The US Assistant Secretary of Health for the Department of Health and Human Services reportedly pressured the world’s top transgender health authority to remove all objective age restrictions for the medical ‘transitioning’ of minors in their latest and 8th edition of guidelines, the Standards of Care (SOC-8).
Admiral Rachel Levine, a trans-identified male and the highest-ranking official in the U.S. Public Health Service Commissioned Corps, “strongly pressured WPATH leadership to rush the development and issuance of SOC-8,” according to a recently unsealed court document presented as evidence in the ongoing court case Boe v. Marshall.
The document, titled “Appendix A to Supplemental Expert Report of James Cantor, PhD,” contains testimony from Cantor, a controversial* American-Canadian sexologist and psychologist who has served as an expert witness against the medical transitioning of child on multiple occasions. Cantor points to internal communications from members of the Guideline Development Group which demonstrate that Admiral Levine was in contact WPATH leaders and “very keen” to have the updated revisions released.
“WPATH’s internal communications reveal that the SOC-8 development process was influenced by pressure from high-level government appointees,” states section D of the document, which was declassified as confidential material on June 24.
According to Cantor, Assistant Secretary of Health Levine “attempted to and did influence the substantive content of SOC-8, based on political goals rather than science.”
Specifically, Cantor alleges that Levine, though a staff member, “pressured WPATH to remove recommended minimum ages for medical transition treatments from SOC-8.”
Evidence for Cantor’s claim includes internal messages which discuss commentary from Sarah Boateng, Admiral Levine’s chief-of-staff, in which it is expressed that his “biggest concern is the section in the Adolescent Chapter that lists specific minimum ages” for treatment.
“[Levine] is confident, based on the rhetoric [he] is hearing in DC, and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care. [He] wonders if the specific ages can be taken out,” reads the internal message.
“The issue of ages and treatment has been quite controversial (mainly for surgery) and it has come up again. We sent the document to Admiral Levine … [He] likes the SOC-8 very much but [he] was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth,” it continues. “[He] asked us to remove them.”
In September 2022, WPATH released the SOC-8 guidelines, which reduced the age at which youth could potentially receive “puberty-blocking” drugs, cross-sex hormones, and surgeries. At the time of the initial release, the specific recommended ages were 14 for hormones; 15 for double mastectomy surgery; 16 for breast implants and facial cosmetic surgery; and 17 for metoidioplasty, orchidectomy (castration), and hysterectomy.
But on September 15, WPATH abruptly issued a correction and removed those specific age guidelines.
The new criteria opens the door for clinicians to halt a child’s puberty, place them on cross-sex hormones, or potentially offer surgeries once they have reached the period of development referred to as Tanner Stage 2, which occurs between 9-11 years of age.
“[W]e heard your [Dr. Levine’s] comments regarding the minimal age criteria for transgender healthcare adolescents; the potential negative outcome of these minimal ages as recommendations in the US … Consequently, we have changes to the SOC 8 in this respect,” states one message in Cantor’s recently revealed report.
“Given that the recommendations for minimal ages for the various gender affirming medical and surgical intervention are consensus-based, we could not remove them from the document. Therefore, we have made changes as to how the minimal ages are presented in the documents.”
According to the September 15 correction, the following statement was removed from the medical guidelines: “Importantly, for each gender-affirming intervention being considered, youth must communicate consent/assent and be able to demonstrate an understanding and appreciation of potential benefits and risks specific to the intervention.”
Cantor further alleges that the minimum ages for potential medical interventions were made subjective “for the explicit purpose of minimizing members’ risk of malpractice liability.”
He cites Dr. Amy Tishelman, one of the Guidelines Development Group members, who, at a 2023 WPATH conference, expressly stated that minimum ages were removed “to protect clinicians from lawsuit should the clinician decide to provide a treatment to someone younger than a specified age minimum.”
Internal documents, Cantor says, also show that WPATH SOC committee members were opposed to the sudden changes made to the medical guidelines for children, with one unnamed individual remarking it was “the most strange experience” to see the elimination of minimum age recommendations made at the “last minute” after internal discussion made clear that “nobody [on the committee] wanted to make them, and personally not agreeing with the change.”
However, Cantor notes that the American Academy of Pediatricians (AAP) issued an “ultimatum” to WPATH, stating that a refusal to delete age minimums would result not only in the AAP withholding endorsement of the SOC-8, but also public opposition to the guidelines.
Because WPATH had released the SOC-8, only to quickly revise age minimums for minors after its publication, the alteration was quickly noticed by some members of the press. In response to questions from journalists, WPATH then devised a false narrative, which committee members discussed adhering to collectively.
“Since the open comment period, a great deal of input has been received and continued to received until the final release,” one WPATH member suggested. “I feel the final document puts the emphasis back on individualized patient care rather than some sort of minimal final hurdle that could encourage superficial evaluations and treatments outside of the thorough and comprehensive pathway recommended by WPATH standards.”
Admiral Levine has continuously advocated for the medical transitioning of children over a period of several years – both publicly and within academic literature.
In June 2022, Levine spoke with Karen DeSalvo, chief health officer at Google, and labeled attempts to impose legislative bans on surgeries and puberty-halting drugs for children as “egregious attacks” on “trans youth.”
“There are numerous state actions which are politically motivated and are egregious and really put trans youth and gender diverse youth at risk, in terms of limiting … the accessibility of gender-affirming medical care. These are politically motivated, they are mean-spirited, and they’re going to hurt people,” Levine said.
He then detailed his intention to work with government officials in order to push gender identity policies onto the public despite the growing opposition. “We’re going to push back in the federal government as much as we can. We’re going to push back in terms of advocacy… in terms of policy… for example, Title IX in the Department of Education, and legally, through the Department of Justice.”
Levine was appointed as the Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS), after being nominated by President Joe Biden, in 2021. He graduated from Harvard College and Tulane University School of Medicine, and trained in Pediatrics and Adolescent Medicine at the Mt. Sinai Medical Center in New York City and had previously worked with youth experiencing eating disorders. He began to declare a transgender status in 2011 at the age of 54.
The world authority on transgender medicine has officially dropped age limits for 'puberty blockers' and hormones to children as young as 9.
— REDUXX (@ReduxxMag) September 18, 2022
The guidelines were created with input from academics involved in a forum hosting castration child pornography.https://t.co/1nA4Mur9qj
The link between pedophilia advocacy, sexology, and trans activism can further be seen in how criteria put forward by WPATH, at Levine’s behest, reflect the stated desires of a castration fetish forum, the members of which were found to have been working intimately with WPATH leaders in a series of Reduxx investigations.
The site also hosts child sexual abuse fantasies that involve halting children’s development for pedophilic purposes. The Eunuch Archive, the forum which is directly named as a resource in WPATH’s newly-released SOC-8, is home to nearly 10,000 fictional pornography stories of an extreme sadomasochistic nature – of which nearly 4,000 feature themes of the rape, castration, torture, and / or killing of children.
In some of the stories, children with stunted puberty are raped by doctors. In others, children are castrated by force as part of a sadistic sexual torture ritual. Other themes include Nazi doctors experimenting on children by castrating and sexually abusing them. There are also erotic stories which describe young boys being given “feminizing” hormones, or “neutered” with drugs which resemble puberty-blocking drugs in effect – only to then be sex trafficked during adolescence.
One story within the forum, titled “Age of Consent,” imagines a “not too distant future” when the age of consent will be lowered to 12 years old, and children “can engage in sex or even have ‘genital mods’ without parental consent or notification.”
In May 2023, research by two WPATH-affiliated academics gathered from participants in the forum was published in the Archives of Sexual Behavior. Drs. Johnson and Wassersug titled the academic paper “Castration for Pleasure: Exploring Extreme Castration Ideations in Fiction”.
“The most popular [Eunuch Archive] stories link sexual gratification and romantic partnership with genital abuse. They are characterized by the absence of consent for genital ablations and multiple [sadomasochism]-related paraphilias,” note Johnson and Wassersug. “Many stories feature attraction to, and ablation of, the genitals of pubescent or adolescent males.”
The men involved in the Eunuch Archive who worked closely with WPATH during the creation of the new SOC-8 guidelines also shared the initial draft release of the document in December 2021 to the forum.
Johnson, under his screen name ‘Jesus,’ encouraged the castration fetishists to submit positive comments to WPATH. In response, one site member professed to being “absolutely delighted,” and said he would “gladly throw millions under the bus” in order to secure “a future where doctors must obey and have no right to demand reasons or withhold surgery and medication.”
*EDITOR’S NOTE: Cantor, who produced the report leaking internal communications that revealed Levine’s involvement, has, despite his criticisms of WPATH, been scrutinized for his affiliations with pedophile-sympathetic charity Prostasia. In 2022, Reduxx reported that Cantor had been prominently featured on Prostasia’s official site with a dedicated profile, and has claimed that pedophilia is no different than any other sexuality. Cantor’s allegations against WPATH are significant, and were substantiated beyond his own opinion or perspective, hence our decision to publish this article.