WPATH FILES: Trans Org Admits Need For Detransitioner Protocols While Pushing Child Sex-Changes

The World Professional Association of Transgender Health (WPATH) is the world’s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group’s medical guidance, called the Standards of Care Version 8, informs clinical practice, insurance policy, and government regulations throughout the United States.

Systematic reviews and legal investigation have shown the SOC-8 to be built on faulty methodology and politicized science. The Federal Trade Commission filed a lawsuit against WPATH in June 2026, stating the organization has “misled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness” of child sex-change interventions.

WPATH members receive access to a member-only forum that discusses various topics related to transgender medicine and policy. Through a public records request The Daily Wire uncovered almost 250 pages of messages from WPATH’s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization’s cultural reach and challenge some of its public-facing recommendations.

This is the second article in The Daily Wire’s investigative series on the uncovered WPATH messages. 

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Members of the world’s leading transgender medical organization admitted protocols were needed to help transgender patients “detransition” back to their real sex while publicly recommending children receive sex-change surgery.

In a private online forum, members of the World Professional Association of Transgender Health (WPATH) asked for advice on treating the complex medical needs of patients wanting to return or “detransition” to their real sex after undergoing sex-change surgeries such as vaginoplasty, breast augmentation, double mastectomy, hysterectomy, and oophorectomy. WPATH members acknowledged in the forum the brutalized bodies of detransitioners needed specialized care and these struggling patients were often forsaken by the medical community which gave them their scars.

“Curious if anyone or any institutions have protocols or policies related to ‘de-transition’ – either request to reverse any gender-affirming surgeries or put people back on prior hormonal state,” wrote Dr. Christopher Terndrup, the associate director of the LGBTQ+ Healthcare Fellowship Program at Vanderbilt Health, in a message thread titled “De-transition Protocols/Policies.”

A screenshot of a message obtained through a public record request by The Daily Wire.

Several WPATH members responded and expressed a need for formalized detransition protocols, writing that a lack of medical guidance left detransitioners feeling “ignored” as they try to reclaim their broken bodies.

“We really need the clinical pathways. People will ask how to go off testosterone or how to restart testosterone and I’ve asked various MDs and gotten different responses. Often, folks who are choosing to detransition feel like they have to do this all on their own,” wrote a psychologist. “When folks restart testosterone there can be mood shifts as well. When people alter their hormones, a lot of regret arises about choices they have made and it seems like it’s helpful to offer patients a non-regret focused frame — ie, that they are embracing who they are at this moment and taking positive steps to embody themselves, etc.”

Members suggested creating a specific group to develop medical guidance for detransitioners and noted transgender patients should receive psychological therapy for a period of time before undergoing any identity changes.

“I still think that we should be developing protocols to handle this regardless of how many detransitioners there are,” wrote a psychologist. “I think it’s important.”

Dr. Kurt Miceli, chief medical officer at Do No Harm, told The Daily Wire there is an “undeniable need” for detransitioner medical protocols.

“There is a critical and undeniable need for detransitioner protocols — a reality acknowledged even by WPATH’s own members. Yet this is the same organization that has ignored systematic review upon systematic review as it promotes harmful and irreversible sex-rejecting procedures for minors,” Miceli told The Daily Wire. “This contradiction cannot be brushed aside: it exposes a fundamental inconsistency in which life-altering interventions are championed for minors on the one hand while the reality of those who later seek to reverse them has unfortunately been minimized and gone unaddressed.”

A screenshot of a message obtained through a public record request by The Daily Wire.

In the Standards of Care Version 8, WPATH recommends that children have access to irreversible sex-change surgeries without any age minimums. The group calls the choice to detransition “proportionally rare” but tells healthcare providers they “should be prepared to support adolescents who detransition” without providing formal protocols to accomplish this.

“We have limited ability to know in advance the ways in which a child’s gender identity and expressions may evolve over time and whether or why detransition,” the standards read.

In a separate post, a physician’s assistant asked for insight on managing the estrogen needs of a young woman who had her breasts, uterus, and ovaries removed while she self-identified as a “trans male.”

“The patient more recently has been experiencing an evolution/shift in gender identity as genderfluid/feminine learning, wanting to detransition,” wrote the physician’s assistant in the thread titled “DETRANSITION: Optimal estrogen therapy for patient detransitioning.”

“This is a complex case with much more to it and I will not be able to go in depth here, but I did want to ask the group specifically your thoughts/experience with detransition and optimal dosing of estrogen for such a patient.”

The young woman was in her 20s and wanted to detransition. But because she had no ovaries, her young body could not produce the needed estrogen and was in a surgically induced post-menopausal state.

Miceli told The Daily Wire that without external estrogen replacement therapy, the patient is at risk of developing osteoporosis, cardiovascular disease, and other health complications.

“Hormone therapy becomes a lifelong medical requirement following this irreversible procedure,” he said. “This reality makes the development of detransition protocols all the more essential, ensuring that hormone management is guided by clinically appropriate, evidence‑based standards rather than left to an ad hoc practice.”

The post brought out strong opinions on detransitioning on the forum thread. One member called on WPATH to “take a leadership role” in researching the “phenomenon of detransition.”

Marci Bowers, a highly influential transgender surgeon and former president of WPATH, called the patient’s situation “tragic” and wrote that one of WPATH’s great challenges was to “help patients sort through their gender diverse feelings” before receiving “irreversible treatment.”

“If ever there was a challenge to the WPATH professional community, it is to help patients sort through their gender diverse feelings prior to undergoing irreversible treatment. Though there can always be a silver lining, cases like this seem tragic,” wrote Bowers. “I don’t feel that greater caution or limits are what are required but rather, brakes, hypothetical questioning, I’m not entirely sure. How can we do better for our patients in avoiding these rare outcomes?”

One WPATH member disagreed that the situation was tragic, writing, “sometimes, like many things in life, people need to go ‘too far’ before they realize where they want to be.”

The physician assistant who asked for help later noted the young woman wanting to detransition had “severe dysphoria dating back to childhood” and was thoroughly evaluated before having surgery to remove her reproductive organs. She noted in the future it might be helpful to educate young transgender patients seeking sex-change surgery on the “potential benefit” of keeping their ovaries, “just in case.”

“They had ongoing support from a comprehensive mental health team and family. They were very much identifying as a trans man most of their life with severe dysphoria, depression, and suicidality,” wrote the physician’s assistant. “There is nothing I think anyone in our team could have done differently to prevent this or ‘do better.’ I’m not sure if we have any data or idea of how gender identity might evolve or change over time, but that seems to be what is happening at least with this patient over time.”

A screenshot of a message obtained through a public record request by The Daily Wire.

Miceli said these messages reveal the “profound tragedy” detransitioners face after undergoing irreversible gender transition treatments.

“Dr. Bowers’ comments within the WPATH Member Forum acknowledge a truth the organization does not confront publicly: the profound tragedy faced by individuals who seek to detransition after irreversible sex‑rejecting surgeries. In fact, WPATH has systematically downplayed and obscured this reality by minimizing detransition and framing regret as rare,” Miceli told The Daily Wire. “These interventions create lifelong anatomical changes and permanent dependence on exogenous hormones, effectively placing patients in chronic medical care.”

Bowers declined to provide a comment to The Daily Wire. WPATH and Vanderbilt Health did not respond to The Daily Wire’s request for comment.