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WHO’s Transgender Health Guidelines

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Summary

The World Health Organization (WHO) is facing criticism for its efforts to develop new transgender health guidelines, with accusations of ideological bias and a lack of scientific rigor. Critics argue that the WHO is prioritizing activism over medical evidence, raising concerns about the safety of gender-affirming interventions and their impact on women’s rights.

Background/Context

The WHO has been revising its approach to transgender health in recent years. In 2019, the International Statistical Classification of Diseases and Related Health Problems (ICD-11) removed “transsexualism” from the category of mental disorders and reclassified it as “gender incongruence” under sexual health. [1]This shift was intended to reduce stigma around transgender identities.[2] However, concerns have grown over the medical interventions associated with gender transition, particularly the use of puberty blockers and cross-sex hormones, which several European countries have begun restricting for minors due to safety concerns.[3] The WHO’s new guidelines aim to promote “gender-inclusive care” and legal recognition of self-determined gender identity, but critics and lawmakers argue that the process is driven by advocacy rather than scientific scrutiny.[4]

Relevant WHO Policy/Action

The WHO established the Guideline Development Group (GDG) in December 2023 to create a framework for transgender health policies.[5] The group’s stated goals include promoting gender-affirming care and legal recognition of self-identified gender identity.[6] Critics have raised concerns that the GDG is composed mainly of activists rather than a balanced panel of medical professionals, with members linked to organizations like the World Professional Association for Transgender Health (WPATH) and Global Action for Trans Equality (GATE).[7]

US Lawmakers also argued that the group bypassed rigorous evidence reviews on the safety and effectiveness of transgender medical interventions, moving directly to recommendations on how to expand access to them. [8]Additionally, WHO is considering classifying cross-sex hormones as "essential medications," which could push countries to make them widely available.[9] This despite the United Kingdom already banned puberty blockers for the treatment of gender incongruence.[10]

Legal or Regulatory Violations

Critics argue that the WHO’s process violates its own standards for developing medical guidelines, which require unbiased assessments and evidence-based recommendations.[11] The secrecy surrounding the GDG’s operations also raises transparency concerns. While no specific legal violations have been cited, lawmakers from the United States argued that the WHO’s actions could undermine national regulations on gender-affirming care and contradict evidence-based health policies in multiple countries.[12]

Consequences/Impact

The WHO’s transgender health initiative has sparked widespread debate, with lawmakers and medical professionals warning of potential risks associated with gender-affirming care.[13] European countries such as Sweden, Finland, and the UK have restricted these interventions for minors, citing insufficient evidence of benefits and significant long-term risks.[14] In the U.S., more and more states are enacting restrictions on transgender medical treatments for minors.[15] Critics also warn that WHO’s policies could threaten women’s rights by promoting gender self-identification, which may undermine protections for female-only spaces, such as shelters, prisons, and sports competitions. [16]

Relevant Documents

WHO Guidelines on the Health of Trans and Gender Diverse People, proposed Members 2024  

WHO/ICD-11 definition of gender incongruence

WHO announcement of the development of a guideline on the health of trans and gender-diverse people

Letter US Congress addressing the Guideline Development Group on the health of trans and gender-diverse people

Order from the United Kingdom to ban puberty blockers, including for the treatment of gender incongruence  

Final Report – CASS review

Link to Commentary

  1. ↑ Gender incongruence and transgender health in the ICD. (n.d.). https://web.archive.org/web/20250219223958/https://www.who.int/standards/classifications/frequently-asked-questions/gender-incongruence-and-transgender-health-in-the-icd
  2. ↑ García, R. R., & Ayuso-Mateos, J. L. (2019). ICD-11 and the depathologisation of the transgender condition. Revista De Psiquiatría Y Salud Mental (English Edition), 12(2), 65–67. https://doi.org/10.1016/j.rpsmen.2019.01.002
  3. ↑ City Journal. (2023, March 25). Yes, Europe is restricting “Gender-Affirming care” | City Journal. https://www.city-journal.org/article/yes-europe-is-restricting-gender-affirming-care
  4. ↑ Melton, G. (2024, February 23). Gender ideologues stack deck on WHO panel on trans ‘Health’ The Daily Signal. https://www.dailysignal.com/2024/02/22/who-enlists-radical-gender-activists-develop-new-guidelines-trans-health/
  5. ↑ World Health Organization: WHO. (2023, December 18). WHO announces the development of a guideline on the health of trans and gender diverse people. https://web.archive.org/web/20250220003206/https://www.who.int/news/item/18-12-2023-who-announces-the-development-of-a-guideline-on-the-health-of-trans-and-gender-diverse-people
  6. ↑ Laxton, B. (2024, March 1). Who should develop guidelines on transgender healthcare? Sex Matters. https://sex-matters.org/posts/healthcare/who-guidelines-on-transgender-healthcare/#:~:text=The%20World%20Health%20Organisation%20(WHO,gender%2Daffirming%20care%2C%20including%20hormones
  7. ↑ Guideline Development Group, Krüger, A., Ayouba El Hamri, McLachlan, C., Russell, C., De Vries, E., & Castellanos, E. (n.d.). WHO GUIDELINES ON THE HEALTH OF TRANS AND GENDER DIVERSE PEOPLE. https://web.archive.org/web/20250213100218/https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library/biographies_tgd-gdg_proposed_members_2024.pdf?sfvrsn=5b1e7491_5
  8. ↑ Letter to the Director-General of the World Health Organization regarding the health of trans and Gender Diverse People. (2024). https://web.archive.org/web/20250214134811/https://dw-wp-production.imgix.net/2024/11/Quill-Letter-L21750-Letter-to-the-Director-General-of-the-World-Health-Organization-RE-Gender-Guideline-Development-Group-Ve-169.pdf
  9. ↑ Hanford, L. B., (2024, May 3). #196 – The WHO guideline to universalize gender transition - ICMDA. ICMDA - A Christian witness through doctors and dentists in every community, in every nation. https://icmda.net/wbnr196/
  10. ↑ Department of Health and Social Care. (2024, December 11). Ban on puberty blockers to be made indefinite on experts’ advice. GOV.UK. https://web.archive.org/web/20250217161529/https://www.gov.uk/government/news/ban-on-puberty-blockers-to-be-made-indefinite-on-experts-advice; Final Report – CASS review. (n.d.). https://web.archive.org/web/20250219235258/https://cass.independent-review.uk/home/publications/final-report/
  11. ↑ Melton, G. (2024, February 23). Gender ideologues stack deck on WHO panel on trans ‘Health’ The Daily Signal. https://www.dailysignal.com/2024/02/22/who-enlists-radical-gender-activists-develop-new-guidelines-trans-health/
  12. ↑ Letter to the Director-General of the World Health Organization regarding the health of trans and Gender Diverse People. (2024). https://web.archive.org/web/20250214134811/https://dw-wp-production.imgix.net/2024/11/Quill-Letter-L21750-Letter-to-the-Director-General-of-the-World-Health-Organization-RE-Gender-Guideline-Development-Group-Ve-169.pdf
  13. ↑ WHO announces the development of a guideline on the health of trans and gender diverse people. (2024, January 8). http://static.heritage.org/2023/Regulatory_Comments/Heritage%20Comment%20to%20WHO%20on%20GDG%20for%20gender%20guidance%20%28Jan%208%202024%29%5B92%5D.pdf
  14. ↑ Galvin, G. (2024, December 13). The UK is the latest country to ban puberty blockers for trans kids. Why is Europe restricting them? Euronews. https://www.euronews.com/health/2024/12/13/the-uk-is-the-latest-country-to-ban-puberty-blockers-for-trans-kids-why-is-europe-restrict
  15. ↑ Barber, A. (2024, October 9). State legislation on gender affirming care for minors. Close up Foundation. https://www.closeup.org/state-and-federal-legislation-on-gender-affirming-care-for-minors/
  16. ↑ Letter to the Director-General of the World Health Organization regarding the health of trans and Gender Diverse People. (2024). https://web.archive.org/web/20250214134811/https://dw-wp-production.imgix.net/2024/11/Quill-Letter-L21750-Letter-to-the-Director-General-of-the-World-Health-Organization-RE-Gender-Guideline-Development-Group-Ve-169.pdf
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