This is the sixth article in the “WPATH Tapes” series on the World Professional Association for Transgender Health and the gender medical industry. Read the overview of our investigation here.
A top official at the leading transgender medical organization appeared to reject the concept of biological sex and applauded attempts to “deconstruct” sex and gender, according to a recorded presentation obtained exclusively by the Daily Caller News Foundation.
The World Professional Association for Transgender Health (WPATH) publishes guidelines for the clinical treatment of transgender patients. In September 2022, the WPATH Global Education Institute (GEI) recorded an 11-part educational series, called “Foundations,” which was used as coursework for licensed WPATH members seeking a certification in transgender medicine.
The DCNF obtained roughly 30 hours of recordings from WPATH’s 2022 educational series through a public records request.
Psychologist Dr. Ren Massey, the co-chair of GEI and WPATH Mental Health Chair, gave an opening 80-minute lecture titled “Introduction to Trans Health.” During the talk, Massey described sex as occurring “beyond the binary” and attempted to “deconstruct” binary views on sex and gender.
“In understanding gender identity, it was actually really helpful for me to do some research and understanding that actually, biology occurs beyond the binary as well,” said Massey.
Neither Massey nor Massey’s offices responded to the DCNF’s requests for comment.
The belief that sex is “non-binary” is common among transgender activists, but it contradicts the long-established scientific understanding of human biology. This belief that sex is “non-binary” and gender is distinct from sex undergirds the entire field of what’s euphemistically called “gender-affirming care.”
“Gender-affirming care” refers to medical interventions that attempt to change someone’s sex, such as puberty blockers, cross-sex hormones, and sex-change surgery.
Dr. Colin Wright, an evolutionary biologist, writer and vocal critic of so-called “gender-affirming care,” said that sex is a fixed, binary reality.
“When biologists refer to sex as a binary, it simply means there are only two sexes. This statement is an undeniable scientific fact because there are only two types of gametes — sperm and ova,” Wright told the DCNF.
“For sex not to be binary, we would have to discover a third distinct gamete type. No third gamete type has ever been discovered, and there are good evolutionary reasons for this,” Wright said.
Slides from Massey’s presentation show how binary views of sex and gender can be deconstructed.
‘A Ladder Of Assumptions’
During the presentation, Massey promised to deconstruct assumptions that sex and gender identity are binary, referring to binary sex as part of a “ladder of assumptions” informed by a cultural narrative.
“This is what I call a ladder of assumptions. And that is that, at birth, we have assumed that we can determine there are people who are given a male gender marker,” said Massey.
“That’s language we use or designated male at birth, and that is a thing that is done to all of us without our consent at birth, and then it is assumed that people who have been assigned that male gender marker are going to grow into individuals who have the gender identity of being a man.”
Massey compared rare biological disorders that alter the physical presentation of sex, such as intersex anomalies and congenital adrenal hyperplasia, to normal variations of human anatomy, like skin color, hair texture and stature. Massey suggested these biological disorders were evidence that sex is not binary.
“Already we see that there are differences in sex development. So, that binary foundational piece of the ladder doesn’t really hold true,” Massey said.
Dr. Heather Heying, an evolutionary biologist and author, disagreed, saying the existence of intersex conditions does not change the reality of binary sex.
“Disorders of sexual development are just that: disorders,” Heying told the DCNF. “Failures of systems do not render the systems invalid or unreal. Sometimes we have misunderstood things, have applied categories where there are no boundaries, but that is not the case with sex. In all animals that have sexual reproduction, sex is binary.”
Human reproduction requires two gametes types, produced by male and female reproductive systems. An anomaly of human genitalia does not change the realities of human reproduction, Wright said.
“Because the sex binary simply refers to the simple fact that there are only two gamete types and thus only two sex categories of sex, the prevalence of intersex conditions has absolutely no bearing on how binary sex is. If somehow the prevalence of intersex conditions shot up to 80%, sex would still be just as binary as it is now,” Wright told the DCNF.
‘Really A Biological Term’
Massey also described sex as a biological term separate from gender identity that has historically been based on genitalia and other biological indicators, such as reproductive structures.
“Now sex, we need to distinguish from gender identity. And sex is typically really a biological term that is been historically based on external genitalia and sex markers were assigned at birth,” said Massey.
Massey said one of the objectives of the presentation was to provide accurate definitions for certain gender-oriented terms, making a distinction between sex and “gender identity.”
“Transgender refers to folks whose gender identity doesn’t fit in, or their gender expression doesn’t fit in or conform to the cultural and social expectations for the sex that they were designated at birth,” Massey said. “Cisgender is the majority of the population. These are folks who feel their gender identity aligns and their expression aligns with the cultural social expectations for the sex they were assigned to birth.”
“Gender identity is a relatively recent term. It wasn’t even around a few decades ago,” Massey told the audience.
The term “gender identity” was popularized by controversial sexologist John Money, who co-founded the Johns Hopkins Gender Identity Clinic in mid-1960’s. The university’s clinic was the first gender-affirming surgery clinic in the U.S. The clinic was closed in 1979, the same year the Harry Benjamin International Gender Dysphoria Association, which would later become WPATH, was founded.
An article published in 1979 by the New York Times reported a John Hopkins University clinic abruptly closed based on a study that questioned the benefits of sex-change surgery. The study’s author, Dr. Jon Meyer of Johns Hopkins, said at the time “it’s clear to me that these patients have severe psychological problems that don’t go away following surgery.”
Today, WPATH defines “gender identity” as “a person’s deeply felt, internal, intrinsic sense of their own gender,” in the Standards of Care, version 8 (SOC 8), which were released shortly before WPATH’s 2022 conference.
SOC 8 is widely influential clinical guidance that is utilized by governments, insurance companies, and medical providers across the U.S. and around the world.
The recently-published Cass Review, a report commissioned by England’s National Health Service (NHS) to make evidence-based recommendations on caring for gender-confused youth, found that SOC 8 underpinned almost all other guidelines in the field of transgender medicine.
“[WPATH] has been highly influential in directing international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour,” the Cass Review found. “Early versions of two international guidelines – the Endocrine Society 2009 and WPATH 7 – influenced nearly all the other guidelines.”
The WPATH SOC 8 supports providing sex reassignment services such as puberty blockers, cross-sex hormones, and surgery to minors.
The Cass Review challenged WPATH guidelines, finding “the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.”
“The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown,” the Cass Review found.
‘False Impression’
During the presentation, Massey told WPATH members part of what clinicians do is help families and parents embrace a worldview that includes deconstructed views on binary sex and gender.
“Ladder of assumptions, we have now totally deconstructed it, right?” Massey said. “And we see that all kinds of possible variations exist. So that’s what we want to embrace and that’s what we are often helping families and parents embrace also.”
Wright said the belief that sex is neither binary nor immutable can influence a child to pursue the impossible.
“WPATH teaches that sex is not binary and that sex is comprised of many different traits, most of which can be modified through hormones and surgery. This gives children and adults the false impression that changing sex is literally possible,” Wright told the DCNF.
“This coupled with WPATH’s definition of ‘transgender’ as anyone who does not conform to society’s traditional stereotypes associated with their sex causes sex-nonconforming kids, who are disproportionately likely to grow up to be gay or lesbian, to believe they’re ‘born in the wrong body,’” Wright said. “And because they’re being taught they can literally change their sex to ‘match’ their nonconforming preferences and behaviors, many are choosing to transition.”
WPATH did not respond to requests for comment.
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