I'm going to make this brief, but I would like to have this point made in writing again because I often am used the Trident which is used to poke at WPATH.

WPATH has been around now for nearly half a century. Their sole purpose and goal at their core is to help transgender people. They have been helping transgender people for longer than I've been alive.

When you get a group of people like this, a group of doctors and clinicians together, they produce a standard of care or guidelines. This is true in any aspect of medicine.

However, when they put this document out as a group, it has to have group approval. In order for something to make it through group approval, it needs to have an overwhelming majority of the group want to put something into that standard of care.

So basically, outlying opinions, or things that are a little too edgy, will end up not making it into the final cut. This is true in literally every branch of medicine. There are doctors out there doing cutting-edge things in their field that are new techniques and new things that are not yet guidelines but they know about them because they're one of the most advanced. Some of these things will be wrong. Some will be right. But the ones that are proven right over a long period of time will end up in the guidelines.

Historically, doctors have used WPATH as their reference of what to do. Also the endocrine society guidelines. These are not bad guidelines, and they will not result in bad outcomes for patients. Historically they have done fine. This doesn't mean that they are the absolute best possible way, but it also means that they're not going to hurt anybody. When you put out guidelines, that is their purpose. To help somebody do what is effectively an almost guaranteed win.

When you start bowling, as a kid, they give you the bumper lanes. These are guidelines. They make it so you can't bowl down into the gutter. these are really important when you don't know what you're doing, because otherwise, throwing someone's bowling ball into the gutter is pretty bad when that bowling ball is their health.

That being said when you look at professional bowlers, nobody's using bumper lanes. Nobody puts a ball into the gutter. They all know what they're doing, they are experts at what they do, and they don't rely on guidelines anymore.

I have thousands of transgender patients and I've been treating them for a decade. I have a lot of experience and I've seen a lot of rare and unique things. I've been able to help a lot of transgender people with very strange situations medically because of that experience. But I had to start somewhere, and where I started was WPATH. Even then, some of the things I have suggested are done over the years have turned out to be incorrect. I've gradually improved, but at this point, I don't need the bumper lanes. Regardless, I still read them, because even if I don't need them, I can better my techniques by learning new things I may not have yet encountered in their publications.

These people are making the bumper lanes so that doctors out there can learn how to do this at least in a basic way to be able to provide care to people who otherwise don't have access to somebody who's a professional bowler. This is not a bad thing. For many people, their doctors have no idea whatsoever what to do for them, and they rely entirely on these guidelines to be able to treat these people at all. Without them, the other option would be not getting care.

In short, they are not your enemy. They are your friend. They may be your conservative friend who doesn't hold the exact same views that you do, but at the same time, they're your friend.

Unfortunately our society has reached a point where people can no longer disagree about something professionally, without it becoming personal. As I said recently, it's one thing to criticize someone's opinion, it's another to criticize them as a human being. I can disagree with many of the things that WPATH has put out, but at the same time, they are good people who care about you. They are not your enemy.

I don't want to have to make a rule on the subreddit that criticism of WPATH is not allowed, but from now on, blanket degrading of them is not acceptable. If you have a complaint about something they say or do, you have to specify what it is and why you don't like it. Not that just "WPATH sucks" as this is unfair to them and doesn't recognize the commitment they have done through 43 years of advocating for trans rights and trans health. People are welcome to scrutinize them, me, or anybody else's opinions or work based on that work's validity. You can say that Einstein's theory of relativity is wrong because X, But you can't say that Einstein is a shitty person or researcher.

In academia, there is literally nobody out there who publishes documents that personally criticize the author of another medical document. That is not how that is done ever. It is wildly unprofessional to do something like that. No peer-reviewed journal would ever do anything of that sort, nor would any respectable academic institution ever allow such a thing to happen. Only criticism of some author's idea or publication is allowed. Never the direct person. Doing so would be honestly so petty and malicious that such a person trying to do such a thing would end up shunned and would probably have to post their "work" on some private website that masquerades as a real journal. I hope I've made this clear.

This subreddit will not devolve like many of the other cancerous subreddits into mudslinging and personal degradation. This place and my office are places where I want people to be able to be their real selves, Express themselves freely, and do so without fear of direct judgment. If you come into my office and you tell me that the Earth is flat, I will tell you that your idea is wrong and that you have been ill-informed. But I won't tell you that you're a stupid loser who doesn't know anything.

We may judge your ideas, but the person is not to be attacked. Attacking someone's person when they have a deeply held belief is very unlikely to cause them to listen to you anyway. Someone might have a wrong idea but it doesn't make them a bad person. WPATH may be a bit conservative at times, but they are definitely your advocate and friend and I will no longer tolerate people degrading them here.

This subreddit will not be like others. That is now a rule.