Erin Reed is Lying to You - Part II

After the release of the WPATH Files, trans activist Erin Reed published a ‘fact check’ of them. Here’s part II of everything he left out.

Reed on X.

Last week, I published part I of my rebuttal to cult journalist Erin Reed’s fact-check of the WPATH Files. In the comments section, someone accused me—among other things—of refusing to engage with the substance of Erin’s article. I hope that commenter will be more satisfied with this installment. 

In Reed’s reporting on the files, he claims to have found “216 errors, misrepresentations, and faulty citations.” Yet he fails to present the full list of errors at any time—despite my detractor claiming that he “thoroughly documents” them. In part II, I’ll be responding to the six or seven out of 216 supposed factual errors Reed actually included in his fact-check. 

2% Fatality Rate

The first point of contention is the death rate associated with ‘sigmoid vaginoplasty’, a form of neo-vaginoplasty which uses the patient’s colon to create a simulacrum of female genitalia. 

Another claim was that a study supported a “2% fatality rate” for gender affirming surgery for those who have a sigmoid vaginoplasty, of which the report states “This one death represents an almost 2% fatality rate. In any other field of medicine, such a high fatality rate would result in the experiment instantly being halted and carefully studied to investigate what went wrong.” A review of the citation reveals a single case report of a death which occurred from a wound infection, a potential complication for any surgery. What the report leaves out, however, are that there are many recent studies designed to look at surgical complication rates, including a much newer study with a sample size of 366 patients and only 2 who experienced “major complications,” with no deaths.

Again, Reed misrepresents the report’s claims, making it seem as if the author claims a 2% fatality rate for all sigmoid neo-vaginoplasties. Instead, the report accurately states that one death was associated with surgery in the Dutch study, amounting to a 2% fatality rate for that study alone, not in all sigmoid neo-vaginoplasties. From the report:

This one death represents an almost 2% fatality rate associated with surgery in the Dutch study. In any other field of medicine, such a high fatality rate would result in the experiment instantly being halted and carefully studied to investigate what went wrong.

Erin states that the death “occurred from a wound infection, a potential complication for any surgery.” While infection is always a risk, JAMA reports that only 0.5-3% of patients will experience an incision site infection post-surgery. Complication rates for colon neo-vaginoplasties, on the other hand, are considerably higher. In the study Erin cites, the authors report a 20% complication rate. While only two of the patients are reported as having “major” complications, the paper inexplicitly categorizes “clitoral necrosis,” or irreversible tissue death of the genitals, as a minor complication. Of the two cases noted as having major complications, the report has the following to say, which Erin also leaves out.

Both patients experienced significant post-operative complications, including stenosis and abscess formation, leading to sigmoid conduit ischemia and necrosis. These complications required major surgical interventions and multidisciplinary care, highlighting the complexity of these procedures and their potential morbidity.

Because of the complexity and potential morbidity the report notes, sigmoid neo-vaginoplasty is usually a last resort to create the desired genitals for MtF patients who have had their puberty suppressed. Puberty suppression leaves these patients with pre-pubescent genitalia, meaning there isn’t enough tissue for a standard neo-vaginoplasty, in which the patient’s penis is inverted and a cavity referred to as a vagina is created. In both sigmoid and standard neovaginoplasties, patients must insert dilators into the wound regularly for the rest of their lives to keep it open. Erin leaves all of this out too. I wonder why?

The section of the colon used to create a “vagina” in male patients who’ve had their puberty suppressed.

Anorgasmia 

Next, Erin takes a swing at the claims of anorgasmia in puberty suppressed patients.

All of these and many more misrepresented citations are then used to frame various portions of the “leaks” as scandalous or negative. For instance, they follow the incorrect claim that citations “do not show positive outcomes” with a discussion between WPATH members centering best practices on the ability transgender people to orgasm after puberty blockers, presumably to highlight the aforementioned “no positive outcomes.”

In this example, Reed tries to paint a discussion between WPATH members on puberty blockers and sexual functioning as merely a conversation on best practices—and not the highly disturbing interaction that it is. Here is the full quotation about the discussion mentioned, which Erin leaves out.

Bowers then said the question of whether or not these young males will be able to achieve orgasm later in life was “thornier,” with the WPATH president admitting that all personal clinical experience up to that point indicated that boys who have their puberty blocked at Tanner Stage 2, the beginning of pubertal development, are completely unable to orgasm. “Clearly, this number needs documentation, and the long-term sexual health of these individuals needs to be tracked,” said Bowers. [Emphasis added.]

This quote shows that WPATH president Marci Bowers knows that patients prescribed puberty blocking drugs have no orgasmic potential. But just in case you needed more proof, here’s a video where Marci states that “every single child who was or adolescent who was truly blocked at Tanner Stage 2 has never experienced orgasm. I mean, it’s really about zero.”

Erin continues this example by stating:

To ensure factual accuracy, studies have shown that those who took puberty blockers are capable of orgasm and are satisfied with their sex lives, with 84% reporting orgasm capability and 12% not trying, similar to cisgender rates of anorgasmia.

Comparing the rate of “cisgender” (normal) rates of anorgasmia to trans-identified rates is incredibly dishonest. Anorgasmia in trans patients is almost always iatrogenic, meaning it’s caused by medical treatment. In the survey of ‘cisgender’ patients Erin cites, factors contributing to anorgasmia include sexual abuse, boredom, fatigue, shyness, and lack of knowledge. None of these are doctor-induced. The closest thing to iatrogenic anorgasmia reported in the survey are prescription drugs like Prozac and Zoloft—but these medications can be discontinued at any time, while puberty suppression followed by genital surgery is irreversible. 

The survey also tracks women’s rates of anorgasmia, not men’s, which would be a much more accurate comparison for anorgasmia in ‘transfem’ patients—who are male. Reed’s source reports that “about 10% to 15% of women have never had an orgasm,” while rates of secondary anorgasmia in men are only about 4%. 

Next, let’s look at the sources Reed cites to back up the claim that puberty suppressed patients “are capable of orgasm and are satisfied with their sex lives.” The first, an article in the Journal of Sexual Medicine on sexual functioning  in puberty suppressed patients, states that “[t]his group of relatively young transgender women reported satisfactory functional and esthetic results of the neovagina and a good quality of life, despite low Female Sexual Function Index scores.” [Emphasis added.]

Patients’ ability to orgasm is not mentioned in the results or conclusion of the article (the full version is not available), even though Erin cites this source to back up his claim that those who took puberty blockers are “capable of orgasm.” In the results section, the authors calculate a median score for all criteria of Cantril's Ladder of Life Scale except for sexual function, which they conveniently leave out.

The second source Erin cites is an article in PubMed tracking the sexual experiences of young trans-identified people during and after “gender affirmative treatment.” Erin uses this citation to back up his claim that puberty suppressed young people “are satisfied with their sex lives”— but the study only tracks patients for one year post-surgery. This is not nearly enough time to gauge patients’ full satisfaction with their sexual function or ability to form long-term relationships. A sort of honeymoon period is likely to set in after surgery, which can last from three months to a year post-op. The Society for Evidence-based Gender Medicine has raised concerns over this honeymoon period, noting that short-term improvements in mood do not provide credible evidence that irreversible genital procedures will ensure satisfaction in the long-term. 

This study also notes that patient reports of sexual intercourse increased from 16.2% to 37.6% after surgery compared to before surgery. This means that less than 40% of patients undergoing gender treatments are even having sex at all. Almost 60% of the patients in this study have yet to find out if they have full sexual functioning. How is this proof of a satisfactory sex life after total puberty suppression, exactly? It remains a mystery, dear reader.

Conversion Therapy 

In trans circles, the specter of conversion therapy looms large. Activists constantly assert that therapists are engaging in conversion therapy of trans people— but when these allegations are probed deeper, they’re revealed to be little more than exploring root causes for declaring an opposite sex identity. When anything other than affirmation is conversion, everything becomes conversion. Erin has this to say on conversion therapy:

For instance, it incorrectly conflates gender identity and sexuality, claiming that gender-affirming care is “a new form of conversion therapy” that “sterilizes lesbians and gays.” Gender identity and sexuality are fundamentally distinct. Regarding the claim of transition being a form of “conversion therapy,” evidence indicates that the vast majority of transgender individuals do not identify as straight after transitioning. Therefore, if transition were meant to serve as “conversion therapy,” it is notably ineffective in such an endeavor.

Critics of trans medicine are well-aware of the distinction between sexual orientation and so-called gender identity. The former describes which sex someone is attracted to, while the latter describes an invisible, supposedly innate woman or man essence. And despite Reed’s claims, transition is undoubtedly being used as a mechanism to convert gay children into straight members of the opposite sex. Parents such as Kimberly Shappley, mother of forced activist Kai Shappley, all but admit this. 

“I remember even thinking before Kai was three that I think this kid might be gay” says Kimberly in an interview with Them. “And I thought that that could not happen. And that would not happen. We started praying fervently. Prayers turned into googling ‘conversion therapy’, and how can we implement these techniques at home to make Kai not be like this. Putting her in timeout for acting like a girl, putting her in timeout for stealing girl toys, spanking her—really spanking her—every time she would say, ‘You know I’m a girl.’” 

Kimberly, in a moment of remarkable candidness, confesses to beating her effeminate son into girlhood. And she’s not the only one. Many de-transitioners, especially women, have confirmed that they too, transitioned to escape the stigmatization associated with same sex relationships. Research shows that historically, gender-nonconforming children were much more likely to grow up to be gay men and lesbian women rather than trans-identified. Now, however, parents and medical professionals are transing them before they even have a chance. In cases like Kai’s and countless others like him, transition is a ‘notably effective’ form of conversion therapy.

Erin Reed and fiancé Zooey Zephyr with Kai Shappley.

While transition as conversion therapy is a sad reality for many young people, this is not the case for everyone. Many so-called trans lesbians, or ‘transbians’ as they call themselves, transition due to a paraphilia known as autogynephilia, or (say it with me) a male’s tendency to be sexually aroused by the thought or image of himself as a woman. Many of these supposed male lesbians pursue relationships with women or with other autogynephiles, making their relationships ‘not straight’ in Erin’s estimation. In reality, he’s half right— they’re either in straight relationships with women or homosexual relationships with other men. 

Gender Diagnoses

Next, Reed takes issue with the report’s claim that most gender dysphoric children will naturally desist and reconcile with their sex if allowed to experience natural puberty. To me, this is a claim so obvious as to not need evidence, but here we are. According to Reed, the two studies the report references to make this claim—which he suspiciously doesn’t link to—use outdated diagnostic criteria. He points out that gender identity disorder in the DSM-IV doesn’t strictly require “desire or insistence to be the other sex,” but what he leaves out is that a diagnosis of gender dysphoria in the DSM-5 requires only this, making it more permissive in many cases. 

Reed also omits that WPATH advises healthcare providers to use the World Health Organization’s International Classification of Diseases (ICD-110) classification of gender incongruence instead of the DSM’5’s gender dysphoria. From the report:

A diagnosis of gender incongruence is even easier to obtain than one of gender dysphoria because all the patient needs to experience is a marked incongruence between their internal sense of self and their biological sex. There is no requirement for the presence of distress as a criterion, meaning a patient’s “embodiment goals” can be deemed medically necessary care.

Contrary to what Reed argues, WPATH is promoting a diagnosis that would result in more young people transitioning, not less.

Reed then asserts that more modern research shows desistance rates of 2.5%, with “97.5% of patients continuing to identify as transgender after social transition.” However, the study he links to in order to back up this claim follows patients only five years after receiving medical care, not nearly long enough to establish accurate rates of desistance or regret. 

Additionally, social transition has proven to be a less than neutral choice, as interventions like new names, pronouns, and clothing can actually cement a child’s cross-sex identity, worsen fears of puberty, and create a perverse incentive for the child to persist in their trans identity—due to both increased positive attention and the overwhelming anxiety associated with changing one’s mind after mountains have been moved for them. 

Editorialized Claims - Rapid fire round

Since this article is already long enough and Erin himself spends barely any time on them, we’ll break down the supposed editorialized claims made in the report, rapid fire style. Here’s the first:

For instance, an editorialized description of an exchange in the WPATH forums suggests that "a patient was leaking prostate secretions through the urethra after vaginoplasty and found it bothersome." However, upon examining the actual exchange, it is revealed that the patient was actually "noticing an ejaculate with orgasm through her urethra," which significantly alters the context - directly contradicting the editorialized assertions made earlier that transgender individuals are often incapable of orgasm.

According to Reed, the report misrepresents an exchange about a male patient who had undergone neo-vaginoplasty leaking prostate secretions, when in reality he was just “noticing an ejaculate with orgasm” despite having a so-called vagina. The ejaculate is described as being “without sperm of course, because the testicles have been removed.” I fail to see how this is any better. This patient may be able to orgasm, but he’s also been rendered permanently sterile. 

Reed also claims that this one patient’s ability to orgasm contradicts “the editorialized assertions made earlier that transgender individuals are often incapable of orgasm.” This one patient doesn’t disprove the claim made, especially since the report refers specifically to puberty suppressed youth being anorgasmic, not “transgender individuals” as a whole.

Claim #2:

Another misrepresentation of the leaked material states, “There is talk about detransition being just another step in a patient’s “gender journey.”...However, a closer examination of the actual WPATH leak reveals that it was not a clinician but the detransitioner themselves who described their experience as part of a "gender journey," specifically noting they were detransitioning without regret - something that harms the editorialized report’s portrayal of regret among trans people.

The report doesn’t claim that a clinician made this statement. One de-transitioner using the language of gender ideology to diminish its impact does not mean he or she was any less harmed by it. As for regret, we simply don’t have accurate data on the true rates of detransition yet, as we’ve only been conducting this unregulated experiment on children for a few decades at the most. I believe the detransition bomb has yet to detonate. 

Claim #3:

Another portion of the editorialized assertions includes a patient discovering "two liver masses" identified as hepatic adenomas, with doctors suggesting "the likely offending agents are the hormones." However, this claim omits the fact that the patient was also taking "oral contraceptives," and it fails to mention that hepatic adenomas are benign. These tumors are more commonly observed in individuals who use birth control pills and are described as "rare but benign epithelial tumors of the liver frequently associated with oral contraceptive pill use." This omission likely explains why the phrase "and/or oral contraceptives" was excluded from the editorialized claim. Furthermore, this information, alongside a solitary post about a transgender individual developing cancer, has been inaccurately used to assert that WPATH privately considers hormone therapy a cause of cancer.

By focusing so heavily on benign tumors found in one patient, Reed likely hopes you won’t notice the “solitary post about a transgender individual developing cancer,” he snuck in there at the end. As revealed in the files, a trans clinician developed and eventually died from liver cancer after taking cross-sex hormones for years. 

While both WPATH and Reed are free to ignore the evidence, research has displayed a clear link between synthetic hormones and cancer. A 2019 study of trans-identified males in Amsterdam found that there was an “increased risk of breast cancer” in patients who had received hormone therapy. A 2020 paper describes a case in which a 17-year-old trans-identified female developed liver tumors after taking testosterone. A systematic review of the literature published in 2023 notes that “Forty-nine papers had cases of hepatocellular adenoma, hepatocellular carcinoma, cholangiocarcinoma, or other biliary neoplasm in the setting of testosterone administration.” Newsweek notes that “Gender-affirming hormone therapies have also been linked to other forms of cancer—though research has so far been inconclusive.” Let’s hope they eventually lack enough guinea pigs to continue. 

Hopefully, if you’ve made it this far, I’ve made a fair and convincing case for how Reed has misrepresented the WPATH Files to his many followers. Although it seems unlikely any of them will engage with what I’ve written, due to the many egregious instances of correctly identifying his sex.

Thanks for reading!

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