The End of WPATH: Introducing the Gender Framework

Where WPATH’s SOC 8 normalizes the idea of altering oneself to conform to the world’s gendered expectations, the Gender Framework proudly stands for gender non-conformity free from medical dependence.

Image Credit: Modified from Customdesigner on iStock

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Last weekend, I had the immense pleasure of both attending and speaking at Genspect’s “The Bigger Picture” conference in Denver, Colorado. The speakers, a diverse group of medical experts, biologists, journalists, and parents, share concerns about the sudden increase in trans identities among youth and the prevailing ideology and "gender-affirmative" medical treatments for gender distress.

For too long, the World Professional Association for Transgender Health (WPATH) has been the sole provider of medical guidance for individuals experiencing distress about their sex and “gender.” Concerningly, WPATH advocates for a highly medicalized approach to treating gender-distressed youth, explicitly foregoing exploratory psychotherapy in favor of puberty blockers, cross-sex hormones, and surgery.

Genspect is determined to break WPATH’s ideological monopoly on this issue. To that end, they have assembled a team of experts to develop a non-medicalized alternative to WPATH’s Standards of Care 8. I am honored to have been selected to write the first section, “Sex and the Body,” which anchors the entire Gender Framework in biological reality and counters the common activist arguments that there are more than two sexes beyond male and female or that the categories of male and female are not distinct but exist along a continuum. My focused work writing this section is largely responsible for the lull in content here on Reality’s Last Stand last month (sorry!), which will now resume as before.

It is with great pleasure that I present the following article by Alasdair Gunn, Vice-Director of Genspect. He outlines the contents and significance of their new and historically significant Gender Framework, which was unveiled during the conference. Its publication is set to be recognized as a pivotal moment when the tide began to turn against WPATH and their radical agenda.

Colin Wright
Founding Editor, Reality's Last Stand

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About the Author

Alasdair Gunn is the Vice-Director of Genspect, an organization that promotes and develops evidence-based approaches to gender-questioning children and young people.

Gunn was working in academia when he became interested in gender issues. After coming into contact with a group of parents of trans-identified boys, he wrote a series of Quillette articles on the topic under the pseudonym “Angus Fox.” As a gay man who tackled body dysmorphia in adolescence, Alasdair brings a unique understanding of issues related to teenage male development.

Since then, his work in gender has focused on design, marketing, research and communications.

Recently diagnosed with a terminal illness, he has stepped back from day-to-day work and is keen to highlight the ways in which gender healthcare falls short of the normal standards of excellence we have come to expect from the medical industry.

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Who we are

In 2021, Genspect was formed as a coalition of parent and professional groups, united in concern about the inappropriate social and medical transitioning of young people questioning their gender. These parents, and their allies, did not believe that their children’s complex challenges would be resolved by hormones and surgeries—and that it was these complex challenges themselves that were causing kids to take flight from their authentic selves. Genspect continues to give voice to this cohort of well-informed, engaged, compassionate parents and professionals, highlighting their concerns in the media and political spaces; yet we have also expanded during our short existence, garnering the support of detransitioned individuals who believe they received inadequate healthcare; transitioned people who share our worries about over-medicalization and the influence of queer theory; teachers about the rise of ideological indoctrination; clinicians and researchers seeking to raise awareness of the low-quality evidence base for medical transition; gay rights campaigners and women’s rights campaigners; politicians and journalists; and, more broadly, members of the public who see a need for a radically different voice on this topic.

We have expanded our mission from being a voice for parents to offering a healthy approach to sex and gender. We unite left, center and right; religious and irreligious; male and female; straight, bi and gay; and, as an international organization, represent members from dozens of countries across the world.

Why we created the Gender Framework

In September 2022, the World Professional Association for Transgender Health (WPATH) released the eighth edition of its Standards of Care. Yet “SOC 8,” as it is called, is no humdrum clinical how-to, as you might find stacked on a lonely corner table at an orthopedics conference. In fact, it is so eccentric and alarming a document that its publication should be seen as an inflection point: the moment at which a fundamental, even historic, change occurs. In this case, the change was a break from the most basic norms of medicine.

SOC 8 represented the victory of one faction in WPATH over another. WPATH has within it many clinicians who object to the idea that simply anyone who wants to should be able to undergo medical transition (hormonal and surgical interventions to attain their embodiment goals). Ranged against them, yet within the same organization, is another faction whose belief is mutually incompatible. Not only do these individuals, sometimes called “trans liberationists,” believe that anyone should be entitled to transition, some also believe that to deny this right is genocide. In this inter-factional battle, it was the trans liberationists who won. Thus, according to SOC8, a diagnosis of gender dysphoria is no longer required to medically transition.

By consequence, SOC 8 arguably became a wildly ideological document. The ethics chapter, though already written, which appeared in the publicly available draft, was deleted. Also deleted were all recommendations regarding minimum age limits for medical transition (with the exception of phalloplasty, which is reserved for those over the age of 18 due to the complexity of the procedure). Perhaps most frighteningly, the concept of a “eunuch gender identity” was advanced, with a view to normalizing the removal of the testes alone in males, leaving the penis in place. The source for this particular “identity,” unbelievable as it may be, turned out to be a paedophilic fetish site where anonymous users exchange sadomasochistic fantasies about castrating boys.

SOC 8, then, is not so much a how-to for the concerned and invested clinician as it is a technical manual for an incurious mechanic, tinkering with a machine. It is rich in information about how to interfere with an existing, fully functional system, yet has no meaningful discussion about whether there’s anything that actually needs fixing. It evangelises the notion of looking within ourselves to find answers, yet blinks blankly at the idea that the answers we find might be wrong. In releasing SOC 8, and caving to the trans liberationists, WPATH turned clinician into vendor, patient into buyer, and primum non nocere (first, do no harm) into caveat emptor (buyer beware). Those concerned that their children are being misled are dismissed as disgruntled and inconvenient malcontents; those angry about the substandard treatment they received have no more moral standing than the office worker who accidentally punches the wrong combination into the vending machine. When the customer is always right, the provider is never right nor wrong. Sorry, buddy: I just work here.

It is in this historically jarring moment that Genspect is releasing the Gender Framework. We believe the Gender Framework should be seen as a rival to WPATH’s SOC 8, notwithstanding the radical differences between the two: both documents address the same cohort, albeit from diametrically opposing angles. Where SOC 8 facilitates medical transition, the Gender Framework presents a comprehensive, non-medical means of dealing with distress about gender issues. Where SOC 8 encourages gender-non-conforming young people to see their bodies as problems to be solved, the Gender Framework advances a more reflective and socially conscious answer, helping kids and young adults to understand themselves as actors in a wider world, subject to—and indeed sometimes able to affect—the forces around them.

Where SOC 8 purports to be a Standards of Care, the Gender Framework does not seek to medicalize identities. Where SOC 8 normalizes the idea of altering oneself to conform to the world’s gendered expectations, the Gender Framework proudly stands for gender non-conformity, free from medical dependence. And where SOC 8 blithely disregards the many concerns about the social consequences of gender identity theory, the Gender Framework aims to pull in voices from across society, ensuring that all welfare is considered, rather than that of just one person.

We are proud of the team we have assembled to create this framework, and of their expertise. We intend to add to this document in the coming months and years—much as WPATH has added to its Standards of Care, although, we hope, to better effect—formulating our ideas as we learn more. In the meantime, we want the Gender Framework to help and inform as many people as possible: those questioning their gender; those who have transitioned, regardless of how they feel about the outcome; those who have detransitioned; the relatives and friends of all these individuals; those working with them in clinical and therapeutic practice; those working in other professional fields affected by these issues; and anyone in society who seeks positive, thoughtful resolution of these often complex and sensitive problems. We hope you find this document to be practical, clear and compassionate, and that the recommendations we advance within it prove useful. 

How to use the Gender Framework

Section 1: Contextual Background

This section gives information on the biology of sex, different theories of gender, and diagnoses of gender-related distress, providing context and foundation for the remainder of the Gender Framework. The biological and physiological knowledge prerequisite to an accurate understanding of natal sex is presented, covering such topics as developmental sex pathways and differences in sex development (DSDs) (also known as “intersex” conditions). Some disparate theories of gender, from queer theory and gender identity theory to the gender critical viewpoint and biopsychosocial perspectives are described. Following this, a comparison of the methods of diagnosing gender dysphoria, how diagnosis intersects with age, and issues such as self-diagnosis and informed consent are also highlighted.

Section 2: The Psychology of Gender Dysphoria

The second section lays out the psychology of gender-related distress. The current understanding of gender dysphoria and its potential causes and risk factors are presented. Multiple pathways to gender dysphoria are outlined, with discussion about specific cohorts, exploring how age, sex, sexuality and external influences impact those experiencing distress about their gender identity. This is expanded upon by analyzing risk factors that can contribute to the development of gender dysphoria, such as autism spectrum diagnoses, depression and internalized homophobia. Various modalities of treatment for gender dysphoria are described along with an analysis of the evidence base supporting the affirmative care model. 

Section 3: Families and Education

In section three we move from discussing those who are dealing with gender-related distress to considering the impact on those around them—family members, and parents in particular, and educational establishments. We have deliberately chosen to unite these two topics as we believe that parents should, under all normal circumstances, be involved in their children’s education, and that the threshold for excluding them should be very high. 

We investigate how families can be impacted by gender issues, detailing how gender distress in one family member can affect others within the family unit as well as the wider family dynamics; how families can deal with suicidality; how families cope with desistance and detransition; and how clinicians can work with families. The many challenges that gender identity theory presents to schools and other educational establishments are rigorously examined, covering such themes as family inclusion, age and age appropriateness, sex education, social transition, single sex spaces, sports, social contagion, desistance and detransition, and post-school education, among others. Just like other sections, the Families and Education section concludes with suggestions for families, schools and colleges.

Section 4: Society

The fourth section examines the concept of the gender identity belief system and its effects on wider society. Some of the challenges that emerge from prioritizing gender identity over natal sex are explored in relation to specific conflicts of interest that are highlighted. Using these examples, we review and critique existing solutions that have been put into practice to address these challenges, analyzing them in ways that consider the rights, needs, interests and privileges of each individual. 

We also put forward the concept of clusivity in this section. Clusivity is a term used in the study of linguistics that distinguishes between inclusivity and exclusivity within the grammatical context. We expand upon this concept of clusivity in relation to society and describe how different circumstances can be inclusive and exclusive. Four ethical concepts that underpin the gender identity belief system are identified in this section: nothing about us without us, prioritarianism, intersectionality, and inclusivity and these concepts are studied within a perspective that focuses on fairness, tolerance and respect for everyone. Finally, suggestions are offered so that professionals tackling these issues can apply them with a deeper understanding and sensitivity to the related issues.

Section 5: Law and Policy

Section five of the Gender Framework offers an analysis of existing law and examines new laws and policies that have been created as a consequence of society’s new understanding of sex and gender identity. The Yogyakarta Principles, which have arguably played a significant role in shaping norms, policies and laws are discussed, highlighting their impact on democratic societies. The complexities related to the concept of informed consent are examined within the context of a legal framework, while laws on conversion practices within psychotherapy are also scrutinized. Issues such as sex education, gender identity and non-discriminatory laws are also considered in this section so as to provide some context to what is occurring in schools across the world.

Glossary and useful terms

Accuracy in language is imperative if we are to provide a reliable foundation on which we can build a road forward. The Gender Framework aims to clarify and address the recent challenges that have emerged due to the recent emphasis on gender identity rather than the natal sex of an individual. This sea-change has been further complicated by nebulous language as there are seldom accepted terms or definitions that are universally accepted. We attempt to resolve this issue with a glossary that offers the most widely accepted definitions. 

Appendix

Finally, we offer sample school policies and sample legislation that are thoughtful, well-considered and creative approaches to ensure everyone’s interests and rights are addressed with fairness. Schools, clinicians and other professionals already apply many of the recommendations consistent with Genspect’s guiding principles. We encourage readers to use this framework to reflect more broadly on issues of sex and gender.

Release information

We released a Draft Version of the Gender Framework last weekend at our conference in Denver, subject to review and public consultation, and we will continue to refine and expand the Gender Framework based on the emerging literature. You can download the Gender Framework below. In September 2024, we aim to release Version 1 at our conference in Lisbon, Portugal. In the meantime, we commit to prioritizing accuracy, fairness and the spirit of compromise while also recognizing the need for dignity and safety, and appreciating the value of gender diversity.

Gf Master Document

3.21MB ∙ PDF file

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Let us know your views: info@Genspect.org

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