A UN panel setting global care standards for trans adults has been accused of cronyism, with four fifths of its members being flagged for conflicts of interest and even of having a financial stake in the group’s work.
The LGBT Courage Coalition, a US-based campaign group, has accused the UN’s World Health Organization (WHO) of appointing experts who are set to gain from the guidelines they’re tasked with writing.
Several are medical professionals with practices that provide cross-sex hormones and other care to trans people, and stand to gain from such care becoming more widespread, it is alleged.
Jamie Reed, a former case manager at a Missouri trans clinic who blew the whistle on kids being fast-tracked onto puberty blockers, bashed WHO for appointing panelists with a financial stake in the work.
The UN’s World Health Organization has faced criticism since it revealed the names of panelists in December
‘A lot of organizations struggle when managing intellectual conflicts of interest, but a financial conflict of interest is kindergarten level,’ Reed, a member of the coalition, told DailyMail.com.
‘The fact that they could not manage basic financial conflicts of interest demonstrates that they are not in a position to manage something as complex as a global guideline, and they need to go back to the drawing board.’
Jamie Reed accuses WHO panel of cronyism
Some 13 members of the panel have ‘significant’ conflicts of interest and another three appear to be compromised, she said in a report.
WHO should kick them out and let in people with a wider range of expertise, including in autism, which may contribute to gender dysphoria, and people who have transitioned and later come to regret it, she added.
Another group, the Society for Evidence-based Gender Medicine (SEGM), agreed, saying the conflicts of interest could ‘interfere’ with members’ ‘ability to impartially assess the evidence and issue evidence-based recommendations.’
SEGM said this was likely by design — that WHO chose experts on one side of a hotly-contested medical debate to deliver guidelines that promote affirmation-on-demand, drugs and surgeries for trans people.
‘The fact that these affiliations were not viewed as problematic and passed the … review sent a strong signal regarding the direction of the guidelines,’ the group said in a statement.
A young woman shows the scars from the breast-removal operation she underwent as a teenager and now deeply regrets
WHO officials haven’t commented on the controversy. The agency has rules against ‘financial’ and ‘intellectual’ conflicts of interest for guideline-writers, but it remains unclear whether they are being enforced.
Advocates of gender-affirming care, as it is known, say it can be life-saving for a suicide-prone group.
Critics say big medical groups have been hijacked by trans ideologues, and that some people who identify as trans would benefit more from counseling than being fast-tracked onto drugs and surgery.
Clinicians who devise guidelines for gender-affirming care are chiefly focussed on helping patients and medical ethics.
But there are big financial implications to standards that will influence the WHO’s 194 member nations.
Cross sex-hormones cost as much as $2,500 each year for US trans patients.
A complete gender-reassignment surgical package can easily exceed $100,000.
Making gender-affirming care more widely available could boost the profits of drugmakers and care providers by millions — or even billions — of dollars.
Sexual-reassignment operations, like this one in France, are fraught with difficulties. A complete head-to-toe package can cost more than $100,000 in the US
Cross-sex hormones can cost $150 for a year’s supply in the US, but more expensive types can exceed $2,500
The coalition says several WHO panelists stand to gain personally from costly drugs and procedures being rolled out more widely.
They include Gale Knudson, a medical doctor and psychiatrist in Vancouver, Canada, whose ‘practice consists largely of approving patients for gender-affirming care,’ the group said.
Another is Walter Bockting, a doctor of psychiatry and researcher with the New York State Psychiatric Institute, who is compromised because ‘his clinical practice is focused on the provision of gender-affirming hormones,’ the group says.
Likewise, Walter Bouman of Britain, Elma de Vries and Chris McLachlan of South Africa, Apako Williams of Uganda, and Rena Janamnuaysoo of Thailand all work for clinics that profit from gender care, it is claimed.
Alicia Krüger, a trained pharmacist in Brazil, would benefit from WHO recommending the wider use of cross-sex hormones, as she consults for the Brazilian government on this issue, it is claimed.
Other panelists draw salaries from organizations that promote gender-affirming care, the group said.
The panelists are not accused of wrongdoing — just that they should not sit on an intergovernmental body devising guidelines aligned to one of their business interests.
Sex-reassignment procedures are complicated and have worrying rates of post-surgery and long-term pain and discomfort
Trans Canadian TikToker Florence Ashley left the panel amid revelations about their past support for a ‘default’ use of puberty blockers on kids
DailyMail.com contacted WHO to offer the agency and its panelists the right to reply, but did not get a response.
The UN agency has been dogged by criticism since it unveiled the members of its panel in December.
The panel is tasked with developing comprehensive guidelines for how health systems treat trans people globally.
They will focus on cross-sex hormones and other sex-change treatments, training doctors and nurses, and policies that allow trans people to choose the sex used to identify them in government documents.
Critics say the group — which is made up of trans campaigners and advocates — is biased.
One trans activist, the Canadian TikToker Florence Ashley, exited amid revelations about their past support for a ‘default’ use of puberty blockers on kids.
Another, the non-binary activist Cianán Russell, remains on the panel, despite revelations they posted X-rated chats from the hookup app Grindr on social media.
Who makes up the panel?
Pictured: Alicia Krüger
Alicia Krüger is a trained pharmacist with training in the epidemiology of sexually transmitted and viral diseases.
She currently works as an epidemiologist and pharmacist in Brazil.
A transgender woman herself, Krüger co-founded and presided over the Brazilian Professional Association for Transgender Health (BRPATH), a WPATH affiliate.
Pictured: Apako Willimas
Apako Willimas is an activist for the human rights of transgender and gender non-conforming persons in Uganda where he founded the Tranz Network Uganda (TNU).
Willimas has a background in social work. He is also a lawyer with about eight years of experience defending LGBTQ+ people.
Pictured: Ayouba El Hamri
Ayouba El Hamri is a trans activist in Morocco who co-founded a Moroccan LGBTQ advocacy group and serves on the steering committee for the African Trans Network and the Global Network of People living with HIV (GNP+).
Pictured: Chris McLachlan
Chris McLachlan, who was born female but identifies more with masculine gender, is a member of the Sexuality and Gender Division of the Psychological Society of South Africa, where he helped develop the first and definitive South African Gender Affirming Healthcare Guideline.
He is also part of the core team that developed the Practice Guidelines for Psychology Professionals Working with Sexually and Gender-Diverse People.
Pictured: Cianán Russell
Cianán Russell is a trained chemist, policy, and trans rights advocate at the Belgium-based think tank ILGA-Europe.
He started out as a LGBTQ+ activist in the US in the 1990s and has since worked in transgender rights groups in Asia and Europe.
Russel is also the Director of Trans Survivors Network, an international nonprofit that focuses on research, advocacy, and raising awareness related to the care of trans people exposed to sexual violence, sexual assault, and rape.
Pictured: Elma de Vries
Elma de Vries is a family doctor and activist for the healthcare needs of South Africa’s trans community who works at the Nelson Mandela University’s School of Medicine.
She is also a founding member of the Professional Association for Transgender Health South Africa (PATHSA).
Pictured: Erika Castellanos
Erika Castellanos is a trans woman and activist from Belize now living in the Netherlands.
She completed a certificate program for conducting research on LGBTQ+ health issues and founded the first network of people in Belize living with HIV like her.
Castellanos currently leads GATE’s work in building up the trans healthcare rights movement.
Pictured: Eszter Kismödi
Eszter Kismödi is an international human rights lawyer specializing in sexual and reproductive health. She leads the Sexual and Reproductive Health Matters group, which oversees an academic journal that publishes a wide range of research pertaining to sexual health and gender rights.
Kismödi also has a long history of working with global health organizations, including the WHO and the World Association for Sexual Health as a human rights advisor.
Pictured: Felisbela de Oliveira Gaspar
Felisbela de Oliveira Gaspar is a gender policy advisor for the Minister of Health of Mozambique, where she trains health workers on addressing gender in their work treating patients.
Since 2016, she has also advised the WHO Geneva office on the development of strategies for using traditional and alternative medicine in a wide range of settings, not just in treating gender dysphoria.
Florence Ashley is a trans woman and law professor in Canada specializing in ethics in medicine.
They authored a book called Gender/Fucking: The Pleasures and Politics of Living in a Gendered Body as well as reports condemning the continued use of harmful conversion therapy to reverse a person’s homosexuality.
Pictured: Gale Knudson
Gale Knudson is a medical doctor and psychiatrist in Vancouver, Canada who has participated on several panels to develop transgender healthcare guidelines, including the Supporting Sexuality Across the Gender Spectrum panel at the American Association of Sexuality Educators, Counselors and Therapists.
She co-authored several versions of the WPATH Standards of Care and co-leads the Global Education Institute and is a former President of WPATH and the Canadian Professional Association for Transgender Health (CPATH).
Pictured: Phan Thi Thu Huong
Phan Thi Thu Huong is a physician specializing in the prevention and control of sexually transmitted and infectious diseases and the Director General of the Vietnam Administration of HIV/AIDS Control.
She has also served as the Vietnam Coordinator of the French Agency for Research on AIDS and Viral Hepatitis and a health professor at Hanoi Medical University.
Pictured: Rena Janamnuaysook
Rena Janamnuaysook is the program manager for Implementation Science at the Institute of HIV Research and Innovation (IHRI) in Bangkok, Thailand. There, she established the Tangerine Community Health Clinic, the first transgender-led health clinic in the region.
Janamnuaysook is a fellow in the National Institutes of Health’s CHIMERA D43 program that built a team of researchers from Cambodia, Malaysia, the Philippines, and Thailand get design studies addressing the link between HIV diagnoses and mental illness.
Pictured: Saima Paracha
Saima Paracha, one of two pediatricians on the panel, works in the National AIDS Control Program of Pakistan with emphasis on HIV and infections that often go alongside it, such as viral hepatitis and STDs.
Much of her work, primarily in Pakistan, has centered on improving HIV/AIDS diagnostics and training other healthcare workers in HIV and tuberculosis.
Pictured: Sanjay Sharma
Sanjay Sharma, who is also a trained pediatrician, was the founding director and CEO of the Association for Transgender Health in India.
As an advisor to the Transgender Empowerment Board of Delhi, Dr Sharma helped formulate sweeping legal protections for trans people against discrimination in India.
Pictured: Shobini Rajan
Shobini Rajan is a medical doctors and Deputy Director General at the National AIDS Control Organization.
She led the agenda of Transgender Health in India and was instrumental in writing the Indian government’s ‘White Paper on Comprehensive Health-related Services for Transgender Health.’
Teddy Cook works in policy and advocacy projects and is the Director of Community Health at ACON, a leading HIV and LGBTQ+ health advocacy organization based in Australia.
He is part of a wide array of trans rights advisory groups, including Australia’s largest LGBTIQ health and wellbeing survey called the Expert Advisory Group and Gender Advisory Board.
Pictured: Walter Bockting
Walter Bockting is a doctor of psychiatry and researcher with the New York State Psychiatric Institute, leading the Area of Gender, Sexuality, and Health.
He has served as president of WPATH and is the lead investigator on three studies on the subject funded by the National Institute of Health, including one looking into the quality of life of trans and nonbinary individuals following gender-affirming surgery.
Pictured: Walter Bouman
Walter Bouman is a medical doctor and trans health specialist in the UK.
He specializes in prescribing, dosing, and monitoring transition hormone treatment, providing referrals for transition surgeries and other medical interventions such as hair removal and speech and language therapy, and providing psychological support for trans people.
Dr Bouman is the founding member of the European Professional Association for Transgender Health (EPATH) and the British Association of Gender Identity Specialists (BAGIS).
Pictured: Yanyan Araña
Yanyan Araña is a trans woman and activist in the Philippines.
She is program manager of an organization called LoveYourself Inc. which provides sexual health and gender transition services, research, and events, to the trans community there.
Pictured: Zakaria Nasser
Zakaria Nasser is an activist based in Lebanon and was a member of the underground LGBTQ+ rights group Meem.
He has since founded the group Qorras, which collects and disseminates reports on civil rights and policies from a feminist, queer perspective.
