{"id":1785,"date":"2026-07-29T15:08:19","date_gmt":"2026-07-29T15:08:19","guid":{"rendered":"https:\/\/blueroutejournal.com\/?p=1785"},"modified":"2026-07-29T15:08:19","modified_gmt":"2026-07-29T15:08:19","slug":"inside-wpath-trans-surgeon-admits-patients-may-experience-painful-complications","status":"publish","type":"post","link":"https:\/\/blueroutejournal.com\/?p=1785","title":{"rendered":"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications"},"content":{"rendered":"<div><div><p><i>The World Professional Association of Transgender Health (WPATH) is the world\u2019s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group\u2019s medical guidance, called the Standards of Care Version 8, informs clinical practice, insurance policy, and government regulations throughout the United States.<\/i><\/p><p>Read more <a href=\"https:\/\/blueroutejournal.com\/?p=1784\">Trump Vows To \u2018Beat The F*cking Sh*t Out Of\u2019 Iran After Its Sneak Attack On U.S. Troops<\/a><\/p><p><i>Systematic reviews and legal investigation have shown the SOC-8 to be built on faulty methodology and politicized science. The Federal Trade Commission filed a lawsuit against WPATH in June 2026, stating the organization has \u201cmisled parents and children about the medical consensus<\/i> and<i> medical necessity, as well as the safety and effectiveness\u201d of child sex-change interventions.<\/i><\/p><p><i>WPATH members receive access to a member-only<\/i> <i>forum<\/i><i> that discusses various topics related to transgender medicine and policy. Through a public records request The Daily Wire uncovered almost 250 pages of messages from WPATH\u2019s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization\u2019s cultural reach and challenge some of its public-facing recommendations. <\/i><\/p><p><i>This is the first article in The Daily Wire\u2019s investigative series on the uncovered WPATH messages.\u00a0<\/i><\/p><p>***<\/p><p>A pioneering transgender surgeon acknowledged that genital surgeries leave patients with painful complications and a burdensome recovery process many cannot cope with.<\/p><p>Members of the World Professional Association of Transgender Health (WPATH) discussed the pain and complications of vaginoplasty, a genital sex-change surgery, in an online member forum in the summer of 2024. Marci Bowers, a transgender surgeon and Immediate Past-President of WPATH, wrote in a message that some patients don\u2019t want to \u201cmaintain their vagina\u201d due to \u201cpain and discharge\u201d after surgery.<\/p><p>\u201cJust because someone does not wish to maintain their vagina because of pain and discharge, jumping to regret should not be our first response,\u201d wrote Bowers.<\/p><p>Vaginoplasty is a procedure that involves removing a penis, scrotum, and testicles, and using the genital tissue to surgically construct a vagina. If the patient doesn\u2019t have enough genital tissue to complete the procedure, surgeons may borrow tissue from the colon. WPATH calls the final product a \u201cneovagina,\u201d which is a large wound that requires lifelong dilatation to prevent vaginal stenosis, a condition where scar tissue in the vagina hardens and narrows.<\/p><p>\u201cVaginal Stenosis after vaginoplasty with symptoms and no desire to keep canal\u201d was the subject of a WPATH forum message thread obtained by The Daily Wire through a public record request.<\/p><p>\u201cI have been seeing quite a few patients recently who after vaginoplasty stop dilating and do not desire to keep the canal,\u201d wrote a nurse practitioner to start the thread. \u201cThey have come to see me with symptoms of pelvic pain, accompanied by bleeding and discharge for a few weeks before symptoms resolve.\u201d<\/p><p>A physical therapist replied to the message that pain and bleeding after vaginoplasty surgery are \u201cvery common.\u201d<\/p><p>\u201cRegarding the issue of pain, it is very common in many cases, especially during the first three months, due to the surgery itself and the muscle tension it generates, as well as bleeding and secretions,\u201d wrote the WPATH member. \u201cBleeding can be due to the operation itself since they have internal wounds that will expel a bloody fluid or slight bleeding during dilations.\u201d<\/p><div>\n<figure class=\"wp-block-image size-medium_large\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" class=\"wp-image-1771\" height=\"394\" src=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/df9f31429abbece939b12df8c6922dc8-768x394.avif\" width=\"768\" srcset=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/df9f31429abbece939b12df8c6922dc8-768x394.avif 768w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/df9f31429abbece939b12df8c6922dc8-300x154.avif 300w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/df9f31429abbece939b12df8c6922dc8.avif 940w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/figure>\n<\/div><p>Patients are typically recommended to dilate for 30 to 60 minutes at least 3-4 times a day during the initial post-operative period, a painful time commitment. Bowers suggested the pain and effort needed to keep the genital wound flexible might not be \u201cworth the time\u201d for some patients.<\/p><p>\u201cDilation is crucial but not for everyone,\u201d wrote Bowers. \u201cFor some, it just isn\u2019t worth the time expended or the pain experienced, if that is the case at all. Or sexual situations can change.\u201d<\/p><p>A social worker asked if patients expressed \u201cany desire to de-transition\u201d when deciding to stop dilating after surgery. Bowers responded that the \u201cfirst response\u201d of members should not be to assume a patient has regretted their sex-change surgery if they no longer wish to \u201cmaintain their vagina.\u201d<\/p><p>Patients who don\u2019t follow dilation recommendations risk losing the ability to experience penetrative sex because the surgically created vaginal canal will lose flexibility without dilation. A psychologist, who described himself as a \u201cpost-op trans woman,\u201d responded to Bowers with his personal experience of stopping dilation after genital surgery.<\/p><div>\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" class=\"wp-image-1772\" height=\"353\" src=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/fb9a236c8ddff11a632b0ed9a1413e7e-1024x353.avif\" width=\"1024\" srcset=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/fb9a236c8ddff11a632b0ed9a1413e7e-1024x353.avif 1024w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/fb9a236c8ddff11a632b0ed9a1413e7e-300x104.avif 300w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/fb9a236c8ddff11a632b0ed9a1413e7e-768x265.avif 768w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/fb9a236c8ddff11a632b0ed9a1413e7e.avif 1026w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div><p>\u201cI\u2019m speaking largely from experience, as a post-op trans woman who stopped dilating after a certain point and is completely fine with that. I have various friends and clients who have reached a similar point,\u201d wrote the psychologist. \u201cIt has nothing to do with regret, I\u2019m so happy to have my body as it is. It\u2019s entirely about how I choose to use the body I have. It\u2019s still good to have the (narrow) vaginal canal that I have, but because I don\u2019t engage in penetrative sex I\u2019ve felt no need to maintain dilation.\u201d<\/p><p>Read more <a href=\"https:\/\/blueroutejournal.com\/?p=1782\">Fireworks At Fauci Hearing As Lawyer Is Thrown Out, Disgraced COVID Doc Pleads Fifth<\/a><\/p><p>WPATH does not recommend any minimum age minor patients should meet before receiving vaginoplasty surgery in its medical guidance, Standards of Care version 8. The only time-connected guardrail WPATH provides in the guidelines is that minors should receive 12 months of cross-sex hormones before undergoing the permanent sex-change surgery, with some exceptions. The Federal Trade Commission alleged WPATH had misled the public regarding the safety and necessity of pediatric transgender medical interventions, including vaginoplasty, in a June 2026  it filed against WPATH.<\/p><p>\u201cIt is inherently harmful and unsafe to surgically remove a child\u2019s healthy and functioning genitals,\u201d states the lawsuit. \u201cNevertheless, WPATH deems it \u2018medically necessary\u2019 for treating dissatisfaction with or distress about sex traits.\u201d<\/p><p>Bowers\u2019 name appears in the lawsuit 18 times, and Bowers is described as advocating for males to receive vaginoplasty surgery as minors because they have the parental support needed to endure the brutal post-operative dilation schedule.<\/p><p>\u201cSome transition doctors, including Dr. Bowers, believe performing the surgery while the boy is a minor still living with his parents is preferable, rather than when the boy is living in a communal setting with limited privacy,\u201d states the FTC lawsuit. \u201cThis is in part due to the brutality of the procedure. Recovery from vaginoplasty requires the patient to \u2018dilate\u2019 the new wound 3-4 times daily for months so that it does not heal.\u201d<\/p><div>\n<figure class=\"wp-block-image size-medium_large\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" class=\"wp-image-1773\" height=\"457\" src=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/c40254dc1d3d951f3085d808d9c7839f-768x457.avif\" width=\"768\" srcset=\"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/c40254dc1d3d951f3085d808d9c7839f-768x457.avif 768w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/c40254dc1d3d951f3085d808d9c7839f-300x178.avif 300w, https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/c40254dc1d3d951f3085d808d9c7839f.avif 958w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/figure>\n<\/div><p>The FTC lawsuit alleges Bowers made more than a million dollars in 2023 \u201cmostly from performing transition surgeries.\u201d<\/p><p>In a separate WPATH forum thread, Laura Kuper, a psychologist at Children\u2019s Health in Dallas and  of WPATH\u2019s \u201cnonbinary\u201d chapter in the Standards of Care, asked peers to recommend \u201cUS-based surgeons\u201d with expertise in performing vaginoplasty on patients who had early pubertal suppression in a September 2024 message. Giving young males puberty blockers stops the growth of male genital tissue and makes it more difficult to perform a vaginoplasty surgery.<\/p><p>One doctor said pubertal suppression prevents \u201cthe growth of the vagina,\u201d during a private WPATH symposium in September 2022, according to reporting from The Daily Caller.<\/p><p>Bowers responded that the surgeries \u201care not easy\u201d and require \u201cexperience and technical skill.\u201d<\/p><p>\u201cLaura \u2014 as you may be aware, limited skin is a severe limitation for those with early puberty blocked, both cosmetically and for attaining depth,\u201d Bowers wrote. \u201cThese cases are not easy, and I would state that a critical combination of experience and technical skill is required, meaning the list of qualified surgeons is not large. We have performed approximately 100 of these procedures thus far with approximately 15 each summer. There are also several excellent surgeons in excellent institutions which may have similar numbers.\u201d<\/p><p>Kuper was a pediatric psychologist at the now-shut-down Children\u2019s Health GENder Education and Care, Interdisciplinary Support clinic. Texas Attorney General Ken Paxton filed a February 2026 lawsuit against Children\u2019s Health that alleges gender-affirming practitioners subverted Texas state law and continued providing minors with sex-change medical interventions after the state\u2019s ban went into effect on September 1, 2023.<\/p><p><span>Other messages acknowledge that transgender voice surgeries, which seek to make an individual\u2019s voice sound more like the opposite sex, are \u201cnot usually effective\u201d and have uncertain outcomes.\u00a0\u00a0<\/span><\/p><p><span>\u201cVoice is one of the hardest things to achieve primarily because surgical options are not usually effective,\u201d wrote a WPATH member in the forum.\u00a0<\/span><\/p><p><span>\u201cIf your patient chose to pursue surgery, they would need to accept the science and physics behind the intention of the procedures as well as the unknowns in terms of outcome,\u201d wrote an ears, nose, and throat doctor.\u00a0\u00a0\u00a0<\/span><\/p><p><span>In the SOC-8, WPATH lists \u201cvoice therapy and\/or surgery\u201d as a \u201cmedically necessary gender-affirming\u201d medical intervention. Transgender voice surgeries are explicitly covered by some <\/span><span>state<\/span> <span>insurance<\/span><span> plans.\u00a0<\/span><\/p><p>WPATH did not respond to The Daily Wire\u2019s requests for comment. Dr. Bowers declined to provide a comment to The Daily Wire. The University of Texas Southwestern Medical Center and Children\u2019s Health did not respond to The Daily Wire\u2019s requests to obtain a comment from Laura Kuper.<\/p><p>Read more <a href=\"https:\/\/blueroutejournal.com\/?p=1781\">Fauci Faces Congress As Explosive Diaries Take Center Stage<\/a><\/p><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>The World Professional Association of Transgender Health (WPATH) is the world\u2019s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group\u2019s medical guidance, called the Standards of Care Version 8, informs clinical practice, insurance policy, and government regulations throughout the United States.Systematic reviews and legal investigation have shown the SOC-8 to be built on faulty methodology and politicized science. The Federal Trade Commission filed a lawsuit against WPATH in June 2026, stating the organization has \u201cmisled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness\u201d of child sex-change interventions.WPATH members receive access to a member-only forum that discusses various topics related to transgender medicine and policy. Through a public records request The Daily Wire uncovered almost 250 pages of messages from WPATH\u2019s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization\u2019s cultural reach and challenge some of its public-facing recommendations. This is the first article in The Daily Wire\u2019s investigative series on the uncovered WPATH messages.\u00a0***A pioneering transgender surgeon acknowledged that genital surgeries leave patients with painful complications and a burdensome recovery process many cannot cope with.Members of the World Professional Association of Transgender Health (WPATH) discussed the pain and complications of vaginoplasty, a genital sex-change surgery, in an online member forum in the summer of 2024. Marci Bowers, a transgender surgeon and Immediate Past-President of WPATH, wrote in a message that some patients don\u2019t want to \u201cmaintain their vagina\u201d due to \u201cpain and discharge\u201d after surgery.\u201cJust because someone does not wish to maintain their vagina because of pain and discharge, jumping to regret should not be our first response,\u201d wrote Bowers.Vaginoplasty is a procedure that involves removing a penis, scrotum, and testicles, and using the genital tissue to surgically construct a vagina. If the patient doesn\u2019t have enough genital tissue to complete the procedure, surgeons may borrow tissue from the colon. WPATH calls the final product a \u201cneovagina,\u201d which is a large wound that requires lifelong dilatation to prevent vaginal stenosis, a condition where scar tissue in the vagina hardens and narrows.\u201cVaginal Stenosis after vaginoplasty with symptoms and no desire to keep canal\u201d was the subject of a WPATH forum message thread obtained by The Daily Wire through a public record request.\u201cI have been seeing quite a few patients recently who after vaginoplasty stop dilating and do not desire to keep the canal,\u201d wrote a nurse practitioner to start the thread. \u201cThey have come to see me with symptoms of pelvic pain, accompanied by bleeding and discharge for a few weeks before symptoms resolve.\u201dA physical therapist replied to the message that pain and bleeding after vaginoplasty surgery are \u201cvery common.\u201d\u201cRegarding the issue of pain, it is very common in many cases, especially during the first three months, due to the surgery itself and the muscle tension it generates, as well as bleeding and secretions,\u201d wrote the WPATH member. \u201cBleeding can be due to the operation itself since they have internal wounds that will expel a bloody fluid or slight bleeding during dilations.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.Patients are typically recommended to dilate for 30 to 60 minutes at least 3-4 times a day during the initial post-operative period, a painful time commitment. Bowers suggested the pain and effort needed to keep the genital wound flexible might not be \u201cworth the time\u201d for some patients.\u201cDilation is crucial but not for everyone,\u201d wrote Bowers. \u201cFor some, it just isn\u2019t worth the time expended or the pain experienced, if that is the case at all. Or sexual situations can change.\u201dA social worker asked if patients expressed \u201cany desire to de-transition\u201d when deciding to stop dilating after surgery. Bowers responded that the \u201cfirst response\u201d of members should not be to assume a patient has regretted their sex-change surgery if they no longer wish to \u201cmaintain their vagina.\u201dPatients who don\u2019t follow dilation recommendations risk losing the ability to experience penetrative sex because the surgically created vaginal canal will lose flexibility without dilation. A psychologist, who described himself as a \u201cpost-op trans woman,\u201d responded to Bowers with his personal experience of stopping dilation after genital surgery.A screenshot of a message obtained through a public record request by The Daily Wire.\u201cI\u2019m speaking largely from experience, as a post-op trans woman who stopped dilating after a certain point and is completely fine with that. I have various friends and clients who have reached a similar point,\u201d wrote the psychologist. \u201cIt has nothing to do with regret, I\u2019m so happy to have my body as it is. It\u2019s entirely about how I choose to use the body I have. It\u2019s still good to have the (narrow) vaginal canal that I have, but because I don\u2019t engage in penetrative sex I\u2019ve felt no need to maintain dilation.\u201dWPATH does not recommend any minimum age minor patients should meet before receiving vaginoplasty surgery in its medical guidance, Standards of Care version 8. The only time-connected guardrail WPATH provides in the guidelines is that minors should receive 12 months of cross-sex hormones before undergoing the permanent sex-change surgery, with some exceptions. The Federal Trade Commission alleged WPATH had misled the public regarding the safety and necessity of pediatric transgender medical interventions, including vaginoplasty, in a June 2026 lawsuit it filed against WPATH.\u201cIt is inherently harmful and unsafe to surgically remove a child\u2019s healthy and functioning genitals,\u201d states the lawsuit. \u201cNevertheless, WPATH deems it \u2018medically necessary\u2019 for treating dissatisfaction with or distress about sex traits.\u201dBowers\u2019 name appears in the lawsuit 18 times, and Bowers is described as advocating for males to receive vaginoplasty surgery as minors because they have the parental support needed to endure the brutal post-operative dilation schedule.\u201cSome transition doctors, including Dr. Bowers, believe performing the surgery while the boy is a minor still living with his parents is preferable, rather than when the boy is living in a communal setting with limited privacy,\u201d states the FTC lawsuit. \u201cThis is in part due to the brutality of the procedure. Recovery from vaginoplasty requires the patient to \u2018dilate\u2019 the new wound 3-4 times daily for months so that it does not heal.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.The FTC lawsuit alleges Bowers made more than a million dollars in 2023 \u201cmostly from performing transition surgeries.\u201dIn a separate WPATH forum thread, Laura Kuper, a psychologist at Children\u2019s Health in Dallas and co-author of WPATH\u2019s \u201cnonbinary\u201d chapter in the Standards of Care, asked peers to recommend \u201cUS-based surgeons\u201d with expertise in performing vaginoplasty on patients who had early pubertal suppression in a September 2024 message. Giving young males puberty blockers stops the growth of male genital tissue and makes it more difficult to perform a vaginoplasty surgery.One doctor said pubertal suppression prevents \u201cthe growth of the vagina,\u201d during a private WPATH symposium in September 2022, according to reporting from The Daily Caller.Bowers responded that the surgeries \u201care not easy\u201d and require \u201cexperience and technical skill.\u201d\u201cLaura \u2014 as you may be aware, limited skin is a severe limitation for those with early puberty blocked, both cosmetically and for attaining depth,\u201d Bowers wrote. \u201cThese cases are not easy, and I would state that a critical combination of experience and technical skill is required, meaning the list of qualified surgeons is not large. We have performed approximately 100 of these procedures thus far with approximately 15 each summer. There are also several excellent surgeons in excellent institutions which may have similar numbers.\u201dKuper was a pediatric psychologist at the now-shut-down Children\u2019s Health GENder Education and Care, Interdisciplinary Support clinic. Texas Attorney General Ken Paxton filed a February 2026 lawsuit against Children\u2019s Health that alleges gender-affirming practitioners subverted Texas state law and continued providing minors with sex-change medical interventions after the state\u2019s ban went into effect on September 1, 2023.Other messages acknowledge that transgender voice surgeries, which seek to make an individual\u2019s voice sound more like the opposite sex, are \u201cnot usually effective\u201d and have uncertain outcomes.\u00a0\u00a0\u201cVoice is one of the hardest things to achieve primarily because surgical options are not usually effective,\u201d wrote a WPATH member in the forum.\u00a0\u201cIf your patient chose to pursue surgery, they would need to accept the science and physics behind the intention of the procedures as well as the unknowns in terms of outcome,\u201d wrote an ears, nose, and throat doctor.\u00a0\u00a0\u00a0In the SOC-8, WPATH lists \u201cvoice therapy and\/or surgery\u201d as a \u201cmedically necessary gender-affirming\u201d medical intervention. Transgender voice surgeries are explicitly covered by some state insurance plans.\u00a0WPATH did not respond to The Daily Wire\u2019s requests for comment. Dr. Bowers declined to provide a comment to The Daily Wire. The University of Texas Southwestern Medical Center and Children\u2019s Health did not respond to The Daily Wire\u2019s requests to obtain a comment from Laura Kuper.<\/p>\n","protected":false},"author":1,"featured_media":1770,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-1785","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-investigation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications - Blue Route Journal<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blueroutejournal.com\/?p=1785\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications - Blue Route Journal\" \/>\n<meta property=\"og:description\" content=\"The World Professional Association of Transgender Health (WPATH) is the world\u2019s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group\u2019s medical guidance, called the Standards of Care Version 8, informs clinical practice, insurance policy, and government regulations throughout the United States.Systematic reviews and legal investigation have shown the SOC-8 to be built on faulty methodology and politicized science. The Federal Trade Commission filed a lawsuit against WPATH in June 2026, stating the organization has \u201cmisled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness\u201d of child sex-change interventions.WPATH members receive access to a member-only forum that discusses various topics related to transgender medicine and policy. Through a public records request The Daily Wire uncovered almost 250 pages of messages from WPATH\u2019s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization\u2019s cultural reach and challenge some of its public-facing recommendations. This is the first article in The Daily Wire\u2019s investigative series on the uncovered WPATH messages.\u00a0***A pioneering transgender surgeon acknowledged that genital surgeries leave patients with painful complications and a burdensome recovery process many cannot cope with.Members of the World Professional Association of Transgender Health (WPATH) discussed the pain and complications of vaginoplasty, a genital sex-change surgery, in an online member forum in the summer of 2024. Marci Bowers, a transgender surgeon and Immediate Past-President of WPATH, wrote in a message that some patients don\u2019t want to \u201cmaintain their vagina\u201d due to \u201cpain and discharge\u201d after surgery.\u201cJust because someone does not wish to maintain their vagina because of pain and discharge, jumping to regret should not be our first response,\u201d wrote Bowers.Vaginoplasty is a procedure that involves removing a penis, scrotum, and testicles, and using the genital tissue to surgically construct a vagina. If the patient doesn\u2019t have enough genital tissue to complete the procedure, surgeons may borrow tissue from the colon. WPATH calls the final product a \u201cneovagina,\u201d which is a large wound that requires lifelong dilatation to prevent vaginal stenosis, a condition where scar tissue in the vagina hardens and narrows.\u201cVaginal Stenosis after vaginoplasty with symptoms and no desire to keep canal\u201d was the subject of a WPATH forum message thread obtained by The Daily Wire through a public record request.\u201cI have been seeing quite a few patients recently who after vaginoplasty stop dilating and do not desire to keep the canal,\u201d wrote a nurse practitioner to start the thread. \u201cThey have come to see me with symptoms of pelvic pain, accompanied by bleeding and discharge for a few weeks before symptoms resolve.\u201dA physical therapist replied to the message that pain and bleeding after vaginoplasty surgery are \u201cvery common.\u201d\u201cRegarding the issue of pain, it is very common in many cases, especially during the first three months, due to the surgery itself and the muscle tension it generates, as well as bleeding and secretions,\u201d wrote the WPATH member. \u201cBleeding can be due to the operation itself since they have internal wounds that will expel a bloody fluid or slight bleeding during dilations.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.Patients are typically recommended to dilate for 30 to 60 minutes at least 3-4 times a day during the initial post-operative period, a painful time commitment. Bowers suggested the pain and effort needed to keep the genital wound flexible might not be \u201cworth the time\u201d for some patients.\u201cDilation is crucial but not for everyone,\u201d wrote Bowers. \u201cFor some, it just isn\u2019t worth the time expended or the pain experienced, if that is the case at all. Or sexual situations can change.\u201dA social worker asked if patients expressed \u201cany desire to de-transition\u201d when deciding to stop dilating after surgery. Bowers responded that the \u201cfirst response\u201d of members should not be to assume a patient has regretted their sex-change surgery if they no longer wish to \u201cmaintain their vagina.\u201dPatients who don\u2019t follow dilation recommendations risk losing the ability to experience penetrative sex because the surgically created vaginal canal will lose flexibility without dilation. A psychologist, who described himself as a \u201cpost-op trans woman,\u201d responded to Bowers with his personal experience of stopping dilation after genital surgery.A screenshot of a message obtained through a public record request by The Daily Wire.\u201cI\u2019m speaking largely from experience, as a post-op trans woman who stopped dilating after a certain point and is completely fine with that. I have various friends and clients who have reached a similar point,\u201d wrote the psychologist. \u201cIt has nothing to do with regret, I\u2019m so happy to have my body as it is. It\u2019s entirely about how I choose to use the body I have. It\u2019s still good to have the (narrow) vaginal canal that I have, but because I don\u2019t engage in penetrative sex I\u2019ve felt no need to maintain dilation.\u201dWPATH does not recommend any minimum age minor patients should meet before receiving vaginoplasty surgery in its medical guidance, Standards of Care version 8. The only time-connected guardrail WPATH provides in the guidelines is that minors should receive 12 months of cross-sex hormones before undergoing the permanent sex-change surgery, with some exceptions. The Federal Trade Commission alleged WPATH had misled the public regarding the safety and necessity of pediatric transgender medical interventions, including vaginoplasty, in a June 2026 lawsuit it filed against WPATH.\u201cIt is inherently harmful and unsafe to surgically remove a child\u2019s healthy and functioning genitals,\u201d states the lawsuit. \u201cNevertheless, WPATH deems it \u2018medically necessary\u2019 for treating dissatisfaction with or distress about sex traits.\u201dBowers\u2019 name appears in the lawsuit 18 times, and Bowers is described as advocating for males to receive vaginoplasty surgery as minors because they have the parental support needed to endure the brutal post-operative dilation schedule.\u201cSome transition doctors, including Dr. Bowers, believe performing the surgery while the boy is a minor still living with his parents is preferable, rather than when the boy is living in a communal setting with limited privacy,\u201d states the FTC lawsuit. \u201cThis is in part due to the brutality of the procedure. Recovery from vaginoplasty requires the patient to \u2018dilate\u2019 the new wound 3-4 times daily for months so that it does not heal.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.The FTC lawsuit alleges Bowers made more than a million dollars in 2023 \u201cmostly from performing transition surgeries.\u201dIn a separate WPATH forum thread, Laura Kuper, a psychologist at Children\u2019s Health in Dallas and co-author of WPATH\u2019s \u201cnonbinary\u201d chapter in the Standards of Care, asked peers to recommend \u201cUS-based surgeons\u201d with expertise in performing vaginoplasty on patients who had early pubertal suppression in a September 2024 message. Giving young males puberty blockers stops the growth of male genital tissue and makes it more difficult to perform a vaginoplasty surgery.One doctor said pubertal suppression prevents \u201cthe growth of the vagina,\u201d during a private WPATH symposium in September 2022, according to reporting from The Daily Caller.Bowers responded that the surgeries \u201care not easy\u201d and require \u201cexperience and technical skill.\u201d\u201cLaura \u2014 as you may be aware, limited skin is a severe limitation for those with early puberty blocked, both cosmetically and for attaining depth,\u201d Bowers wrote. \u201cThese cases are not easy, and I would state that a critical combination of experience and technical skill is required, meaning the list of qualified surgeons is not large. We have performed approximately 100 of these procedures thus far with approximately 15 each summer. There are also several excellent surgeons in excellent institutions which may have similar numbers.\u201dKuper was a pediatric psychologist at the now-shut-down Children\u2019s Health GENder Education and Care, Interdisciplinary Support clinic. Texas Attorney General Ken Paxton filed a February 2026 lawsuit against Children\u2019s Health that alleges gender-affirming practitioners subverted Texas state law and continued providing minors with sex-change medical interventions after the state\u2019s ban went into effect on September 1, 2023.Other messages acknowledge that transgender voice surgeries, which seek to make an individual\u2019s voice sound more like the opposite sex, are \u201cnot usually effective\u201d and have uncertain outcomes.\u00a0\u00a0\u201cVoice is one of the hardest things to achieve primarily because surgical options are not usually effective,\u201d wrote a WPATH member in the forum.\u00a0\u201cIf your patient chose to pursue surgery, they would need to accept the science and physics behind the intention of the procedures as well as the unknowns in terms of outcome,\u201d wrote an ears, nose, and throat doctor.\u00a0\u00a0\u00a0In the SOC-8, WPATH lists \u201cvoice therapy and\/or surgery\u201d as a \u201cmedically necessary gender-affirming\u201d medical intervention. Transgender voice surgeries are explicitly covered by some state insurance plans.\u00a0WPATH did not respond to The Daily Wire\u2019s requests for comment. Dr. Bowers declined to provide a comment to The Daily Wire. The University of Texas Southwestern Medical Center and Children\u2019s Health did not respond to The Daily Wire\u2019s requests to obtain a comment from Laura Kuper.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blueroutejournal.com\/?p=1785\" \/>\n<meta property=\"og:site_name\" content=\"Blue Route Journal\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-29T15:08:19+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/#\\\/schema\\\/person\\\/19da116f8d79cf8987781569801c6b7c\"},\"headline\":\"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications\",\"datePublished\":\"2026-07-29T15:08:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785\"},\"wordCount\":1526,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blueroutejournal.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/85d6fc481a48694559e0d36d20959440.avif\",\"articleSection\":[\"Investigation\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785\",\"url\":\"https:\\\/\\\/blueroutejournal.com\\\/?p=1785\",\"name\":\"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications - 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Blue Route Journal","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blueroutejournal.com\/?p=1785","og_locale":"en_US","og_type":"article","og_title":"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications - Blue Route Journal","og_description":"The World Professional Association of Transgender Health (WPATH) is the world\u2019s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group\u2019s medical guidance, called the Standards of Care Version 8, informs clinical practice, insurance policy, and government regulations throughout the United States.Systematic reviews and legal investigation have shown the SOC-8 to be built on faulty methodology and politicized science. The Federal Trade Commission filed a lawsuit against WPATH in June 2026, stating the organization has \u201cmisled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness\u201d of child sex-change interventions.WPATH members receive access to a member-only forum that discusses various topics related to transgender medicine and policy. Through a public records request The Daily Wire uncovered almost 250 pages of messages from WPATH\u2019s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization\u2019s cultural reach and challenge some of its public-facing recommendations. This is the first article in The Daily Wire\u2019s investigative series on the uncovered WPATH messages.\u00a0***A pioneering transgender surgeon acknowledged that genital surgeries leave patients with painful complications and a burdensome recovery process many cannot cope with.Members of the World Professional Association of Transgender Health (WPATH) discussed the pain and complications of vaginoplasty, a genital sex-change surgery, in an online member forum in the summer of 2024. Marci Bowers, a transgender surgeon and Immediate Past-President of WPATH, wrote in a message that some patients don\u2019t want to \u201cmaintain their vagina\u201d due to \u201cpain and discharge\u201d after surgery.\u201cJust because someone does not wish to maintain their vagina because of pain and discharge, jumping to regret should not be our first response,\u201d wrote Bowers.Vaginoplasty is a procedure that involves removing a penis, scrotum, and testicles, and using the genital tissue to surgically construct a vagina. If the patient doesn\u2019t have enough genital tissue to complete the procedure, surgeons may borrow tissue from the colon. WPATH calls the final product a \u201cneovagina,\u201d which is a large wound that requires lifelong dilatation to prevent vaginal stenosis, a condition where scar tissue in the vagina hardens and narrows.\u201cVaginal Stenosis after vaginoplasty with symptoms and no desire to keep canal\u201d was the subject of a WPATH forum message thread obtained by The Daily Wire through a public record request.\u201cI have been seeing quite a few patients recently who after vaginoplasty stop dilating and do not desire to keep the canal,\u201d wrote a nurse practitioner to start the thread. \u201cThey have come to see me with symptoms of pelvic pain, accompanied by bleeding and discharge for a few weeks before symptoms resolve.\u201dA physical therapist replied to the message that pain and bleeding after vaginoplasty surgery are \u201cvery common.\u201d\u201cRegarding the issue of pain, it is very common in many cases, especially during the first three months, due to the surgery itself and the muscle tension it generates, as well as bleeding and secretions,\u201d wrote the WPATH member. \u201cBleeding can be due to the operation itself since they have internal wounds that will expel a bloody fluid or slight bleeding during dilations.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.Patients are typically recommended to dilate for 30 to 60 minutes at least 3-4 times a day during the initial post-operative period, a painful time commitment. Bowers suggested the pain and effort needed to keep the genital wound flexible might not be \u201cworth the time\u201d for some patients.\u201cDilation is crucial but not for everyone,\u201d wrote Bowers. \u201cFor some, it just isn\u2019t worth the time expended or the pain experienced, if that is the case at all. Or sexual situations can change.\u201dA social worker asked if patients expressed \u201cany desire to de-transition\u201d when deciding to stop dilating after surgery. Bowers responded that the \u201cfirst response\u201d of members should not be to assume a patient has regretted their sex-change surgery if they no longer wish to \u201cmaintain their vagina.\u201dPatients who don\u2019t follow dilation recommendations risk losing the ability to experience penetrative sex because the surgically created vaginal canal will lose flexibility without dilation. A psychologist, who described himself as a \u201cpost-op trans woman,\u201d responded to Bowers with his personal experience of stopping dilation after genital surgery.A screenshot of a message obtained through a public record request by The Daily Wire.\u201cI\u2019m speaking largely from experience, as a post-op trans woman who stopped dilating after a certain point and is completely fine with that. I have various friends and clients who have reached a similar point,\u201d wrote the psychologist. \u201cIt has nothing to do with regret, I\u2019m so happy to have my body as it is. It\u2019s entirely about how I choose to use the body I have. It\u2019s still good to have the (narrow) vaginal canal that I have, but because I don\u2019t engage in penetrative sex I\u2019ve felt no need to maintain dilation.\u201dWPATH does not recommend any minimum age minor patients should meet before receiving vaginoplasty surgery in its medical guidance, Standards of Care version 8. The only time-connected guardrail WPATH provides in the guidelines is that minors should receive 12 months of cross-sex hormones before undergoing the permanent sex-change surgery, with some exceptions. The Federal Trade Commission alleged WPATH had misled the public regarding the safety and necessity of pediatric transgender medical interventions, including vaginoplasty, in a June 2026 lawsuit it filed against WPATH.\u201cIt is inherently harmful and unsafe to surgically remove a child\u2019s healthy and functioning genitals,\u201d states the lawsuit. \u201cNevertheless, WPATH deems it \u2018medically necessary\u2019 for treating dissatisfaction with or distress about sex traits.\u201dBowers\u2019 name appears in the lawsuit 18 times, and Bowers is described as advocating for males to receive vaginoplasty surgery as minors because they have the parental support needed to endure the brutal post-operative dilation schedule.\u201cSome transition doctors, including Dr. Bowers, believe performing the surgery while the boy is a minor still living with his parents is preferable, rather than when the boy is living in a communal setting with limited privacy,\u201d states the FTC lawsuit. \u201cThis is in part due to the brutality of the procedure. Recovery from vaginoplasty requires the patient to \u2018dilate\u2019 the new wound 3-4 times daily for months so that it does not heal.\u201dScreenshot of a WPATH member forum message obtained by The Daily Wire through a FOIA request.The FTC lawsuit alleges Bowers made more than a million dollars in 2023 \u201cmostly from performing transition surgeries.\u201dIn a separate WPATH forum thread, Laura Kuper, a psychologist at Children\u2019s Health in Dallas and co-author of WPATH\u2019s \u201cnonbinary\u201d chapter in the Standards of Care, asked peers to recommend \u201cUS-based surgeons\u201d with expertise in performing vaginoplasty on patients who had early pubertal suppression in a September 2024 message. Giving young males puberty blockers stops the growth of male genital tissue and makes it more difficult to perform a vaginoplasty surgery.One doctor said pubertal suppression prevents \u201cthe growth of the vagina,\u201d during a private WPATH symposium in September 2022, according to reporting from The Daily Caller.Bowers responded that the surgeries \u201care not easy\u201d and require \u201cexperience and technical skill.\u201d\u201cLaura \u2014 as you may be aware, limited skin is a severe limitation for those with early puberty blocked, both cosmetically and for attaining depth,\u201d Bowers wrote. \u201cThese cases are not easy, and I would state that a critical combination of experience and technical skill is required, meaning the list of qualified surgeons is not large. We have performed approximately 100 of these procedures thus far with approximately 15 each summer. There are also several excellent surgeons in excellent institutions which may have similar numbers.\u201dKuper was a pediatric psychologist at the now-shut-down Children\u2019s Health GENder Education and Care, Interdisciplinary Support clinic. Texas Attorney General Ken Paxton filed a February 2026 lawsuit against Children\u2019s Health that alleges gender-affirming practitioners subverted Texas state law and continued providing minors with sex-change medical interventions after the state\u2019s ban went into effect on September 1, 2023.Other messages acknowledge that transgender voice surgeries, which seek to make an individual\u2019s voice sound more like the opposite sex, are \u201cnot usually effective\u201d and have uncertain outcomes.\u00a0\u00a0\u201cVoice is one of the hardest things to achieve primarily because surgical options are not usually effective,\u201d wrote a WPATH member in the forum.\u00a0\u201cIf your patient chose to pursue surgery, they would need to accept the science and physics behind the intention of the procedures as well as the unknowns in terms of outcome,\u201d wrote an ears, nose, and throat doctor.\u00a0\u00a0\u00a0In the SOC-8, WPATH lists \u201cvoice therapy and\/or surgery\u201d as a \u201cmedically necessary gender-affirming\u201d medical intervention. Transgender voice surgeries are explicitly covered by some state insurance plans.\u00a0WPATH did not respond to The Daily Wire\u2019s requests for comment. Dr. Bowers declined to provide a comment to The Daily Wire. The University of Texas Southwestern Medical Center and Children\u2019s Health did not respond to The Daily Wire\u2019s requests to obtain a comment from Laura Kuper.","og_url":"https:\/\/blueroutejournal.com\/?p=1785","og_site_name":"Blue Route Journal","article_published_time":"2026-07-29T15:08:19+00:00","author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"admin","Est. reading time":"8 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blueroutejournal.com\/?p=1785#article","isPartOf":{"@id":"https:\/\/blueroutejournal.com\/?p=1785"},"author":{"name":"admin","@id":"https:\/\/blueroutejournal.com\/#\/schema\/person\/19da116f8d79cf8987781569801c6b7c"},"headline":"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications","datePublished":"2026-07-29T15:08:19+00:00","mainEntityOfPage":{"@id":"https:\/\/blueroutejournal.com\/?p=1785"},"wordCount":1526,"commentCount":0,"image":{"@id":"https:\/\/blueroutejournal.com\/?p=1785#primaryimage"},"thumbnailUrl":"https:\/\/blueroutejournal.com\/wp-content\/uploads\/2026\/07\/85d6fc481a48694559e0d36d20959440.avif","articleSection":["Investigation"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blueroutejournal.com\/?p=1785#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blueroutejournal.com\/?p=1785","url":"https:\/\/blueroutejournal.com\/?p=1785","name":"Inside WPATH: Trans Surgeon Admits Patients May Experience Painful Complications - 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