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Open letter to EPATH

Updated: Dec 18, 2021


EPATH Succalaan 26 Destelbergen 9070 Belgium August 11, 2021


Dear EPATH National Conference 2021 Representatives,

We are an international alliance of organisations seeking to promote safe, compassionate, ethical and evidence-based healthcare for children, adolescents and young adults with gender dysphoria. We represent thousands of people, from those who have experienced gender dysphoria to parents, doctors and members of the LGB community. As EPATH holds a three day conference in Gothenburg, we have a number of questions we would like EPATH to answer:

  1. The epidemiology of paediatric cases has changed markedly from prepubescent males to adolescent girls, now the largest group consulting transgender health specialists. What plans does EPATH have to produce more objective research and statistics on this phenomenon, especially in terms of social factors?

  2. Recent epidemiological shifts remain poorly understood and have profound implications for treatment decisions. Since they were not included in the basic research evaluating medical treatment of gender dysphoric minors, how does EPATH seek to correct this?

  3. How will EPATH guidelines account for the high levels of mental health and neurocognitive comorbidities - particularly autism - among cases of gender dysphoria?

  4. Where medical transition occurs on the basis of a superficial assessment and is later regretted, what measures does EPATH set in place to ensure that such poor clinical practice is corrected?

  5. The UK National Institute of Health and Care Excellence states that the potential benefits of hormones must be weighed against their largely unknown long-term safety profile when it comes to children and adolescents with gender dysphoria. How does EPATH intend to conduct prospective, longitudinal, ethically approved research on gender dysphoria in children and adolescents?

  6. The correlation between gender dysphoria and suicidality side-lines the precautionary principle. Most research on this relationship is biased and of poor quality. How does EPATH intend to demonstrate the suicide rates being claimed?

  7. Gender non-conforming behaviours and interests in childhood are highly predictive of homosexual orientation in adulthood. How do EPATH guidelines safeguard against conversion therapy under another name?

We are confident that EPATH will agree with us that young people with gender issues deserve quality support, based on impartial and up-to-date medical evidence. In this spirit, we look forward to their responses to our questions.


Signatories: AMQG (Switzerland)

Bayswater Support (UK)

Gender Dysphoria Alliance (Canada)

Gender Dysphoria Support Network (Europe)

GENID (Sweden, Norway)

Genspect (international)

Kirjo (Finland)

La Petite Sirène (France)

LGB Alliance

No Corpo Certo (Brazil)

Our Duty (UK, Germany, Australia, USA)

Parents of ROGD Kids (UK, Germany, USA)

Post Trans (Belgium)

Thoughtful Therapists (UK and Ireland)

TransTeens Sorge berechtigt (Germany)

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