Dear Concerned Global Citizens,

World Health Organization (WHO)

Background:

A critical development in the field of youth gender medicine needs your urgent attention. On December 18th 2023, the World Health Organization (WHO) announced that it had completed the formulation of a clinical practice guideline panel to oversee development of a new WHO guideline.

The proposed guidelines will cover 5 area of transgender care, ranging from promoting ‘gender affirming care’, physician education, health policies, and self-id laws.

This looks like a politicized, rushed process that will promote gender transition for youth, and will harm the health of many vulnerable youth worldwide.

They announced the full panel list on December 18^th.

The comment period ends January 7^th.

The panel will convene in Geneva from February 19^th-21^st 2024.

The full panel composition is demonstrably biased. Among the 21 guideline panel members, the majority have serious conflicts of interest. Many are WPATH senior leaders who promote a singular position. Some are well-known activists with extreme views (e.g., Florence Ashley). You may wish to read the biographies that WHO published and do research, so that the WHO receives a wide range of examples of statements such individuals have made. 

In addition, the pace of the guideline development is remarkably fast, considering the complexity of the field, the intensity of the process when performed correctly, and the profound implications for the health of hundreds of thousands of gender nonconforming youth worldwide.

While a biased WHO guideline is likely to have little impact on developed countries with strong public health authorities that have already demonstrated their adherence to the principles of evidence-based medicine (i.e., England, Finland, Sweden), it will have a detrimental effect on other countries where the debate is just emerging (i.e., Australia, Germany, the US).  It will also likely negatively influence public health in developing countries, which do not have the resources and expertise to invest in a quality guideline development process, and who have come to depend on the WHO guidance to promote evidence-based care. It also has the potential to push a westernized medicalized response to gender non-conformity globally, displacing other non medicalized cultural views.

Photo by Krzysztof Hepner on Unsplash

“Gender-affirming care” is a euphemism for highly invasive, irreversible interventions. One of the biggest, and by far the fastest growing demographic of trans-identified individuals is teenagers with no previous history of transgender identification. A disproportionate number of them are females, the majority have a high burden of neurocognitive and psychiatric comorbidities. This epidemiological shift remains poorly understood. Many of these young people are now medically detransitioning within a short period of time after initiating a medical gender transition —this number may be as high as 30%, and even higher among the female cohort. Any guideline recommendations made by this panel will inevitably address the needs of this complex and vulnerable group, yet the panel absolutely lacks any representation of by experts working with this complex group of patients.

A number of detranstioners have expressed regret over the irreversible effects that transgender treatments had on them, physically and mentally. The panel also lacks any representation from detransitioners.

We only have a brief window of opportunity to send comments to the WHO. The comment period will end on January 7th, 2024.

We are urging everyone to send an email to hiv-aids@who.int

Your email can be as long or as short as you like.

The primary points:

• The composition of the panel is biased and conflicts of interest have not been managed. 

• The overall process of formulating such a critical guideline is extremely rushed. 

•  The WHO should pause the process and go back to the drawing board.

• The WHO should cancel the meeting February 19th-21st until the panel’s conflict of interests can be assessed and managed.

This is just the start of the global response and we will provide updates to you as additional calls to action are developed.

Consider upgrading your free subscription to support the LGBT Courage Coalition as we consider if we can support sending individuals to Geneva if this meeting will take place.

As always, if you send an email feel free to share it in the comments. If anyone does get a response please share in the comments.

Reach us at LGBTcouragecoalition@gmail.com