FTC and Four States Sue WPATH, Alleging Deceptive Guidance on Youth Gender Treatments

The Federal Trade Commission and four states sued the World Professional Association for Transgender Health and its U.S. affiliate in federal court Wednesday, alleging the influential medical group’s guidance helped clinicians make deceptive claims to parents about pediatric gender-transition treatments. The civil complaint, filed in the U.S. District Court for the Northern District of Texas, targets WPATH and the United States Professional Association for Transgender Health, or USPATH, over claims tied to puberty blockers, cross-sex hormones and surgeries for minors.

The FTC, joined by Alaska, Iowa, Nebraska and Texas, alleges the groups violated Sections 5(a) and 12 of the FTC Act, which prohibit unfair or deceptive practices and false advertising, and that they enabled false or unsubstantiated representations about the safety, effectiveness, medical necessity and scientific support for those interventions. The states also brought claims under their own consumer-protection laws. The complaint, filed as Case No. 4:26-cv-00748-P, seeks a permanent injunction and other relief.

WPATH is an international professional association whose Standards of Care are widely used by clinicians working in transgender health. The lawsuit centers on Standards of Care, Version 8, known as SOC-8, which WPATH published in 2022 and which includes chapters on adolescents, hormone therapy and surgery.

According to the complaint, WPATH’s recommendations and related materials misrepresented the degree of medical consensus behind pediatric transition services and overstated their benefits while understating their risks. The plaintiffs allege WPATH provided the “means” for clinicians to tell parents that such treatments were established, necessary and safe even when, the complaint says, those claims were not backed by competent and reliable scientific evidence.

Among the suit’s most significant allegations is that WPATH in 2022 removed age limits for procedures including mastectomy, often called top surgery, and genital surgery, and did so without a medical-evidence basis. The complaint also alleges that WPATH and clinicians relying on its guidance did not adequately disclose some adverse effects, including mood disturbances, pelvic pain and sexual dysfunction.

The complaint further alleges that WPATH and clinicians described pediatric transition interventions as “lifesaving” despite what the plaintiffs say is a lack of competent and reliable scientific evidence that the treatments reduce suicide risk. In one allegation, the complaint says some parents were asked whether they would “rather have a live daughter or a dead son.” The filing presents that as part of what it describes as deceptive marketing of medical services to families.

Another key allegation concerns insurance coverage. The plaintiffs say WPATH labeled nearly every pediatric transition service as “medically necessary” in order to increase the likelihood that insurers would pay for them, despite what the complaint describes as insufficient scientific support for those claims.

FTC Chairman Andrew N. Ferguson said in a statement announcing the case: “Today, the FTC filed a lawsuit against WPATH alleging that the organization made false and unsubstantiated claims regarding the necessity, effectiveness and safety of puberty blockers, hormones and sex-change surgeries.”

The FTC said the commission vote authorizing the complaint was 2-0.

Wednesday’s filing comes weeks after a separate fight between WPATH and the FTC in Washington, D.C. On May 7, Chief Judge James Boasberg granted a preliminary injunction blocking the FTC from enforcing a civil investigative demand against WPATH, finding the organization had shown a likelihood of success on a First Amendment retaliation claim. The new Texas case is a separate enforcement action, not the earlier dispute over the agency’s investigative demand.

The source materials for Wednesday’s case do not include a new response from WPATH or USPATH to the Texas lawsuit. In a May 8 statement about the earlier Washington case, WPATH said, “For more than 50 years, WPATH has been committed to developing guidelines informed by established scientific standards, expert consensus, and patient-centered values.” That statement was made in response to the D.C. ruling, not Wednesday’s complaint.

The case now moves to the Texas court, where the FTC and the four states will have to prove the allegations in their newly filed complaint.