The World Professional Association of Transgender Health (WPATH) is the world’s preeminent transgender medical organization and a leading force in the push for minors to receive transgender medical interventions, including sex-change surgeries. The group’s 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 “misled parents and children about the medical consensus and medical necessity, as well as the safety and effectiveness” 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’s member-only forum written between June 2024 and November 2024. The messages offer a glimpse into the organization’s cultural reach and challenge some of its public-facing recommendations. This is the first article in The Daily Wire’s investigative series on the uncovered WPATH messages.  *** 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’t want to “maintain their vagina” due to “pain and discharge” after surgery. “Just because someone does not wish to maintain their vagina because of pain and discharge, jumping to regret should not be our first response,” 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’t have enough genital tissue to complete the procedure, surgeons may borrow tissue from the colon. WPATH calls the final product a “neovagina,” which is a large wound that requires lifelong dilatation to prevent vaginal stenosis, a condition where scar tissue in the vagina hardens and narrows. “Vaginal Stenosis after vaginoplasty with symptoms and no desire to keep canal” was the subject of a WPATH forum message thread obtained by The Daily Wire through a public record request. “I have been seeing quite a few patients recently who after vaginoplasty stop dilating and do not desire to keep the canal,” wrote a nurse practitioner to start the thread. “They have come to see me with symptoms of pelvic pain, accompanied by bleeding and discharge for a few weeks before symptoms resolve.” A physical therapist replied to the message that pain and bleeding after vaginoplasty surgery are “very common.” “Regarding 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,” wrote the WPATH member. “Bleeding can be due to the operation itself since they have internal wounds that will expel a bloody fluid or slight bleeding during dilations.” Screenshot 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 “worth the time” for some patients. “Dilation is crucial but not for everyone,” wrote Bowers. “For some, it just isn’t worth the time expended or the pain experienced, if that is the case at all. Or sexual situations can change.” A social worker asked if patients expressed “any desire to de-transition” when deciding to stop dilating after surgery. Bowers responded that the “first response” of members should not be to assume a patient has regretted their sex-change surgery if they no longer wish to “maintain their vagina.” Patients who don’t 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 “post-op trans woman,” 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. “I’m 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,” wrote the psychologist. “It has nothing to do with regret, I’m so happy to have my body as it is. It’s entirely about how I choose to use the body I have. It’s still good to have the (narrow) vaginal canal that I have, but because I don’t engage in penetrative sex I’ve felt no need to maintain dilation.” 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 lawsuit it filed against WPATH. “It is inherently harmful and unsafe to surgically remove a child’s healthy and functioning genitals,” states the lawsuit. “Nevertheless, WPATH deems it ‘medically necessary’ for treating dissatisfaction with or distress about sex traits.” Bowers’ 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. “Some 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,” states the FTC lawsuit. “This is in part due to the brutality of the procedure. Recovery from vaginoplasty requires the patient to ‘dilate’ the new wound 3-4 times daily for months so that it does not heal.” Screenshot 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 “mostly from performing transition surgeries.” In a separate WPATH forum thread, Laura Kuper, a psychologist at Children’s Health in Dallas and co-author of WPATH’s “nonbinary” chapter in the Standards of Care, asked peers to recommend “US-based surgeons” 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 “the growth of the vagina,” during a private WPATH symposium in September 2022, according to reporting from The Daily Caller. Bowers responded that the surgeries “are not easy” and require “experience and technical skill.” “Laura — as you may be aware, limited skin is a severe limitation for those with early puberty blocked, both cosmetically and for attaining depth,” Bowers wrote. “These 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.” Kuper was a pediatric psychologist at the now-shut-down Children’s Health GENder Education and Care, Interdisciplinary Support clinic. Texas Attorney General Ken Paxton filed a February 2026 lawsuit against Children’s Health that alleges gender-affirming practitioners subverted Texas state law and continued providing minors with sex-change medical interventions after the state’s ban went into effect on September 1, 2023. Other messages acknowledge that transgender voice surgeries, which seek to make an individual’s voice sound more like the opposite sex, are “not usually effective” and have uncertain outcomes.   “Voice is one of the hardest things to achieve primarily because surgical options are not usually effective,” wrote a WPATH member in the forum.  “If 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,” wrote an ears, nose, and throat doctor.    In the SOC-8, WPATH lists “voice therapy and/or surgery” as a “medically necessary gender-affirming” medical intervention. Transgender voice surgeries are explicitly covered by some state insurance plans.  WPATH did not respond to The Daily Wire’s requests for comment. Dr. Bowers declined to provide a comment to The Daily Wire. The University of Texas Southwestern Medical Center and Children’s Health did not respond to The Daily Wire’s requests to obtain a comment from Laura Kuper.

Something has shifted in American pediatrics. After the American Academy of Pediatrics recommended in 2023 that doctors offer weight-loss medication to children as young as 12, prescriptions of GLP-1 drugs such as Wegovy and Saxenda for kids jumped sharply almost overnight, and they have climbed every month since. Clinical trials are now underway to push these drugs to children younger than 12. We are, in effect, deciding that the cure for a childhood spent eating processed foods and addicted to screens is a weekly injection that reengineers a developing brain’s hunger signals. Have we fallen so far off the cliff that we must inject our kids to lead them down a healthy path? This is not a solution. There are some adults with serious metabolic conditions for whom these medications can be a genuine tool. But we have to address our cultural disease at the roots. “Let food be thy medicine” could never ring truer than it does at this pivotal juncture.  Clearly, in this instance, GLP-1 drugs are a Band-Aid stretched over a wound not yet cleaned up. They suppress appetite; they do not teach a child what to eat and how to move. They lower a number on a scale; they do not change a home or a school cafeteria. The moment a child stops taking them, the weight tends to return because the underlying habits never change, and all of the issues will be exacerbated. Are we truly willing to commit a generation of kids to lifelong pharmaceutical dependence when basic, wholesome meals and daily outside play is usually all that’s needed? The food put in front of children is the real scandal. Roughly 70% of the calories American children eat now come from ultra-processed foods, the engineered snacks and drinks designed in laboratories to override the body’s natural sense of fullness. We have built an environment that makes children sick and then act surprised when they are.  The MAHA Commission’s report last year, “Make Our Children Healthy Again,” named this plainly, pointing to poor diet, environmental toxins, physical inactivity, and the over-medicalization of childhood as the roots of a genuine crisis in chronic disease. It’s good to have a clear prognosis on the dire state of things, but the real shift needs to start at dinner tables and in schools. We need to bring back simple, time-tested wisdom and real foods from God’s green earth. The good news is that the solution is not complicated, and it does not require a prescription. It requires basic foods. Start with protein at every meal, especially a real breakfast, the kind that steadies a child through a school morning instead of delivering the sugar spike and crash of a toaster pastry. Fill the plate with vegetables until they become ordinary rather than a negotiation. Get kids moving their bodies every day, not as punishment, but as play, the way childhood is supposed to be. And cut the processed foods and refined sugars that are doing the damage. None of this is exotic. It is exactly how previous generations of healthy children were raised before their nutrition was outsourced to vending machines, cafeterias that offer mac and cheese or pizza, and drive-throughs. We’ve been working with women and their families for the last 15 years, and our latest book, “The 7 Skills to Lasting Health,” provides all of these tools in a simple, accessible way. We’d be happy to make it available as a curriculum for schools nationwide. But, if you don’t know where to start, this is an easy on-ramp. This is not merely a matter of personal health. A nation whose children are growing up sicker, weaker, and more medicated than their parents is a nation weakening at its foundation. When military recruiters struggle to find young people fit to serve and when the cost to treat the epidemic of chronic disease consumes an ever-larger share of our economy, the health of our children stops being a private concern and becomes a question of national strength. We may be celebrating 250 years of America, but a country cannot lead the world while its next generation is too unwell to carry it forward. We have a clear choice in front of us. We can keep treating the symptoms, normalizing injections for children addicted to their screens and hoping the bill never comes due. Or we can do the harder, better thing and address this at its root, one breakfast, one home-cooked dinner, one afternoon outside at a time. The drugs will always be there for the few who truly need them for breakthrough. But for the millions who simply need real food and a healthier life, reaching for the syringe first is a failure. Our children are our future. They deserve more than a bandage. They deserve to be made well. *** Pearl Barrett and Serene Allison are New York Times bestselling authors and the founders of Trim Healthy Mama. This article is part of Upstream, The Daily Wire’s new home for culture and lifestyle. Real human insight and human stories — from our featured writers to you.

A Michigan mother who authorities say was killed alongside her six children in an apparent murder-suicide documented years of marital problems in Reddit posts that surfaced after the tragedy. Authorities say Kristopher Karolkiewicz, 47, fatally shot his wife, Amanda Karolkiewicz, 39, and their six children before taking his own life and setting the family’s home on fire.  According to The Detroit News, Amanda posted under the Reddit username MandyK1179, where she wrote extensively about her marriage and alleged her husband’s infidelity. The Holland Sentinel reported that it independently verified the account by matching details about the couple, including their residence, ages, and occupations. The account, which spanned roughly three years, initially described the marriage as  “living in a Hallmark movie.” Later posts painted a dramatically different picture, including allegations that Kristopher had an affair with an intern.  “I was the intern at the company we both worked for. He was divorced and older than me… fast forward ten years and five kids, he was cheating with the intern again- the same age I was when I was the intern,” she wrote in the ‘As One After Infidelity’ subreddit. “I was five babies in, and was actually not in bad physical shape, but I was in the trenches of little kids, and just couldn’t be who I was before.” According to the posts, Amanda also wrote that she was “terrified” and would not have remained married if not for their children. The account further alleged that Kristopher’s infidelity led the couple to marriage counseling and therapy.  “I don’t feel bad still. He towers over me and destroyed me mentally,” the account commented on the page two years ago. “It felt like I was being assaulted and needed to fight back. I think it’s a fight or flight thing.” The couple had been married for 17 years before the apparent murder-suicide. Authorities have not announced a motive and said the investigation remains ongoing. 

The Senate overwhelmingly approved a bipartisan sanctions package targeting Russia and Iran on Tuesday, passing the Lindsey O. Graham Sanctioning Russia and Iran Act of 2026 by an 86-12 vote just hours after Ukrainian President Volodymyr Zelensky met with lawmakers on Capitol Hill and attended the funeral of the bill’s namesake. The legislation, named in honor of the late South Carolina GOP senator, represents one of the final initiatives Graham worked to secure before his unexpected death earlier this month. Graham had spent the days leading up to his passing negotiating the measure with the White House after returning from a trip to Ukraine. The vote came after Zelensky personally lobbied senators during a closed-door meeting on Capitol Hill before final passage. Zelensky traveled to Washington both to attend Graham’s funeral and to press lawmakers to approve the sanctions package aimed at increasing pressure on Russian President Vladimir Putin. Following the meeting, Sen. Richard Blumenthal (D-CT), one of the bill’s lead sponsors, said to reporters, “This bill is the one that will pass. This bill is the one that the President will sign. We want a law, not just a bill.” Blumenthal added that “it sends a message to Putin: your days of war are numbered. You are on the losing side.” The legislation would impose sweeping new sanctions on Russian political officials, oligarchs, financial institutions and the so-called Russian “shadow fleet” used to evade existing sanctions. It also authorizes secondary sanctions and tariff authority targeting countries that continue purchasing large quantities of Russian oil and gas, one of the Kremlin’s primary sources of wartime revenue. In addition to Russia, the bill extends sanctions targeting Iran’s energy and weapons sectors through 2031, preserving restrictions that were otherwise set to expire this year. Senators agreed to combine the Russia and Iran sanctions into a single package after weeks of negotiations.  Supporters described the measure as a fitting tribute to Graham, who was among the Senate’s most outspoken advocates for Ukraine throughout Russia’s invasion. “There is no greater way to honor Senator Graham’s legacy than to move forward with this bipartisan agreement,” the bill’s bipartisan sponsors said in a joint statement before Tuesday’s vote. The measure drew opposition from a much smaller group of bipartisan senators. Sen. Rand Paul (R-KY), who frequently opposes sanctions legislation on libertarian grounds, joined 11 Democrats voting against the bill. Democratic opponents cited concerns over the legislation’s tariff provisions rather than the sanctions themselves. “I support Zelensky,” Sen. Andy Kim (D-NJ) said after voting no. “We’re all on board on the sanctions … But why do we need the tariff power in there right now?”  Despite those objections, the legislation secured well above the 60 votes needed to pass, underscoring broad bipartisan support for increasing economic pressure on Russia as the war in Ukraine continues. The House is not expected to consider the legislation until lawmakers return from the August recess. If approved there, the bill will head to President Donald Trump’s desk for his signature.

WASHINGTON — The Senate confirmed Jay Clayton as the new director of national intelligence Tuesday, replacing acting Director Bill Pulte following months of Democratic opposition to both men. The Senate voted 51 to 47 to confirm Clayton on Tuesday evening, just hours after Pulte announced the latest round of drastic cuts to the agency, his final act before he departed. “Having known and worked with Jay for years, I was encouraged when he was first nominated for the position of DNI,” Sen. Mark Warner (D-VA) said on Tuesday. “Unfortunately, I came away from his confirmation process with serious reservations about whether he would be willing to stand up to political pressure when it matters most.” “Now that he has been confirmed, I sincerely hope he proves those concerns unfounded, because the Intelligence Community deserves steadier leadership than it has received in recent months,” he added. United States attorney for the Southern District of New York Jay Clayton testifies during his confirmation hearing on July 15, 2026. (Photo by Nathan Posner/Anadolu via Getty Images) Democrats had vociferously protested Pulte as the acting Director of National Intelligence, and initially appeared more receptive to Clayton as the permanent spy czar. Once it came time for his confirmation, however, Clayton received heavy pushback from Senate Democrats, prompting Senate Majority Leader John Thune to accuse them of “playing the same partisan games with this qualified nominee as they have for so many of President Trump’s picks.” “Democrats were so worked up over the president’s temporary choice for this position, they allowed our nation’s most important counterterrorism tool to go dark for the first time ever,” Thune said on the Senate floor on Monday. “Now Democrats have the opportunity to replace that acting official,” he added. “But they’re in no apparent rush to confirm a permanent director of national intelligence. They’ve opposed his nomination in committee. They’ve delayed things here on the floor. And I don’t expect we’ll see a lot of Democrat support for him in the final roll call.”