[image added by me- GM]

[image added by me- GM]

By Dr. Kelly Winters, Ph.D., member of the International Advisory Panel for the World Professional Association for Transgender Health (WPATH) Standards of Care:

WPATH: clarify and correct the childhood “desistance” myth statement in the SOC7

WPATH: Issue a public policy statement discrediting the practice of gender-conversion psychotherapies that is consistent with the SOC7

APA: clarify and correct the childhood “desistance” myth statement in the DSM-5

APA: remove “Transvestic Disorder” category from the DSM-5

WHO: initiate substantive conversation on converging the Adult/Adolescent Gender Incongruence categories in the proposed ICD-11 with the childhood category to refute the historical stereotype of childhood gender “confusion” and practice of gender conversion psychotherapies

US Dept. of HHS: align transition related categories in ICD-10-CM to ICD-11 in 2018

US Dept. of HHS/CMS: issue a National Coverage Determination for surgical transition care that is recognized as medically necessary by US and international medical authorities


From here: https://gidreform.wordpress.com/2016/09/19/gender-madness-in-psycho-politics-transgender-children-under-fire/



On June 2, 2016 the Centers for Medicare & Medicaid Services (CMS) denied national coverage for gender reassignment surgery after the agency conducted a  year long review which determined that there is no medical evidence of a therapeutic outcome for patients who have undergone these procedures.


Excerpts from their report:


On December 3, 2015, CMS accepted a formal complete request from a beneficiary to initiate a national coverage analysis (NCA) for gender reassignment surgery.

CMS opened this National Coverage Analysis (NCA) to thoroughly review the evidence to determine whether or not gender reassignment surgery may be covered nationally under the Medicare program.



In general, when making national coverage determinations, CMS evaluates relevant clinical evidence to determine whether or not the evidence is of sufficient quality to support a finding that an item or service is reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. (§ 1862 (a)(1)(A)). The evidence may consist of external technology assessments, internal review of published and unpublished studies, recommendations from the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC), evidence-based guidelines, professional society position statements, expert opinion, and public comments.


The overall objective for the critical appraisal of the evidence is to determine to what degree we are confident that: 1) specific clinical question relevant to the coverage request can be answered conclusively; and 2) the extent to which we are confident that the intervention will improve health outcomes for patients.



CMS staff extensively searched for primary studies evaluating therapeutic interventions for gender dysphoria. There was particular emphasis on the various surgical interventions, but other treatments including hormone therapy, psychotherapy, psychiatric treatment, ancillary reproductive and gender modifying services, and post-operative surveillance services for natal sex organs were also included because of their serial and sometimes overlapping roles in patient management. The emphasis focused less on specific surgical techniques and more on functional outcomes unless specific techniques altered those types of outcomes.


The reviewed evidence included articles obtained by searching literature databases and technology review databases from PubMed (1965 to current date), EMBASE, the Agency for Healthcare Research and Quality (AHRQ), the Blue Cross/Blue Shield Technology Evaluation Center, the Cochrane Collection, the Institute of Medicine, and the National Institute for Health and Care Excellence (NICE) as well as the source material for commentary, guidelines, and formal evidence-based documents published by professional societies. Systematic reviews were used to help locate some of the more obscure publications and abstracts.



CMS reviewed and considered potential objective measures of function including mortality, psychiatric treatment, and attempted suicide. None of the longitudinal studies in which patients served as their own control, however, comprehensively tracked changes in these events as objective measures of function before and after surgery. Events such as suicide and institutionalization were mentioned incidentally when describing patients excluded from a follow-up study or during the study (Heylens et al., 2014; Ruppin, Pfafflin, 2015). Other times investigators tracked these functional outcomes (e.g., psychiatric out-patient treatment, psychiatric in-patient treatment, and substance abuse) for the most current prior year (Ruppin, Pfafflin, 2015).


The most comprehensive study with functional endpoints, the Swedish study that followed all patients who had undergone reassignment surgery (at mean age 35.1 years) over a 30 year interval and compared them to 6480 matched controls, identified increased mortality and increased psychiatric hospitalization (Dhejne et al., 2011). The mortality was primarily due to completed suicides (19.1-fold greater than in control Swedes), but death due to neoplasm and cardiovascular disease was increased 2 to 2.5 times as well. The divergence in mortality from the Swedish population did not become apparent until after 10 years. The risk for psychiatric hospitalization was 2.8 times greater than in controls even after adjustment for prior psychiatric disease (18%). The risk for attempted suicide was greater in male-to-female patients regardless of the gender of the control. Unfortunately, the study was not constructed to assess the impact of gender reassignment per se. The finding of this study, again, demonstrated that reassignment surgery does not return patients to a normal level of morbidity risk and that the morbidity risk is significant, because of its clinical importance, its persistence over the interval of data collection and the increase in risk over time for the individual.



The currently available evidence has limitations:


  • There were design deficiencies. All but one of the studies were observational in nature. All but two were non-blinded. The accompanying loss to follow-up suggests that there is selection bias and that the population that seeks treatment for gender dysphoria is not the same population that undergoes reassignment surgery without hesitation or regret.
  • The psychometric and psychosocial function endpoints are not well validated.
  • There were limitations of the psychosocial endpoints and of the data collection of other hard functional outcomes. Evidence on mortality and especially suicide was stronger. The mortality and psychiatric hospitalization rates even after vetting in highly structured programs are of concern.
  • There are insufficient data to select optimal candidates for surgery.
  • The results were inconsistent, but negative in the best studies, i.e., those that reduced confounding by testing patients prior to and after surgery and which used psychometric tests with some established validation in other large populations. (Atkins et al., 2004; Balshem et al., 2011; Chan, Altman, 2005; Deeks et al., 2003; Guyatt et al., 2008a-c; 2011a-e; Kunz, Oxman,1998; Kunz et al., 2007 and 2011; Odgaard-Jensen et al., 2011).

Data on reassignment surgery performed on geriatric patients or follow-up data in geriatric patients who had reassignment surgery in the distant past is anecdotal (Orel, 2014).



Based on a thorough review of the clinical evidence available at this time, there is not enough evidence to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria. There were conflicting (inconsistent) study results – of the best designed studies, some reported benefits while others reported harms.


The quality and strength of evidence were low due to the mostly observational study designs with no comparison groups, potential confounding and small sample sizes. Many studies that reported positive outcomes were exploratory type studies (case-series and case-control) with no confirmatory follow-up. Due in part to the generally younger and healthier study participants, the generalizability of the studies to the Medicare population is also unclear. Additional research is needed. This proposed conclusion is consistent with the West Midlands Health Technology Assessment Collaboration (2009) that reported “[f]urther research is needed but must use more sophisticated designs with comparison groups.” WPATH also noted the need for further research: “More studies are needed that focus on the outcomes of current assessment and treatment approaches for gender dysphoria.” Further, as mentioned earlier, patient preference is an important aspect of any treatment. With that in mind, CMS is interested in knowing from the patients with gender dysphoria what is important to them as a result of a successful gender reassignment surgery.


Knowledge on gender reassignment surgery for individuals with gender dysphoria is evolving. The specific role for various surgical procedures is less well understood than the role of hormonal intervention. Much of the available research has been conducted in highly vetted patients at select care programs integrating psychotherapy, endocrinology, and various surgical disciplines and operating under European medical management and regulatory structures. Standard psychometric tools need to be developed and tested in the patients with gender dysphoria to validly assess long term outcomes. As such, further evidence in this area would contribute to the question of whether gender reassignment surgery improves health outcomes in adults with gender dysphoria.


Because CMS is mindful of the unique and complex needs of this patient population and because CMS seeks sound data to guide proper care of the Medicare subset of this patient population, CMS strongly encourages robust clinical studies with adequate patient protections that will fill the evidence gaps delineated in this decision memorandum.



Currently, the local Medicare Administrative Contractors (MACs) determine coverage of gender reassignment surgery on an individual claim basis. The Centers for Medicare & Medicaid Services (CMS) proposes to continue this practice and not issue a National Coverage Determination (NCD) at this time on gender reassignment surgery for Medicare beneficiaries with gender dysphoria. Our review of the clinical evidence for gender reassignment surgery was inconclusive for the Medicare population at large.



Read the complete evidence review and text of Medicare’s denial of a national coverage determination for ‘Gender Reasignment Surgery” here:



Fascinating account of some of the history behind Charing Cross, the predominant Gender Identity Clinic in the UK, and an analysis of the factors leading to the surprise announcement this week that the West London Mental Health Trust which has governed the clinic for 60 years, was terminating its contract and cutting all ties to the service.

[ http://www.pinknews.co.uk/2016/08/25/nhs-trust-terminates-gender-identity-service-contract-amid-trans-health-turmoil/ ]

[https://www.theguardian.com/society/2016/aug/26/plan-to-transform-nhs-could-led-to-downgrade-of-major-london-hospitals ]

First, Do No Harm: Youth Trans Critical Professionals

by Susan Matthews, UK Academic


The Charing Cross Gender Identity Clinic is the ‘oldest and largest adult clinic’ in the UK. It was founded in 1966, the year that the first sexual reassignment surgery was carried out at Johns Hopkins Gender Identity Clinic, the world’s first GIC  founded the previous year by psychiatrist and sexologist John Money (1921-2006). The founding clinician at Charing Cross, Richard Green (1936 -), came with an impressive academic pedigree, having worked with Money, collaborating on research on boys who demonstrated cross-gender behaviour. Money liked to claim (with some justification) that he had invented the modern sense of the word ‘gender’ – andit was Money who named the clinic (specialising in the treatment of intersex and transsexual patients) a ‘Gender Identity Clinic’.[1] (Up until the second half of the twentieth century, the word ‘gender’ referred to grammatical gender, a feature of language not human…

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Bernard and Terry Reed- Fitting into normative social sex categories saves lives!

Bernard and Terry Reed- Fitting into normative social sex categories saves lives!

The following gems are excerpted from GIRES’ submission to the proposed new NHS Service Specification (“treatment guidelines” to you and me) for the UK Gender Identity Development Service for Children and Adolescents (GIDS). The ‘fitting-youth-into-social-sex-categories-development-service’ in question operates out of the Tavistock and Portman facility and is run by Dr. Polly Carmichael.

The clinic, which attempts to treat children who are disturbed by sex-based social roles with pharmaceuticals, has quietly posted two items on their website for public feedback without notifying the press or public. The deadline for replies is April 20.

The first item is a ‘Policy Proposal’ which quite sensibly rejects lowering the age for cross-sex hormones below the age of sixteen in the UK. This is a response to transgender industry and activist lobbying to allow permanent irreversible changes to be performed on children below the age of legal consent. You can read that policy proposal, and rationale, in full here: https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wave8/user_uploads/e03x16-policy-prop.pdf

NHS Gender Identity Development Service for Children and Adolescents - proposed service specification

NHS Gender Identity Development Service for Children and Adolescents – proposed service specification

The second item is a 62-page proposed service specification (treatment pathway) for the kids and teens referred to the clinic. No huge surprises. The usual circular definitions, which avoid outlining specifically what is actually being “treated” (“Gender Identity is an individual’s personal experience of their own gender”, LOL). The usual confusion and conflation of sex with gender (“biological natal gender” OH MY).

It is truly amazing that 50 years of existing work on gender: Analysis of what gender is, how it functions, its specific characteristics, modes of violent enforcement, harms, and lived experiences of such, is completely ignored because the authors of those five decades of work are Women. Lesbians. Feminists.

Holy shit.

The proposed new GIDS service policy does mention obliquely in the most understated way imaginable that massive numbers of adolescent lesbians are seeking escape from sexual objectification and pornification and second-class humanity by adopting “anything but female” identities en masse. (“Gender identification is diversifying!”). (“The number of adolescents referred to specialized gender identity clinics for GD appears to be increasing. There also appears to be a corresponding shift in the sex ratio, from predominantly favouring natal males to one favouring natal females.”) (“Social and sociocultural explanations are offered to account for this recent inversion in the sex ratio of adolescents with GD.” ) COUGH.

And that trans-trending is now a subcultural teen fashion statement for entitled tumblrite millenials weaned on non-essential daily prescription pharmaceuticals that form their consumer identity every bit as much as the brands of clothing or carbonated beverage or types of piercing they express their core selves by sporting (“Yet it is also true that many youngsters who present to gender services are not acutely distressed”) LOL.

They also manage to note the absurdly high concurrence of social category dysphoria (gender identity malfeasance) among individuals who are less likely to observe social norms, ie. those on the autism spectrum. And that most “transgender” children will desist in adulthood. And that “social transition” in childhood results in distress, fear of teasing, and shame for those who wish to revert. And that a potential outcome of treatment for 2% (one youth out of 55 study participants in the only existing outcome study) is death due to complications from surgical castration and genital reshaping.

You can read the proposed service specification in full here: https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wave8/user_uploads/gids-serv-spec-upd.pdf

And leave your comments, corrections or concerns, here:


The largest transgender industry lobbying group in the country, GIRES (Gender Identity Research and Education Society) has already posted their response. GIRES is run by a straight non-transgender couple, Bernard and Terry Reed. Bernard has an MBA from Oxford and serves as treasurer. Terry has a degree in Physiotherapy (occupational therapy) and serves as secretary. They started the group after their son, Niki Reed, suffered harassment when he transitioned on the job as a carnival ride operator and went on to win a groundbreaking 1997 employment tribunal that created precedent for transsexual individuals to sue on the basis of sex discrimination. (Chessington World of Adventures ltd v Reed, 1997)

Niki is heterosexual and went on to marry his female partner as a legal male. He does not publicly support the group his parents started and seems to have dropped out of sight. In all their public appearances his parents never speak of him.

What’s interesting is that GIRES is basically part of the UK government. They are “partners” with the Surrey and Borders NHS Partnership Foundation Trust which is their largest funder, and they co-produce educational materials on gender for providers together [PDF].

In addition, GIRES claims at least 79 “corporate members” of their group, including the Office for Nuclear Regulation, Imperial College London, South East Coast Ambulance Service, Learning and skills improvement service, Royal College of Nursing, Royal College of General Practitioners, among others. They were awarded the Orders of the British Empire in 2010.  They donated over fifty thousand dollars to WPATH (World Professional Association of Transgender Health) ostensibly to fund foreign language translations of the lobbying group’s standards of care. They are the establishment. A revolutionary besieged minority group fighting the power they are not. They are the power of the state. They are the state.

Who's your daddy? Bernard Reed wants you to take those hormones, misfit!

Who’s your daddy? Bernard Reed wants you to take those hormones, misfit!

Here are a few nuggets of gender wisdom from Bernard and Terry Reed at GIRES to the youth of today, excerpted from their submission to the Gender Identity Development Service. You can read their full submission here: https://drive.google.com/file/d/0B7n9HajupVrLSzdzVEhvaEVhZmRBNzVXMkMxdlZlZlV4SGFv/view?pref=2&pli=1 or here: http://archive.is/6rm1m



[Page 2 Gender Identity refers to conformity to sexist social categories]

 Gender identity refers to a person’s sense of fitting into social categories of boys/men; women/girls. These are binary identities, but identities may also be non-binary, that is somewhere on a spectrum between the two, or outside that spectrum, known as non-gender. More of these widely diverse identities are now emerging, and many will be needing the support of medical services.

Gender dysphoria describes the unease experienced when the gender identity is not aligned with the sex assigned at birth: the gender role and expression typically associated with that sex are also sources of unease.


[Page 3 Absent all data, “associations” and “suggestions” “support” biologically based sexist social categories]

“Although no studies to date demonstrate the mechanism, multiple studies have reported associations with gender identity that support it being a biologic phenomenon.[…] Current data suggest a biologic etiology for transgender identity” (Saraswat et al 2015) [sic]


[Page 4 Skip the blockers]

Cross-sex hormones are acknowledged to be effective in treating gender dysphoria (which hormone blockers are not).


[Page 4 Hormones are harmless]

N.b. Cross-sex hormones are partially reversible.


[Page 4 Failure to attempt correction of sex role nonconformity is like waterboarding]

Delaying treatment causes “Psychological torture”.


From a GIRES and NHS partnership pamphlet.

From a GIRES and NHS partnership pamphlet.


[Page 5 Give kids who are still in the closet at puberty hormones]

It is not always possible to know whether gender non-conforming behaviors in a child are actually a reflection of gender dysphoria, or whether they are related to some other possible outcome, such as being gay, lesbian or bisexual. Usually, at the onset of puberty, the outcome becomes clearer to the child, and therefore to the relevant adults, including clinicians if they are already involved.


[Page 5 When in doubt: prescribe hormones]

The argument that the possibility of ‘desistance’ exists, is neither relevant nor a rational excuse for withholding cross-sex hormones. ‘Desistance’ should be completely detached from decisions about cross-sex hormones.


[Page 7 Hormones cure autism]

Anecdotally, young people who have been successfully treated, are often described as having no residual ASD [Autism Spectrum Disorder]. The symptoms have disappeared once the dysphoria has been treated.


[Page 9 Actual death is a scare tactic compared to threat of potential self harm due to waiting for hormones]

The tragic death of a young person is not really a useful anecdote in this context. All surgeries carry risk, but unless you give the figures to show how many have had surgery, sometimes several surgeries and survived, mentioning one death is not meaningful. It seems like a deliberate scare tactic.


[Page 9 Hormones are the grail, the truth, the light. Nonconformity is death]

Preventing premature death would be overcome by providing cross-sex hormones to overcome the misery of gender dysphoria [sic]


[Page 9 Social sex role nonconformists provoke abuse upon themselves.]

Refusing timely interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization


[Page 9 Social sex category nonconformity is ghastly, bleak, mentally ill, fatal.]

Psychological support is important but if the current reluctance to provide timely cross-sex hormones, young people will not recover from dips in their mental health but will continue to deteriorate.


[Page 14 The vast majority of people that quit hormones after a few months or years don’t exist]

Therefore it is extremely rare for CSH [cross-sex hormones] to be started and then have the young person decide they want to stop.


Sense of Fitting Into Social Categories Research and Education Society

Sense of Fitting Into Social Categories Research and Education Society

transgender trend org

A group of concerned parents has announced the formation of ‘Transgender Trend’, an international organization that aims to educate the public, support families and youth, and provide an alternative to the medical “transgender children” trend.

From their website:


Welcome to Transgender Trend

We have set up this website with the aim of providing an alternative source of evidence-based information which questions the theory, diagnosis and treatment of ‘trans kids.’ The mainstream media has been uniformly and uncritically accepting of the transgender diagnosis of children and in the absence of any public scrutiny the number of children referred to gender clinics has risen exponentially over the last few years.

We question who gains from this lifelong medicalisation of children, and whose vested interests are fueling the promotion of transgender ideology. We ask why it has become impossible to debate the subject without being labeled ‘transphobic.’

We’re not ‘anti’ transgender; those who suffer true ‘gender dysphoria’ need access to treatment, understanding and support, but we have serious questions about the current treatment paradigm. In particular we think there needs to be extreme caution before treating children. The theory of gender as an identity which overrides biological sex is just that: a theory. It is new, untested, and its application to children who are in the process of developing their identities contradicts all we know about child and adolescent development and psychology.

There are very different reasons why a four-year-old may insist they are the opposite sex compared to a teenager making the decision after searching online; there are also different reasons why boys and girls may want to transition. We will be differentiating between the ages and sexes of children as we build the content of this site, rather than lumping all kids together as a homogeneous group under the ‘trans’ umbrella. Much more research needs to be done regarding these distinct groups.

This site is not a forum for debate about our position, so please respect the fact that we are not interested in hearing arguments ‘for’ the transgender diagnosis of kids. Any such comments will not be published. That view is extensively available online already and is not the point of this site. However, we welcome contributions from supporters, please email us at the address at the top of the page.

Huge thanks to the feminists who have been documenting the rise of transactivist ideology for years, it would have taken a lot longer to get this far on the site without your work.

We hope that parents, the media and policy-makers will all make use of this site as a source of information, as well as young people and anyone who would like to know more about the subject and is frustrated at the one-sided view currently promoted.

Everyone is very welcome.


‘Transgender Trend’ Spokesperson Stephanie Davies-Arai is a specialist in teacher training and the author of “Communicating With Kids”

Please take a few moments to forward this information to media contacts, particularly those with an interest in covering the “transgender children” trend.


logo with clear border


snopes.com trannies midwivessnopes mana midwife comment



With a name sounding more like something out of a sci-fi film, the US National Institutes of Health in partnership with former medical leaders of transgender industry group WPATH (World Professional Association for Transgender Health) have formed “TransNet”, a research consortium merging commercial, academic, and government interests in data collection, funding, and regulation of the medicalization of gender. The project aims to set the groundwork for the mainstreaming of transgender medical care by conducting research that supports the practice.

Recent Obama administration changes to Medicare/VA/IRS regulations allow for taxpayer subsidized cosmetic breast implants, facelifts, genital re-shaping and off-label drugs as treatment for transgender individuals. These patients seek to alleviate distress caused by possessing what they believe are innate psychological or mental traits related to the reproductive biology of the opposite sex. The goal of the treatments is an attempt to create the appearance that their bodies are the opposite sex: the sex the patient believes is congruent with their experienced personality traits. But such interventions (and beliefs) have no established scientific rationale. While there is indeed a political will behind performing these treatments, a very profitable medical/psychiatric/therapeutic industry to accommodate them, and an increasing number of patients demanding the treatments, there is an absence of science to support them.

Self-diagnosed consumer-driven “pathology” that mainly afflicts objectively healthy patients seeking off-label care has been a boon for providers and suppliers such as cosmetic surgeons, pharmaceutical companies, rogue physicians and gate-keeping therapists but there comes a point- say, when government bureaucrats become involved, that certain boxes need to be checked and forms filled out.

None of the only fifty or so “sex-change” surgeons worldwide that provide genital reconfiguring for this population accept Medicare reimbursed clients. And why would they? Their specialty has thrived as an underground economy. Their procedures are incredibly risky with high rates of complication. Long-term outcomes are, objectively, poor. Yet their clients will pay through the ear, and sign waivers to boot, and are lined up on waiting lists.

You would think surgeons would be clamoring to get aboard this gravy train but they aren’t. New York State and Massachusetts provider networks have been aggressively recruiting surgical providers for over a year since their states’ Medicaid began covering these procedures, to no avail. The only surgical group that stepped up in California when the Department of Corrections mandated the high-profile state-funded surgery for incarcerated murderer Jeffrey “Michelle” Norsworthy was Brownstein and Crane, whose practice specializes in bilateral mastectomies for healthy genetic females who believe their personalities are in conflict with their secondary sex characteristics.

The mainstreaming of medical body modification for those who clamor to look like members of the other sex has outpaced the usual steps that precede any generic medical care: basic scientific research. While authorities in medicine, government, and the highest courts have jumped on an opportunity to “correct” those who struggle at conforming to social sex-roles (not coincidentally rolling-back decades of gains made by the women’s liberation movement), they did so using the aegis of WPATH, the World Professional Association of Transgender Health, a transgender industry lobbying group comprised of two groups: those who seek such body modification and those who make a good income providing it.

WPATH had never based their suggested practices on any scientific study, which was unnecessary to represent the interests of their two codependent groups of constituents. The American Psychiatric Association however, who invented the pathology of Gender Identity in the first place, lurched awake in 2008 after thirty years of slumber and decided that maybe now was the time for some follow up to their Diagnostic and Statistical Manual GID (Gender Identity Disorder)/ GD (Gender Dysphoria) diagnosis. Some sort of data or guidelines related to the care of this population would be appropriate, in light of the explosion of numbers of patients now presenting with this diagnosis. WPATH, whose last transgender “Standards of Care” had been issued in 2001, realized that they needed to start presenting themselves as an evidence-based authority. They publicly resolved to create new, updated, plausibly authoritative Standards, this time including research citations.

But there was no science. The WPATH board was infested by grifters such as Randi Ettner,PhD who specializes in pseudoscientific “energy” and “body meridian” psychology and her husband Frederic who runs a family practice for anti-vaxxers and sponsors testosterone mills (“Low T?”) for men desiring rejuvenation.

In 2009 two mainstream doctors, both providers to transgender clients, saw the pseudoscientific writing on the wall and attempted to stay the inevitable WPATH disaster. They collaborated to produce a document pointedly suggesting evidence-based revisions to the WPATH standards of care. These physicians were Dr. Jamie Feldman, a family practitioner specializing in transgender care and doctorate of anthropology and associate professor at University of Minnesota and Dr. Joshua Safer, an endocrinologist and associate professor at Boston University.

Their paper: “Feldman, J., & Safer, J. (2009). Hormone therapy in adults: Suggested revisions to the sixth version of the standards of care.” was cited 22 times in the eventual 7th edition WPATH standards of care [PDF].

Despite the efforts of Feldman and Safer, the APA announced they rejected WPATH Standards due to the overall lack of scientific research supporting them, and would begin the long process of formulating their own evidence-based recommended treatment guidelines. The APA issued press releases to calm the resulting panic in the transgender patient population. They affirmed APA support of the Gender Identity diagnosis and their intent to continue authorizing medical body modification services to those so afflicted. “The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups.” 

Doctors Jamie Feldman and Joshua Safer are at the helm of the new NIH TransNet project.

Project Goals at the initial TransNet meeting, “TransNet: Developing a Research Agenda in Transgender Health and Medicine”, which was held this May in Washington DC, included:

“1) further develop a productive transgender health and medicine research consortium that would become a national forum for an evolving comprehensive research agenda in transgender health, as well as a mechanism for interdisciplinary collaboration in research on cross-sex hormone therapies, surgical interventions, STI/HIV prevention, and trans-appropriate primary and mental health care; 2) develop new research methodologies effective in conducting clinical research with transgender people, a stigmatized, vulnerable, and underserved population; 3) develop and use of standardized approaches to data collection, management, and analysis across a variety of clinical and non-clinical settings; and 4) incorporate community engagement in the research process within the structure and function of the consortium, including transgender community advisory representatives, LGBT community health centers, and community engagement procedures throughout the research process.”

Project Number: 1R13HD084267-01 Contact PI / Project Leader: FELDMAN, JAMIE


One of the interesting implications of the TransNet project is the development of a National Institutes of Health “national database of transgender persons”. From the Daily Free Press:

“Members of the NIH are hoping to develop a national database of transgender people to see what trends appear from different types of intervention. “They want to know what kind of things we could be learning over the next five or ten years depending on how much money is available for research, and the purpose of this conference is to set that strategy and create some priorities for NIH,” [Dr. Joshua Safer] said.”

Such a database has been a long-running goal for Dr. Safer, author of “Out of the Shadows: It is Time to Mainstream Treatment for Transgender Patients (2008)”.

Safer created one himself at Boston Medical Center but due to HIPAA regulations patients were required to give informed consent to being listed in the registry:

“[O]ur work includes the development of a Transgender Health Registry at BMC.  All transgender-identified individuals who have had hormone therapy or other transgender health care management at Boston Medical Center (BMC) who give consent to participate will have their name, date of birth, and medical record number recorded in a registry. By compiling a list of those treated here at BMC, researchers (approved by the Institutional Review Board) will be able to access more complete data when studying the long term effects of hormonal treatment and/or other aspects of care.  It is our hope that by establishing the first BMC registry of Transgender Health, we will be able to better serve individuals who identify as transgender within our community both now and in the future.” [sic]

The coming TransNet national database of transgender people, operating and funded by the National Institutes of Health under the authority of the Department of Health and Human Services, using standardized and regulated data collection, promises to be the most vast and comprehensive pool of research subjects ever studied in the history of the medical industry practice of treating gender.