of Care appear carefully crafted to offer maximum protection for health practitioners from litigation, rather than to safeguard patients. The Standards are in no sense comparable to clinical practice guidelines issued by recognised bodies, such as the UK National Institute for Health and Clinical Excellence (NICE) (Jenkins, 2022; 2023a; 2023b).

The Eunuch Files and a major NHS cybersecurity breach:

Strong evidence that some WPATH material is not at all orthodox, mainstream, or the stuff of dull routine came in the form of a surprising critical incident. In June 2022, the draft Standards of Care allegedly blew a sizeable hole in NHS Scotland’s cybersecurity defences. This happened after draft WPATH Standards of Care 8 were uploaded to a NHS website in Scotland. The Standards contained a chapter acknowledging eunuch as a new type of gender identity.

This chapter also included a specific link to a website, alleged to be a repository of child abuse material specialising in the sexual abuse and mutilation of children. The uploading caused a major critical incident, which was picked up by the national press. “In the summer, the health service apologised for a scandal in which a WPATH document, including a link to a website with graphic fictional depictions of child castration and sexual abuse, was uploaded to an NHS website” (Sanderson, 2022).

The incident was then the subject of a formal investigation by the Scottish National Specialist Service, as a Category 1 event. The latter is defined as one that “may have contributed to or resulted in permanent harm, for example death, intervention required to sustain life, severe financial loss (£>1m), ongoing national adverse publicity, or breach of highly sensitive personal information” (NSS, 2022: 3).

The NSS Cybersecurity team review reported the website content and recommended reporting the end website to Police Scotland.  Curiously, this investigation did not confirm whether a referral to the police had in fact been made, or followed up, nor whether an international referral to the relevant police and investigative authorities in the US had been initiated.

WPATH and extensive policy capture:

Despite these and other shortcomings, WPATH has managed to achieve extensive and undeserved influence over medical institutions and policy formation within the UK. According to Sex Matters (2024), WPATH Standards of Care are referenced by the British Medical Association, General Medical Council, and the Royal College of Psychiatrists.

The Standards of Care are cited by the (now defunct) Tavistock Gender Identity Development Service for children, and also by the corresponding Tavistock and Portman Adult Clinic. In Scotland, the Standards of Care are referenced in current endocrine and fertility preservation guidance and within the Sandyford Gender Identity Services clinic guidance for adult patients.

WPATH is also cited by the Welsh Health Specialised Services Committee, which is responsible for commissioning future gender identity services in Wales. In addition, within the lower levels of the judicial system, a General Medical Council Tribunal has determined that “WPATH SOC7 has the status of peer-reviewed expert guidance” (MPTS, 2022).

Whether any of this malign influence will now be reviewed and rooted out, following the sustained reputational damage inflicted by the WPATH Files, is still pretty much an open question. Government agencies have quickly moved to put clear blue water between themselves and WPATH influence as part of their damage limitation strategy. Thus “The Department of Health said NHS England ‘moved away from WPATH guidelines more than five years ago’” (Beckford and Ward, 2024).

So, presumably, nothing to see here? Not quite. WPATH is still cited by the Tavistock and Portman Adult Gender Clinic, after all. Much  more significantly, NHS England remains as a committed signatory of the Memorandum of Understanding on Conversion Therapy (MOU) (Bacp, 2022). In fact, it might be argued by some critics that, on account of this crucial endorsement, the WPATH/MOU tail is still decidedly wagging the NHS therapy dog on key policy matters.

Remind me: what is the MOU?

As for the MOU itself, this is a document of inter-professional agreement against conversion therapy, signed by 28 leading organisations, either professional therapy associations, such as the British Association for Counselling and Psychotherapy, or employers of therapists, such as Mind, plus non-therapist trans activist organisations, such as Stonewall, and even more strangely, the Northern Ireland Humanists.

The first version of the MOU in 2015 opposed conversion therapy on the grounds of sexual orientation, i.e. classical aversion therapy for gay and lesbian people. The second version, adopted in 2017, controversially added opposition to conversion therapy on the grounds of gender identity (Charlesworth, 2021). Whereas sexual orientation is a normal human variant, and part of the ordinary range of human sexuality, gender identity springs from a strongly contested belief system.

The Memorandum commits members of signatory organisations to awareness of ethical issues, appropriate training, informed and ethical practice, plus adequate knowledge and understanding of gender and sexual diversity. Therapists are required to be free from any agenda that favours one gender identity, or sexual orientation, as preferable to other gender and sexual diversities.

They may perform a clinical assessment of suitability prior to medical intervention; and explore therapeutic options to help people who are unhappy about their sexual orientation, or their gender identity, to live more comfortably with it, reduce their distress and reach a greater degree of self-acceptance. An essential requirement is for therapists to acknowledge the broad spectrum of gender identities and gender expressions, in addition to sexual orientation.

WPATH and MOU parallels:

The MOU channels WPATH ideology in a number of key respects. Firstly, like WPATH, the MOU is a hybrid organisation, presenting itself as a professional association, but actually containing a significant number of non-professional activist lobby groups. Secondly, like WPATH, the MOU has achieved remarkable success in the policy capture of almost all major employer or therapy associations in the UK, with a very few exceptions, such as COSCA (Counselling & Psychotherapy in Scotland), and the Association for Child Psychotherapists. Thirdly, the forms of gender identity ideology espoused by WPATH and the MOU are very closely aligned, to the point where they are almost indistinguishable from each other.

Gender identity ideology here is based on the foundational concept of gender identity, i.e. an innate, immutable and internal sense of gender, which may be incongruent with natal sex. According to a similarly captured and repurposed variant of human rights narrative, people with this sense of gender incongruence are heavily discriminated against, experience minority stress and require access to gender affirming healthcare in its broadest sense. This process includes emotional, social and therapeutic support, extending through interlocking processes of social, medical and legal transition towards the preferred gender.

There are a few minor points of difference between the MOU and WPATH, which may be more about their respective cultural style than substance. As the older and more successful relative, WPATH seems brash, flamboyant and perhaps just a tad over-confident, given its current dominance of the US gender healthcare market. In contrast, the MOU as an organisation can be seen as opaque, secretive and almost minimalist, with rare public statements or appearances, unlike its more verbose US cousin. The following illustrative statements are taken from MOU evidence to the Scottish Parliament Equalities, Human Rights and Civil Justice Committee and from a MOU video webinar.

MOU as the key vector for WPATH’s gender identity ideology:

In broad terms of gender ideology, WPATH and MOU have a shared commitment to the following core themes:

  • rejecting a binary, biological model of human sexual differentiation;
  • framing exploratory therapy as problematic and delaying transition;
  • minimising age boundaries and safeguarding issues within therapy;
  • adopting an unsystematic stance towards data collection and research;
  • pursuing comprehensive re-education of health professionals on ‘intersectionality’.

The following MOU statements, made by its chair Igi Moon, tend to demonstrate a close alignment with the core elements of gender identity ideology espoused by WPATH:

  • Rejecting a binary, biological model of human sexual differentiation: this is a core, defining feature for the MOU: “The idea of a two-sex model may be great for some people if that’s what you want to believe then fine you believe it but you can’t believe that alone if you want to work with clients” (MOU, 2021, at 31.00). This stance apparently contradicts the Forstater Appeal judgement, which has confirmed that gender critical beliefs are protected by law for employment purposes (Forstater v CGD, 2020);
  • Framing exploratory therapy as problematic and delaying transition: “A number of organisations use language in a particular way to present the idea that people can explore their gender in a safe way, but when we dig down into it, we realise that most of those organisations do not want to be on the MOU, that they do not agree with it and that the extended exploration of someone’s traumatised history is really a way of preventing them from being able to live their life and have the gender or sexual orientation that they wish to have. We want that to be addressed” (SP, 2021: Col 30: emphasis added: PJ);
  • Minimising age boundaries and safeguarding issues within therapy: The comment made during a MOU webinar, to the effect that “…for those of us who want to access transition, whatever age that might be, however young or however old…” is telling (MOU, 2021: 17.07). WPATH Standards of Care version 8 have removed most age restrictions on medical procedures for minors under 18 years (Coleman et al, 2022). Of course, the MOU itself as a document makes no reference at all to any distinctions between children and adults, in complete contradiction to basic safeguarding policy and practice. This is in contrast with other accepted statements of ethical practice in therapy, which specifically require special levels of competence and awareness of relevant legal issues for any therapists working with children and young people (BACP, 2018: 21);
  • Adopting an unsystematic stance towards data collection and research. “We were told very clearly by two people at the meeting that we needed more research to show that transgender people were being persuaded into conversion therapy in some way, shape or form. My argument was that, while we did the research, people would be dying, and I would not be culpable for that. The anecdotal and testimonial evidence that we gathered from witnesses is available. There was plenty of it, and it told us that trans binary and trans non-binary people were receiving conversion therapy…” (SP, 2021: Col 28: emphasis added: PJ);
  • Pursuing comprehensive re-education of health professionals on ‘intersectionality’: For all of the above to take root will require nothing less than a major cultural revolution in terms of therapist attitudes, guided by a major and coordinated effort to re-educate a generation of health practitioners. Thus, « In relation to affirmative therapy, we probably need to upgrade our thinking, actually. In the training of therapists, psychologists, psychiatrists and doctors, effort needs to be made to ensure that there is intersectional thinking »  (SP, 2021: Col 26). According to critics of the key concept of intersectionality, the core assumption being made here is that « disparate outcomes can have one, and only one, explanation, and it is prejudicial bigotry » (Pluckrose and Lindsay, 2021: 128).

Summary and conclusion :

The seismic impact of The WPATH Files has led to major organisations, such as NHS England, to try to minimise the extent of influence of the Standards of Care on current policy and practice within gender healthcare in the UK. This radically understates the widespread infiltration of WPATH’s version of gender identity ideology within major healthcare institutions, ranging from the General Medical Council to the Royal College of Psychiatrists.

Much closer attention now needs to be directed to the role of the MOU as the key vector for WPATH ideology into the UK. The MOU closely mimics WPATH themes on gender identity ideology, and enjoys support from the leadership, and hence the membership, of almost all therapy professional associations in the UK, plus that of major employers of therapists, such as NHS England and NHS Scotland. This undeserved influence needs to be challenged and ended as soon as possible.

Gender identity ideology is an extreme political ideology, attempting to remake society on the basis of an anti-scientific and irrationalist worldview. The MOU closely follows the key themes of gender identity ideology espoused by WPATH, such as rejecting a binary, biological model of human sexual differentiation; framing exploratory therapy as problematic and delaying transition; minimising age boundaries and safeguarding issues within therapy; adopting an unsystematic stance towards data collection and research; and pursuing comprehensive re-education of health professionals on ‘intersectionality’.

Each of these is destructive of mainstream ethical therapeutic practice with adults and children who may be questioning their sexual identity in the broadest sense.

All signatory organisations urgently need to suspend their membership of the MOU with immediate effect, in order to freely debate these concerning issues with their members and to pause the ongoing efforts to neutralise mainstream exploratory therapy, via an unwarranted and unevidenced criminal ban on conversion therapy.

References:

Beckford, M. and Ward, A. (2024) “Trans healthcare doctors are exposed admitting that some patients are too young or mentally ill to understand the consequences of their treatment.” Daily Mail, 5th March. https://www.dailymail.co.uk/news/article-13156695/Trans-healthcare-doctors-exposed-admitting-patients-young-mentally-ill-understand-consequences-treatment.html

British Association for Counselling and Psychotherapy (BACP) (2018) Ethical Framework for the Counselling Professions. Lutterworth: BACP.  https://www.bacp.co.uk/media/3103/bacp-ethical-framework-for-the-counselling-professions-2018.pdf

British Association for Counselling and Psychotherapy (BACP) (2022) Memorandum of understanding on conversion therapy.  https://www.bacp.co.uk/events-and-resources/ethics-and-standards/mou/

Charlesworth, S. (2021) Captured! The full story behind the memorandum of understanding on conversion therapy. https://www.transgendertrend.com/product/captured-the-full-story-behind-the-memorandum-of-understanding-on-conversion-therapy/

Coleman, E. et al. (2022) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health. 23:sup1, S1-S259.

DOI: 10.1080/26895269.2022.2100644 https://www.wpath.org/publications/soc

Hughes, M. (2024) The WPATH Files: Pseudoscientific surgical and hormonal experiments of children, adolescents and vulnerable adults. Albany, California: Environmental Progress. 

https://environmentalprogress.org/big-news/wpath-files

Jenkins, P. (2022) WPATH 8 Standards of Care: Greasing the slipway to medical transition. Critical Therapy Antidote: https://criticaltherapyantidote.org/2022/10/08/wpath-8-standards-of-care-greasing-the-slipway-towards-medical-transition/

Jenkins, P. (2023a) “Get them on treatment!” WPATH and the long reach of gender ideology into UK healthcare. Critical Therapy Antidote. https://criticaltherapyantidote.org/2022/11/17/get-them-on-treatment-wpath-and-the-long-reach-of-us-trans-ideology-into-uk-healthcare/

Jenkins, P. (2023b) Suing for medical transition The case against considering WPATH as a competent reasonable body of expert opinion. Genspect. https://genspect.org/suing-over-medical-transition-the-case-against-considering-wpath-as-a-competent-reasonable-body-of-expert-opinion/

Medical Practitioners Tribunal Service (MPTS) (2022) Record of Determinations: Dr Helen Webberley: (3657058).

Memorandum of Understanding on Conversion Therapy (MOU) (2021) Therapists against Conversion Therapy: 4/11/2021. Video.

National Specialist Service (2022) Adverse Event Review Report: National Gender Identity Clinical Network for Scotland website content. https://www.nss.nhs.scot/media/3889/foi-000234-appendix-3-ngicns-website-adverse-event-review-report-v2.pdf

Pluckrose, H. and Lindsay. J. (2020) Cynical Theories: How activist scholarship made everything about race, gender and identity – and why this harms everyone. Croydon: Swift.

Sanderson, D. (2022) Gender identity clinics across Scotland secretly use extreme guidelines from controversial trans group. Daily Telegraph. 27th October. https://www.telegraph.co.uk/news/2022/10/27/gender-identity-clinics-across-scotland-secretly-use-extreme/

Scottish Parliament (2021) Equalities, Human Rights and Civil Justice Committee: Conversion Therapy. Transcript: https://www.parliament.scot/chamber-and-committees/committees/committee-official-reports/ehrcj-21-09-2021?meeting=13321

Sex Matters (2024) WPATH in the UK. https://sex-matters.org/posts/publications/wpath-in-the-uk/

Therapists against Conversion Therapy (2021): Conversion Therapy. 4/11/2021: Video.

Legal references:

Forstater v. CGD UKEAT/0105/20/JOJ.  

Maya_Forstater_v_CGD_Europe_and_others_UKEAT0105_20_JOJ.pdf (publishing.service.gov.uk)

This Post Has One Comment

  1. charles lewis

    I seem to remember that when the MOU for affirmation was on the table for “discussion” ( haha!) Kenneth Zucker was virtually the only medic speaking up for sanity–and look what happened to him!
    As this article makes clear, the gender identity movement is a postmodernist political movement bent on destroying our democratic society. There are a limited number of dedicated activists, virtually all of whom know full well they are talking nonsense, but, importantly, nonsense which will help to destroy our society, and they are aided by innumerable feeble-spirited or feeble-minded (or both) professionals and others who should be profoundly ashamed of themselves.
    But with the courage and determination of the sane among us, like TransgenderTrend these contemptible wretches will not win in the end. As more and more evidence comes into the public purview about the depraved nature of their practices, the vigour, the force and the effect of their attack on all of us steadily diminishes. Goodness will surely prevail!

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