For the past two years, it has been a matter of public record that in 2022, when leaders at the World Professional Association for Transgender Health were finalizing the eagerly-awaited revisions to their transgender-care guidelines, they caved to pressure from outside entities to remove the age limits on almost all gender-transition interventions. This revelation came from internal records the Alabama attorney general, Steve Marshall, subpoenaed from WPATH as a part of his defense in the Boe v. Marshall lawsuit against the state’s ban on gender-transition interventions for minors.
In particular, the records showed that Dr. Rachel Levine, a high-ranking health official in the Biden administration and a transgender woman herself, pressured WPATH to remove the age limits, citing political reasons. Leaders within the organization resisted and balked internally, according to internal emails.
But on Aug. 5, 2022, someone from the organization—the name was redacted in the subpoenaed records released in 2024—sent someone else an email that suggested that WPATH had taken into consideration the email recipient’s “constructive comments” about the pending Standards of Care, Version 8, or SoC 8, as the guidelines are called. Following internal discussions, including with the authors of the adolescent chapter and with the leaders of the SoC 8 revision—those names were also redacted—this person said that WPATH was going to shift from having age limits be a “recommendation” to merely suggesting “minimal ages as long as the adolescent fulfils” various criteria.
I have now obtained an unredacted copy of this email. So I can report for the first time that it was written by Dr. Walter Bouman, a trans-care specialist at the University of Nottingham who was then WPATH’s president, and addressed to Dr. Levine. It was routed through staffers at the U.S. Department of Health and Human Services, where Dr. Levine was the assistant secretary for health—the highest-ranking openly transgender federal official in history. This included Sarah Boateng, Dr. Levine’s then-chief of staff. Also cc’d was Blaine Vella, WPATH’s executive director.
