FTC Sues WPATH Over Misleading Transgender Treatment Guidelines for Minors

The organization widely considered the leading authority on medical treatment for transgender people faces accusations from the Federal Trade Commission that it developed influential treatment guidelines for minors based on evidence that its own leaders privately acknowledged was limited and uncertain.

The complaint, filed in federal court in Texas by the Federal Trade Commission and the attorneys general of Alaska, Iowa, Nebraska and Texas, accuses the World Professional Association for Transgender Health (WPATH) of developing and promoting guidelines that health care providers relied on when recommending puberty blockers, cross-sex hormones and sex reassignment procedures for minors.

The case could determine whether medical guidance that shaped transgender treatment for thousands of children was based on solid evidence or agenda-driven speculation.

FTC Chairman Andrew Ferguson said the lawsuit is a consumer protection case focused on whether families were adequately informed about the risks and benefits of these treatments.

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“Children, but especially their parents, should have complete and accurate information when making health care purchasing decisions,” Ferguson said in a statement. “For decades, the FTC has taken action against entities that make misleading and unsubstantiated health claims.”

At the center of the lawsuit are allegations that WPATH publicly described its Standards of Care as evidence-based and rooted in expert consensus, while some of the organization's own leaders privately acknowledged the limitations of the available evidence.

The complaint cites a 2023 strategy memo from the lead author of the eighth edition of Standards of Care, Dr. Eli Coleman, which states that “we are all painfully aware that there are many gaps in the research that support our recommendations.”

People hold signs during a joint meeting of the Florida Board of Medicine and the Florida Board of Osteopathic Medicine to establish new guidelines limiting gender-affirming care in Florida on November 4, 2022. (Ricardo Ramírez Buxeda/Orlando Sentinel/Tribune News Service)

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It also references comments from Dr. Amy Tishelman, lead author of the organization's chapter on children, who acknowledged in an NPR interview that there was no established “research base” to determine the best screenings or treatments for “transgender youth.”

Federal regulators further allege that WPATH removed minimum ages from its 2022 Standards of Care for procedures including breast removal surgeries without scientific justification. According to the complaint, internal discussions revealed that some WPATH leaders had difficulty identifying evidence-based reasons to support the change.

Kurt Miceli, medical director of Do No Harm, a medical ethics advocacy organization, said the allegations raise serious questions about how the organization's guidelines were developed.

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“The conflicts of interest that are within the standards of care are significant and, again, are not brought to light, and this is part of that deception, and the concern that WPATH has stated that the science is behind pediatric medical transition when it is not.”

Federal regulators allege that many of the doctors and surgeons who helped write the WPATH guidelines had financial and professional interests tied to the recommended treatments.

“What WPATH did was fill the deck with people who had a financial interest invested in promoting pediatric medical transition, and subsequently you get guidelines that push hormones, puberty blockers and surgeries,” Miceli said.

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The lawsuit contends that WPATH's influence extends far beyond its members. Its Standards of Care have been widely cited throughout medicine and have helped shape treatment protocols, insurance coverage decisions, and professional guidance throughout the United States.

WPATH is a co-sponsoring organization of the Endocrine Society's widely used clinical practice guideline on gender dysphoria and incongruence. The American Academy of Child and Adolescent Psychiatry describes the WPATH and Endocrine Society guidelines as the two best-known clinical guidelines used by providers caring for youth with gender dysphoria.

Among the most serious allegations are claims that WPATH promoted pediatric transition procedures as “lifesavers” despite insufficient evidence that such interventions reduce suicide risk.

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The complaint cites cases in which parents were allegedly asked whether they would “rather have a living daughter or a dead son” when considering treatment options for their children.

“When WPATH says these are life-saving interventions, and then we hear doctors say to parents, 'Would you rather have a dead son or a living daughter?', and we hear that phrase repeated, which again is not supported by evidence in any way,” Miceli said.

“The benefits that WPATH claims actually don't exist,” Miceli told Fox News Digital. “In fact, the benefits are very little certain.”

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Graham Linehan poses with a sign that reads “There is no such thing as a transgender child” outside Westminster Magistrates' Court in London on September 4, 2025. (Dan Kitwood/Getty Images)

The complaint alleges that some minors who underwent medical transition experienced lasting complications, including chronic pain, sexual dysfunction, urinary incontinence, fertility problems, nerve damage, and ongoing psychological distress.

WPATH rejected the allegations Wednesday, calling the lawsuit politically motivated and legally flawed.

“This is the second time this year that the Trump Administration has abused the authority of its agencies to interfere with Americans' rights to seek and obtain health care that must be decided between a patient and their doctor,” the organization said in a statement.

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“For more than 50 years, WPATH has been committed to developing guidelines based on established scientific standards, expert consensus, and patient-centered values.”

Miceli said the lawsuit should prompt a broader review by medical organizations that have relied on WPATH's guidance.

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“We need the American Medical Association, the Endocrine Society, the American Academy of Pediatrics, the American Psychiatric Association… the list goes on; we need them to look at the evidence as well, and they need to do it immediately,” he said.

“The standards of care are terribly flawed and, again, have caused considerable harm as a result,” Miceli continued.