The United Nations special envoy on violence against women and girls is speaking out against the World Health Organization’s “one-sided” approach to its development of new guidelines on transgender healthcare and gender transition medicine.
Reem Alsalem sent a letter to WHO Director-General Tedros Adhanom Ghebreyesus on Jan. 4 criticizing the composition of the working group developing the guidelines for their strong support of hormonal and surgical treatment for gender dysphoria.
“The majority of the [guideline development group] clearly have strong, one-sided views in favor of promoting hormonal gender transition and legal recognition of self-asserted gender,” wrote Alsalem.
Alsalem also highlighted that from the 21-person group, “not one appears to represent a voice of caution for medicalizing youth with gender dysphoria or the protection of female only spaces.”
A spokesperson for the WHO told the Washington Examiner that the anticipated guidelines are “focused on adults only.”
Originally from Cairo, Egypt, Alsalem was an independent consultant to the U.N. on gender issues and gender-based violence before being appointed to her current position in 2021. Her limited term in office is scheduled to conclude in August 2024.
Several women’s rights and medical groups in the United States and Europe have questioned the medical safety of gender transition medicine, especially for minors.
In July, an international group of doctors from Europe, Africa, and the United States emphasized that psychological therapy ought to be the first line of treatment for gender dysphoric youth, contradicting other groups such as the Endocrine Society.
Experts in Finland, Sweden, and England have also called for stronger evidence-based approaches to youth gender transition that also consider comorbidities of gender dysphoria, such as autism, psychological trauma, and same-sex attraction.
“The vast majority of individuals contacting gender-related services worldwide are now adolescents and young adults who had no prior history of gender-related distress, and whose gender dysphoria appeared only after puberty in the context of complex mental illness and neurodiverse diagnoses,” wrote Alsalem.
The WHO has been compiling the guidelines development group since June, but the group’s composition was not announced publicly until late December, with only three weeks of open comment on the composition.
Alsalem called on Ghebreyesus to extend the period for comment on the group’s composition until “at least the end of February 2024 for it to be meaningful.”
The WHO spokesperson told the Washington Examiner that the notice phase for the guideline development group is the appropriate process to “solicit feedback from the public and relevant stakeholders” and that “all views will be weighed on the composition of” the working group.
“WHO guidelines are always based on balancing of available evidence, human rights principles, consideration of harms and benefits and inputs of end users and beneficiaries,” said the organization’s spokesperson.
The WHO has not publicly responded to Alsalem’s letter.
The WHO has been compiling the guidelines development group since June, but the group’s composition was not announced publicly until late December, with only three weeks of open comment on the composition.
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Alsalem called on Ghebreyesus to extend the period for comment on the group’s composition until “at least the end of February 2024 for it to be meaningful.”
The WHO has not publicly responded to Alsalem’s letter, nor have they responded to the Washington Examiner’s request for comment.
