When Manufactured Evidence Meets Institutional Ambition
When Manufactured Evidence Meets Institutional Ambition
Stella O'Malley's latest piece, "Why Genspect Is Following WPATH Across the World," reads like a victory speech. The tone is confident, even triumphant. Positioning Genspect as the credible institutional alternative to a supposedly discredited WPATH. O'Malley presents their organization's evolution from "tea shop indignation" to serious medical reformer as a natural progression driven by mounting evidence of WPATH's failures.
The narrative arc is compelling: scrappy upstarts who dared to question medical orthodoxy, vindicated by revelations that exposed institutional corruption, now stepping forward as the rational alternative. O'Malley cites several key pieces of evidence as the foundation for this transformation: the WPATH Files that allegedly revealed internal dysfunction, the Cass Review that supposedly demolished the evidence base for gender-affirming care, and historical claims about the Dutch Protocol's problematic origins and expansion.
These are serious allegations that deserve serious examination. If accurate, they would indeed justify Genspect's positioning as a necessary institutional alternative. If the evidence O'Malley presents is sound, their confidence in declaring victory over WPATH would be warranted.
But evidence requires scrutiny, not acceptance. Claims about institutional failure demand the same rigorous fact-checking we would apply to any consequential allegation. The potential for harm is too great for healthcare systems, for medical professionals, and most importantly, for the patients who depend on evidence-based care to simply accept such sweeping indictments without thorough investigation.
Let's examine each piece of evidence O'Malley presents, starting with the WPATH Files that supposedly exposed institutional corruption, then moving to the Cass Review's methodology and conclusions, and finally to the historical claims about the Dutch Protocol. Only after this systematic examination can we properly evaluate whether Genspect's victory lap is premature or justified.
The WPATH Files: Examining the Evidence
O'Malley treats the WPATH Files as their smoking gun, the devastating revelation that supposedly exposed WPATH as a "zombie organisation staggering forward with no credibility." The reality is considerably less dramatic and far more instructive about the methods of modern propaganda.
Erin Reed's comprehensive fact-check identified 216 instances of factual errors in the WPATH Files report [1]. This is not a document that occasionally gets details wrong, it is a systematic distortion machine that spends 37,000 words telling readers what to think about cherry-picked excerpts from internal communications [1]. The authors were not neutral investigators uncovering institutional failures; they were ideologically motivated activists upset that the leaked communications showed trans people reporting positive outcomes from their care [1].
The Files authors' own words reveal their bias. They expressed frustration that trans people were "suspiciously happy" with their healthcare outcomes, a reaction that tells us everything about their predetermined conclusions [1]. When your investigation is derailed by evidence that contradicts your thesis, in this case, that gender-affirming care harms people, you are not conducting science. You are conducting propaganda.
The decontextualization is systematic and deliberate. Internal discussions about complex clinical cases are presented as evidence of malpractice, when they actually demonstrate thoughtful clinical consideration of challenging situations. Conversations about patients with comorbid mental health conditions are framed as evidence of reckless endangerment, when they show clinicians grappling responsibly with the reality that trans people, like all people, sometimes have multiple healthcare needs.
Reed's analysis exposes the Files as what they actually are: a heavily editorialized hit piece designed to create the impression of institutional failure where none exists [1]. The 37,000 words of commentary vastly outweigh the actual leaked material, serving as an interpretive framework that tells readers how to understand communications that, in their original context, show a medical organization doing exactly what medical organizations should do—discussing complex cases and evolving best practices.
The Files were produced by Environmental Progress, an organization with no medical expertise but considerable ideological motivation [2]. Michael Shellenberger, the primary author, has built a career on manufacturing controversies where none exist, and the WPATH Files represent his most ambitious attempt yet to weaponize selective editing and decontextualization in service of anti-trans activism [2][3].
The Cass Review: Evaluating the Academic Response
O'Malley's treatment of the Cass Review as vindication of their position demonstrates either profound misunderstanding of evidence evaluation or deliberate misrepresentation. The academic response to the Cass Review has been devastating, but not in the way Genspect imagines.
Yale Law School's comprehensive analysis found that the Review "misinterprets and misrepresents its own data" and "levies unsupported assertions about gender identity" [4]. The Yale researchers concluded that "although the Cass Review does criticize the evidence base for gender-affirming care, the Review's conclusions in this regard are unsupported" [4]. This is not a minor methodological quibble, it is a fundamental indictment of the Review's scientific integrity.
Multiple academic critiques have identified systematic problems with the Review's approach [5][6]. The Review applies evidence standards to gender-affirming care that are not consistently applied to other medical treatments, creating an impossible bar that no healthcare intervention could meet. It excludes trans researchers from the review process while including team members with documented links to anti-trans organizations [6]. Most tellingly, it dismisses evidence that contradicts its predetermined conclusions while accepting lower-quality evidence that supports them.
The Review's influence stems not from its scientific merit but from its utility to those seeking to restrict trans healthcare. It provides the veneer of evidence-based analysis while reaching conclusions that align perfectly with anti-trans political goals. This is not coincidence, it is design. The Review was commissioned not to evaluate evidence objectively but to provide academic cover for predetermined policy positions.
The Dutch Protocol: Examining Historical Claims
O'Malley's account of the Dutch Protocol's development and expansion contains enough distortions to fill a separate article. They present Dr. Annelou de Vries as an unwitting architect of medical catastrophe, comparing the protocol's expansion to nuclear proliferation. This framing is not merely hyperbolic, it is fundamentally dishonest about both the protocol's origins and its outcomes.
The Dutch Protocol was never intended as a universal treatment for all gender-dysphoric youth. It was developed for a specific population, adolescents with persistent, well-documented gender dysphoria who met strict criteria for treatment. The protocol's expansion reflects not reckless abandonment of standards but evolving understanding of gender diversity and improved access to care.
O'Malley's claim that "most children who experience gender dysphoria will desist without medical intervention" relies on outdated studies with significant methodological problems. These studies often conflated gender nonconformity with gender dysphoria, included children who never met criteria for gender dysphoria diagnosis, and used follow-up methods that systematically undercounted persistence[20][21]. Modern research with more rigorous methodology shows much higher persistence rates among adolescents who meet current diagnostic criteria[22][23].
The characterization of the protocol's outcomes as catastrophic ignores the substantial body of research showing positive outcomes for appropriately selected patients. O'Malley cherry-picks negative outcomes while ignoring systematic reviews that demonstrate the protocol's effectiveness when properly implemented.
Current Dutch guidelines still recommend their protocol despite criticism from anti-trans organizations[7]. Dutch pediatric gender clinics continue defending their approach and emphasize their "holistic approach" remains standard in the Netherlands [7]. The original researchers continue publishing and defending their work with 20-year follow-up studies [8][9].
This selective presentation of evidence is not accidental. It serves Genspect's broader narrative that all gender-affirming care is harmful, regardless of patient selection, implementation quality, or outcome measurement. The Dutch Protocol becomes not a medical intervention with specific indications and contraindications, but a symbol of medical overreach that must be eliminated entirely.
Examining the Source Network
Having dismantled O'Malley's foundational claims, we can now understand why their transmisic worldview necessitates such systematic deception. Genspect's fundamental premise, that gender-affirming care is inherently harmful and should be eliminated, cannot be supported by honest engagement with the evidence. This creates a problem that can only be solved through the systematic manufacture of contrary evidence.
The sources O'Malley treats as credible; SEGM, Alliance Defending Freedom, Heritage Foundation, Manhattan Institute, are all part of what the Southern Poverty Law Center has documented as an interconnected anti-trans advocacy network [10]. These organizations share funding sources, cross-reference each other's "research," coordinate messaging and strategy, and present themselves as independent while operating as a unified campaign.
SEGM, which O'Malley cites extensively, presents itself as a medical organization but functions primarily as an anti-trans advocacy group [11]. Its members regularly appear at Genspect conferences, contribute to anti-trans legal briefs, and coordinate messaging with other network organizations. The appearance of independent medical consensus is manufactured through this circular citation pattern.
Alliance Defending Freedom, another frequent source in O'Malley's piece, is a legal advocacy organization with an explicitly anti-LGBTQ+ mission [10]. Their "medical" reports are produced not by healthcare researchers but by lawyers and activists seeking to provide legal ammunition for restricting trans healthcare. The organization has been designated as a hate group by the Southern Poverty Law Center for its systematic campaigns against LGBTQ+ rights.
The organization's evolution from "tea shop indignation" to institutional alternative reveals the sophistication of modern anti-trans activism. Rather than relying on crude bigotry or religious objections, they have learned to weaponize the language of evidence-based medicine and patient safety. They present themselves as concerned healthcare reformers rather than ideological opponents of trans existence.
This strategy requires constant production of evidence that supports their predetermined conclusions. When legitimate evidence does not exist, it must be manufactured through selective citation, decontextualization, and systematic misrepresentation. The WPATH Files, Cass Review, and distorted Dutch Protocol narrative all serve this function—they create the appearance of scientific consensus where none exists.
Historical Analogies and Self-Positioning
The historical analogies O'Malley employs, comparing WPATH to Nazi Germany and positioning themselves as principled opponents of appeasement, reveal the grandiose self-conception that drives their movement [12][13]. They are not healthcare reformers seeking incremental improvement; they are crusaders seeking total victory over an enemy they have constructed through systematic distortion of evidence.
The comparison of medical guidelines to the Munich Agreement or Vichy France is not merely overwrought, it is fundamentally dishonest about the stakes involved. WPATH is not a totalitarian regime threatening global democracy; it is a medical organization providing clinical guidelines for healthcare providers. The hyperbolic language serves to justify extreme measures against what is, in reality, standard medical practice.
Their refusal to engage with WPATH reflects not principled opposition to institutional failure but recognition that honest engagement would expose the manufactured nature of their evidence base. Collaboration requires good faith, and good faith requires honest engagement with evidence. Genspect's entire project depends on avoiding such engagement.
The historical analogies also reveal the apocalyptic thinking that characterizes anti-trans activism. In their worldview, gender-affirming care represents not a medical intervention with benefits and risks like any other, but an existential threat requiring total elimination. This framing justifies any means necessary to achieve their ends, including systematic deception about evidence and outcomes.
The Gender Framework: Examining the Alternative
O'Malley's description of their forthcoming Gender Framework reveals the ultimate goal of their evidence manufacturing operation, the creation of parallel institutions that can implement their ideological vision without the constraints of scientific accountability [14][15]. The Framework promises "evidence-based alternatives" while systematically rejecting the evidence base that supports current practice.
The Framework's emphasis on "multiple pathways into and out of gender-related distress" sounds reasonable until one recognizes it as code for conversion therapy approaches that have been rejected by legitimate medical organizations. The focus on "neurodevelopmental conditions, mental health factors, and sociocultural influences" represents not holistic care but systematic pathologization of trans identity.
This approach treats gender dysphoria not as a legitimate medical condition requiring appropriate treatment but as a symptom of underlying pathology that must be eliminated. The Framework does not offer alternatives to gender-affirming care—it offers alternatives to recognizing trans people as legitimate.
The Killarney Group's composition—"experts in biology, psychology, philosophy, sociology, law, medicine, and education"—sounds impressive until one examines the actual credentials and affiliations of its members [16]. Many are connected to the same anti-trans network that produced the WPATH Files and influenced the Cass Review. This is not interdisciplinary expertise but ideological coordination across multiple fields.
The Framework represents the institutionalization of conversion therapy under the guise of evidence-based medicine. By positioning their approach as the "rational alternative" to current practice, they seek to legitimize systematic attempts to eliminate trans identity through psychological manipulation and social pressure.
WPATH's Institutional Response
While O'Malley portrays WPATH as a discredited organization in retreat, the reality is quite different. WPATH has responded systematically to manufactured criticisms while continuing to advance evidence-based care for trans people [17][6].
WPATH's response to the Cass Review methodically dismantled its methodological problems and biased conclusions [6][18]. The organization noted that the Review excluded trans researchers, relied on flawed evidence evaluation, and reached conclusions unsupported by its own data. WPATH's critique has been supported by multiple academic analyses that reached similar conclusions about the Review's fundamental flaws.
WPATH's public statements consistently emphasize evidence-based care, patient safety, and the importance of individualized treatment approaches [17][19]. The organization has condemned legislative attacks on trans healthcare as ideologically motivated rather than evidence-based, noting that such legislation "is not about protections for children but about eliminating transgender persons on a micro and macro scale."
Assessing the Victory Claims
O'Malley's victory lap is premature and based on fundamentally flawed premises. Their "success" in drawing attendees from WPATH conferences reflects not the superiority of their evidence but the effectiveness of their propaganda campaign. When you systematically manufacture evidence of institutional failure, some people will inevitably be convinced by the manufactured evidence.
The real test of Genspect's approach will not be their ability to attract conference attendees or produce alternative guidelines. It will be their ability to improve outcomes for gender-diverse people while maintaining scientific integrity. On this measure, they have already failed by building their entire project on systematically dishonest engagement with evidence.
Their positioning as the "rational, scientific alternative" to WPATH depends entirely on maintaining the illusion that their manufactured evidence represents legitimate scientific consensus. As more researchers examine their claims with appropriate skepticism, this illusion becomes increasingly difficult to maintain.
The ultimate irony of O'Malley's piece is that it demonstrates exactly why rigorous fact-checking is necessary when evaluating claims about trans healthcare. They present contextual criticisms, WPATH's supposed institutional failures, as if they were established facts requiring no further examination. Only by first exposing these "failures" as manufactured propaganda can we understand how their transmisic ideology necessitates such systematic deception.
Understanding the Risks
Behind the academic language and institutional posturing lies a simple reality: Genspect seeks to eliminate access to gender-affirming care for trans people. Their "evidence-based alternatives" are conversion therapy approaches designed to eliminate trans identity rather than support trans people. Their "institutional reforms" are systematic attempts to pathologize gender diversity and deny trans people access to appropriate healthcare.
The manufactured evidence serves this ideological goal by creating the appearance of scientific consensus where none exists. The WPATH Files, Cass Review, and other sources O'Malley cites are not independent confirmations of institutional failure, they are coordinated products of the same anti-trans network seeking to justify predetermined policy positions.
The stakes could not be higher for trans people, particularly trans youth, who depend on access to evidence-based healthcare for their wellbeing and survival. Genspect's "victory" would mean the systematic elimination of such care in favor of conversion therapy approaches that have been rejected by legitimate medical organizations for their documented harms.
O'Malley's confidence in their trajectory reflects not the strength of their evidence but the effectiveness of their propaganda operation. They have successfully manufactured the appearance of scientific controversy where none exists, creating doubt about well-established medical practices through systematic deception and ideological coordination.
Manufactured Consensus Exposed
Genspect's victory is illusory, built on foundations of manufactured evidence and sustained by networks of ideological coordination. Their "credible alternative" to evidence-based care is neither credible nor alternative, it is simply ideology dressed in the language of medical reform. The real victory will come when healthcare systems recognize this deception for what it is and recommit to providing ethical, evidence-based care for all gender-diverse people.
O'Malley's piece serves as a perfect example of how sophisticated propaganda operations function in the modern era. By weaponizing the language of evidence-based medicine, manufacturing the appearance of scientific consensus, and positioning ideological opponents as institutional reformers, they create compelling narratives that can deceive even well-meaning healthcare providers and policymakers.
The antidote to such deception is not more sophisticated propaganda but rigorous fact-checking, systematic exposure of coordinated networks, and unwavering commitment to actual evidence rather than manufactured alternatives. The trans community and their allies must continue to expose these deceptive practices while supporting legitimate research and evidence-based care.
The gender wars that O'Malley celebrates are not a battle between competing medical approaches, they are a systematic campaign to eliminate trans people from public life through the elimination of their healthcare. Recognizing this reality is the first step toward defending evidence-based care and protecting the vulnerable people who depend on it for their survival and wellbeing.
Citations
[1] Reed, E. (2024, March 5). Fact check: 216 instances of factual errors found in right-wing "WPATH Files." Erin in the Morning. https://www.erininthemorning.com/p/fact-check-216-instances-of-factual
[2] Environmental Progress. (2024, March 4). The WPATH Files. https://environmentalprogress.org/big-news/wpath-files
[3] Reed, E. (2024, March 20). "Delete this": Mistaken victory claims show why you should not trust the "WPATH Files." Erin in the Morning. https://www.erininthemorning.com/p/delete-this-mistaken-victory-claims
[4] Yale Law School. (2024, July 2). An evidence-based critique of the Cass Review. https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf
[5] Cheung, C. R. (2024). Gender medicine and the Cass Review: why medicine and the law make poor bedfellows. PMC, 12013558. https://pmc.ncbi.nlm.nih.gov/articles/PMC12013558/
[6] WPATH. (2024, May 17). WPATH and USPATH comment on the Cass Review. https://www.wpath.org/wp-content/uploads/2024/11/17.05.24-Response-Cass-Review-FINAL-with-ed-note.pdf
[7] Tijdschrift voor Geneeskunde. (2025, May 28). International criticism of the Dutch Protocol; time to change Dutch pediatric gender care and its guideline. https://pubmed.ncbi.nlm.nih.gov/40433715/
[8] Ristori, J., et al. (2023). Children and adolescents in the Amsterdam Cohort of Gender Dysphoria: trends in diagnostic- and treatment trajectories during the first 20 years of the Dutch Protocol. Journal of Sexual Medicine, 20(3), 398-409. https://academic.oup.com/jsm/article/20/3/398/7005631
[9] Society for Evidence-Based Gender Medicine. (2023, February 8). New "20-year" study from Amsterdam's VUmc Youth Gender Clinic: A critical analysis. https://segm.org/20-years-of-the-Dutch-Protocol-critical-analysis
[10] Southern Poverty Law Center. (2023, December 12). Dynamics within the anti-LGBTQ+ pseudoscience network. https://www.splcenter.org/resources/reports/defining-pseudoscience-network/
[11] Society for Evidence-Based Gender Medicine. (2024, July 11). WPATH influence undermines WHO's transgender guidelines. https://segm.org/wpath-evidence-manipulation-risks-discrediting-WHO-transgender-guidelines
[12] National Archives. (n.d.). Chamberlain and Hitler 1938. https://www.nationalarchives.gov.uk/education/resources/chamberlain-and-hitler/
[13] National WWII Museum. (2024, October 15). Appeasement and 'Peace for Our Time'. https://www.nationalww2museum.org/war/articles/appeasement-and-peace-our-time
[14] Genspect. (2024, June 24). Gender Framework: Sample policies. https://genspect.org/resources/gender-framework-sample-policies/
[15] Genspect. (n.d.). Medical ethics. https://genspect.org/resources/gender-framework-sample-policies/medical-ethics/
[16] Genspect. (2023, June 16). Genspect launches new think tank to draft a gender care framework. https://genspect.org/genspect-launches-new-think-tank-to-draft-a-gender-care-framework/
[17] WPATH. (n.d.). WPATH public statements. https://wpath.org/resources/public-statements/
[18] WPATH. (2024, May 17). WPATH statement regarding publishing of systematic reviews. https://wpath.org/resources/public-statements/
[19] WPATH. (2025, June 18). USPATH & WPATH condemn decision in US v Skrmetti allowing states to ban access to healthcare for transgender youth. https://wpath.org/
[20] Steensma, T. D., Biemond, R., de Boer, F., & Cohen-Kettenis, P. T. (2018). A critical commentary on "A critical commentary on follow-up studies and 'desistance' theories about transgender and gender non-conforming children" by Temple Newhook et al. (2018). International Journal of Transgenderism, 19(2), 225-230. https://doi.org/10.1080/15532739.2018.1468292
[21] Ristori, J., Cocchetti, C., Romani, A., Mazzoli, F., Vignozzi, L., Maggi, M., & Fisher, A. D. (2022). Defining desistance: Exploring desistance in transgender and gender expansive youth. PMC, 9829142. https://pmc.ncbi.nlm.nih.gov/articles/PMC9829142/
[22] Temple Newhook, J., Pyne, J., Winters, K., Feder, S., Holmes, C., Tosh, J., Sinnott, M. L., Jamieson, A., & Pickett, S. (2018). A critical commentary on follow-up studies and "desistance" theories about transgender and gender-nonconforming children. International Journal of Transgenderism, 19(2), 212-224. https://doi.org/10.1080/15532739.2018.1456390
[23] D'Angelo, R., Syrulnik, E., Ayad, S., Marchiano, L., Kenny, D. T., & Clarke, P. (2021). One size does not fit all: In support of psychotherapy for gender dysphoria. Archives of Sexual Behavior, 50(1), 7-16. https://doi.org/10.1007/s10508-020-01844-2
