Second opinions

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MARY REICHARD, HOST: Up next: going to court over transgender misinformation.

The Federal Trade Commission and four states are suing the group known as WPATH … the World Professional Association for Transgender Health. The organization publishes medical guidelines and generally encourages medical intervention like hormones and surgery at young ages.

NICK EICHER, HOST: The FTC says WPATH misled parents and children.

WORLD’s Mary Muncy has the story.

MARY MUNCY: Prisha Mosely started taking testosterone when she was 17.

PRISHA MOSELY: I actually told my endocrinologist that I wanted to look different fast. And instead of questioning how honestly scary that sounds, coming from a teenage girl who's been assaulted, she was essentially like, 'Sure thing, sir.’

At 18, she got a double mastectomy, just as WPATH recommends. Mosely says her doctors presented the “science” of her “cure” as settled, and so did WPATH.

MOSELY: And they tried to use WPATH to bolster themselves and stuff like that, and gain my trust, I would say.

WPATH says it’s an “interdisciplinary professional and educational organization” for what it calls transgender “health.” A group of doctors started it in 1979, and they published their first “standards of care” that year. They published their eighth iteration in 2022.

Now, Moseley is suing her doctors, saying they didn’t follow WPATH’s recommendations fully as far as psychiatric care, but she says they did point to WPATH’s claims that hormones and surgery are safe and effective.

MOSELY: I definitely remember WPATH stuff being pushed the most when they said to my parents, ‘Would you rather have a dead daughter or a living son?’ because they talked about how WPATH would say it was life-saving care.

WPATH’s most recent Standards of Care references data showing early intervention is good for adolescents, and says more research is necessary. They say the potential negative consequences outweigh the risks.

But in 2024, the UK published a systematic review of gender identity services for young people, the Cass Review. The review states that WPATH is one of the most influential guidelines for youth with gender dysphoria, but it says WPATH “overstates the strength of the evidence” it uses to make recommendations. 

It says some of the citations are circular, meaning WPATH cites studies that cite WPATH. That’s why the FTC sued.

JOSH PAYNE: They need to understand that what they're getting into is not a surefire cure.

Josh Payne is a lawyer with Cambell Miller Payne. He and his firm represent several clients who say the medical system did not treat their gender dysphoria correctly.

PAYNE: It is not a adequately, totally proven life raft that will save their life, but yet that's what they're being led to believe, and that is--that is where the dishonesty lies.

Payne says Americans do have free speech rights, but the FTC polices the claims that businesses make.

PAYNE: Because if we don't have good information, the market really isn't operating as a truly free market.

The FTC says WPATH’s founding members wanted to legitimize transition treatment so they could monetize it. It says the specific claim that pediatric medical transition is “lifesaving” misrepresents the risks and benefits of any procedure.

PAYNE: When you oversell something to a child, an adolescent, a vulnerable young adult who is just searching for an answer to profound mental health challenges that they're going through, profound trauma, and you oversell them on something. Well, the harm is permanent there. It's irreversible, it's irreparable, as we say in legal terms.

That’s what allows the FTC to step in and ask for “injunctive relief”... which essentially means the court would order WPATH to tell the truth.

PAYNE: The states that have partnered with the FTC to bring this case, they're seeking more than just an order from the court, they're seeking monetary penalties under state law, which can be very significant.

Alaska’s statute requires $25,000 per violation. Payne says that could mean every time WPATH makes a statement, or it could mean every time an individual is affected by a false WPATH statement. That would quickly add up to millions of dollars.

PAYNE: We'll see how, you know, all of the proof comes in and what the court does with it. But, you know, this is a moment where I think all clinicians are going to take that step back that they should have taken already with with their patients and give them better health care.

The case will likely take years to unfold unless the FTC asks the court to fast-track it—then it could be decided in months. Payne says WPATH could also try to settle it out of court and negotiate a deal where they change their wording on their own.

Reporting for WORLD, I’m Mary Muncy.

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