Newly unsealed documents in a lawsuit against Alabama’s transgender surgery ban for minors revealed the Biden administration lobbied against including minimum age requirements in the World Professional Association for Transgender Health’s (WPATH) standards of care for surgeries.

In April 2022, Gov. Kay Ivey signed VCAP (SB184) into law, which prohibits doctors in Alabama from performing transgender operations or prescribing cross-sex hormones and puberty blockers to individuals under 19. Left-wing groups are currently suing the state of Alabama to try to get the law overturned.

Some discovery and deposition documents in the case were unsealed on Monday night. One of those documents showed internal communications of unnamed WPATH members developing a standard of care guidelines discussing lobbying efforts in 2022 from Biden administration officials such as Admiral Rachel Levine, who serves as the 17th Assistant Secretary for Health for the U.S. Department of Health and Human Services in Biden’s cabinet.

“The issue of ages and treatment has been quite controversial (mainly for surgery) and it has come up again. We sent the document to Admiral Levine…She likes the SOC-8 very much but she was very concerned that having ages (mainly for surgery) will affect access to health care for trans youth and maybe adults too,” one WPATH member wrote. “Apparently, the situation in the USA is terrible, and she and the Biden administration worried that having ages in the document will make matters worse. She asked us to remove them. We have the WPATH executive committee in this meeting and we explained to her that we could not just remove them.”

Another WPATH communication mentioned lobbying efforts by Levine’s chief of staff. 

“Sarah Boateng, who is Adm. Levine’s chief of staff (said the) biggest concern is the section below in the Adolescent Chapter that lists specific minimum ages for treatment, she is confident, based on the rhetoric she is hearing in D.C., and from what we have already seen, that these specific listings of ages, under 18, will result in devastating legislation for trans care,” another WPATH member said. “She wonders if the specific ages can be taken out and perhaps an adjunct document could be created that is published or distributed in a way that is less visible than the SOC8, is the best way to go.”

WPATH later removed age minimums at their next annual conference, according to the document. 

“I don’t see how we can remove something that important from the document…I realize that those in favor of the bans are going to go right to the age criteria and ignore the fact that we actually strengthened the strictness of the criteria to help clinicians better discern appropriate surgical candidates from those who are inappropriate…It’s all about messaging and marketing,” another WPATH member said. 

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