The far-right law firm Alliance Defending Freedom offered a Florida anti-trans hate group $15,000 to “refute” the WPATH Standards of Care “for use in litigation”

A wider lens on the American College of Pediatricians.

Recent subpoenas by Republican state governments against trans-supportive professional and medical organizations

• In 2022 and 2023, professional organizations endorsing gender-affirming care received extensive subpoenas from the states of Alabama and Florida during cases on the states’ legislation and policy limiting access to transition treatment for trans youth and adults. These subpoenas and other requests for production of documents have demanded several years of the groups’ internal discussions and deliberations on their support for gender-affirming treatment, as well as other material relating to their trans-supportive position statements.
• The American Academy of Pediatrics (AAP), Endocrine Society (ES), and World Professional Association for Transgender Health (WPATH) received subpoenas beginning in August 2022 in Boe v. Marshall (previously Eknes-Tucker v. Ivey, the suit against Alabama’s total ban on gender-affirming medical care for trans youth. In November 2022, Florida’s Agency for Health Care Administration (AHCA) subpoenaed these three groups and more than a dozen other trans-supportive professional organizations who had submitted amicus briefs in the case against the state’s Medicaid coverage exclusion for transition care (Dekker v. Weida challenging Rule 59G-1.050(7)). This April, State Rep. Randy Fine of the Florida House Health and Human Services Committee was authorized to issue subpoenas against the Florida Chapter of the AAP (FCAAP), promptly resulting in a lawsuit (FCAAP v. Fine, doc 10–1; April 23, 2022 Renner letter to Fine).
• Alabama attorney general Steve Marshall explained his justification for the subpoenas in a filing with Alliance Defending Freedom (ADF) senior counsel Roger Brooks: “How did those groups come to their conclusions? Do the positions represent the considered view of membership, or only of carefully ‘stacked’ committees? What process did they use to determine who would have input, and who would not? Did the groups conduct systematic examinations of the scientific literature, or did they cherry-pick studies? In short: Is there evidence indicating that the alleged ‘consensus’ is not actually based on best scientific practices but, at least in part, on ideology, self-interest, organizational politicking, or other considerations?” (Boe v. Marshall, doc 219, Jan 17, 2023)
• When the AAP, ES, WPATH and others challenged the AHCA’s subpoenas, Secretary Jason Weida argued: “Openness and transparency are hallmarks of the scientific method. Casting themselves in the underlying case as the standard bearers of the prevailing scientific view regarding gender dysphoria treatment — and used as such by Plaintiffs — the non-parties now seek to shield their perspective from any scrutiny. The non-parties refuse to answer whether their perspective is the result of careful study and debate among their memberships or the result of a handful of people dictating a result, as a past president of the American Academy of Pediatrics suggested.” (In re subpoenas served on AAP et al., doc 11, Jan 20, 2023) That past president is Joseph Zanga, founder of the American College of Pediatricians.

Demands for internal communications about the anti-LGBT American College of Pediatricians hate group

• Although Alabama’s subpoenas to AAP, ES, and WPATH contained similar requests for essentially all of their internal discussions of care for trans youth, the October 13, 2022 subpoena to WPATH uniquely demanded all of their documents on a specific list of prominent groups and individuals who have opposed the current gender-affirming standard of care: “Produce all Communications and Documents regarding the Society for Evidence Based Gender Medicine (“SEGM”), the American College of Pediatricians, 4th Wave Now, Transgender Trend, Michael Laidlaw, MD, William Malone, MD, Paul Hruz, MD, Quentin Van Meter, MD, Julie Mason, MD, Stephen Levine, MD, Andre Van Mol, MD, Michelle Cretella, MD, Deborah Soh, Abigail Schrier, Jesse Singal, and Hilary Cass.” (Boe v. Marshall, doc 208–2 Ex. 3 at 43, Oct 13, 2022)
• The Gainesville, Florida-based American College of Pediatricians (ACPeds) is a fringe conservative Christian hate group that opposes queer identities and relationships, same-sex parenting, marriage equality, contraception, abortion, and transitioning. Its members and collaborators, including Quentin Van Meter, Paul Hruz, Michael Laidlaw, Michelle Cretella, Andre Van Mol, Miriam Grossman, Joseph Zanga, and G. Kevin Donovan, worked on behalf of the AHCA during the sham anti-trans rulemaking process, and several have served as expert witnesses for the state of Florida in Dekker v. Weida.
• Notably, Quentin Van Meter’s May 17, 2022 “Attachment E” report for AHCA — intended to contribute to the agency’s objective evaluation of evidence regarding gender-affirming treatment — appears to be copied almost entirely from his May 1, 2022 expert declaration defending the state of Alabama (doc 69–4). Experts at the Yale School of Medicine also found that the text of Van Meter’s Attachment E overlaps substantially with the American College of Pediatricians’ 2016/2018 position statement “Gender Dysphoria in Children”, coauthored by Michelle Cretella (Alstott et al., July 8, 2022).

AHCA tries and fails to shield its internal communications with ACPeds experts from discovery

The AHCA, an apolitical public health agency determining state Medicaid policy, has proven unusually resistant to disclosing the agency’s internal communications and documents surrounding the development of the transition treatment coverage exclusion. In January 2023, the AHCA inappropriately attempted to assert attorney-client privilege and work-product protection over dozens of communications between AHCA staff and the anti-trans experts hired to develop the Medicaid exclusion (Dekker v. Weida, doc 81, Jan 20, 2023). This argument was unsuccessful, and AHCA was ordered to produce the requested documents and pay the plaintiffs $2,000 in fees (doc 89, Jan 31, 2023):

Even if this leaves room in an appropriate circumstance for protection of documents created for dual purposes — not just when the primary purpose was to aid in future litigation — the experts at issue here were an essential part of the mandated rulemaking process. Either the experts were retained to assist in an honest evaluative process — in which event their communications were not within work-product protection — or the rulemaking process was a sham and the real goal was to prevail in the anticipated litigation — a possibility the defendants could embrace to win the discovery battle only by acknowledging that the rulemaking process was fatally flawed, or nearly so.

By March 2, 2023, AHCA was still attempting to withhold a 17-page internal memo from July 2022 as privileged (doc 109). When this memo was eventually filed as a trial exhibit (doc 183–30, Pl. ex. 327), it was revealed to be a response by Andre Van Mol to criticism of the proposed exclusion by AAP, ES, WPATH, and the Yale faculty. In the memo, he called WPATH’s credibility into question: “The report misrepresents WPATH and cites it as a clinical organization, when in reality it is an advocacy group that anyone can join.”

Other trial exhibits show that Andre Van Mol, who had been recommended to the AHCA by Michelle Cretella as her fellow co-chair of ACPeds’ Committee on Adolescent Sexuality (Pl. ex. 279), had previously provided the agency with a 55-page list of sources in May 2022 to support common anti-trans arguments (Pl. ex. 328A). A disclosure in April-May 2023 of ACPeds’ internal documents, apparently originating from their own publicly viewable Google Drive folders, exposed the likely source for this bibliography: Van Mol mostly reused a previous ACPeds reference document written in January 2022 or earlier. According to an October/November 2020 report to ACPeds’ board of directors, six anti-trans experts for the AHCA are also members of the Committee on Adolescent Sexuality (Committee on Adolescent Sexuality Report.docx); another, AHCA expert report contributor G. Kevin Donovan, served on ACPeds’ Medicine & Morality Committee (Committee List_revised_11.2.17.xls).

AHCA employee Matthew Brackett, the attributed author of the June 2, 2022 GAPMS report justifying the exclusion, was unable to answer basic questions in deposition (doc 120–6, Feb 8, 2023) regarding who at the Florida Department of Health had provided AHCA’s Jason Weida with the names of Michelle Cretella and other anti-trans experts. Consequently, the plaintiffs sought to depose Weida on this and other unanswered questions, at which point AHCA filed for a protective order to prevent the deposition (doc 115, Mar 15, 2023). When the court denied their motion (doc 118, Apr 4, 2023), Weida petitioned the 11th Circuit Court of Appeals for a writ of mandamus against the deposition (doc 146–1, Apr 10, 2023), which was also denied (doc 173, Apr 21, 2023).

Meanwhile on April 23, House Speaker Paul Renner authorized Rep. Fine to subpoena Florida-based organizations endorsing gender-affirming care and investigate “whether the integrity of the medical profession has been compromised by a radical gender ideology”. Renner offered high praise for the principles of open review and transparent processes in developing medical guidance:

AHCA sought to probe that assertion by serving subpoenas on those entities and others that endorse “gender-affirming care” for minors in order to determine whether this purported medical consensus was truly the result of an intellectually rigorous and open process — as any medical consensus should be. … As our courts and the Supreme Court have long recognized, “sunlight is said to be the best of disinfectants.” Yet it appears that the medical organizations who create and endorse guidelines on a contentious issue fraught with scientific uncertainty have gone to great lengths to avoid scrutiny and to keep the public (and their duly elected representatives) in the dark regarding the process by which these “consensus” guidelines were developed.

Documents from the April-May 2023 ACPeds disclosures show a possible reason why the AHCA tried to claim that the ACPeds experts’ policy contributions to a state agency were protected as a product of litigation: members of ACPeds working with AHCA, including Michelle Cretella and Quentin Van Meter, have previously been offered payment to attack gender-affirming standards of care for the purposes of litigation, in contrast to the “honest evaluative process” expected within the AHCA.

ACPeds has a history of axiomatically and religiously opposing professional organizations’ gender-affirming standards of care

Minutes of an ACPeds board meeting on October 14, 2016 (Minutes Board Oct 13–14_2016.pdf) show that the hate group has a long history of targeting trans-supportive medical organizations, stating their opposition to gender-affirming guidance by the AAP and ES even at the earliest stages of drafting their own competing statements. ACPeds directors and other members, including Cretella, Van Meter, and Hruz, sought to “stop” the Endocrine Society’s 2017 transgender guidelines and produce a “rebuttal” to the AAP:

Collaboration to stop Endocrine Society’s revision of guidelines for GD in Children

Drs Cretella, Hruz, Hoffman and Van Meter are crafting a response for the open comment period to the Endocrine Society’s proposed revision of Guidelines for treatment of GD in Children. Dr. Lawrence Mayer of Johns Hopkins and The New Atlantis are drafting a scientific rebuttal of the Human Rights Campaign funded American Academy of Pediatrics Transgender Report. College member Dr. Paul Hruz (Missouri) will co- author this rebuttal and it is expected to be published in Spring 2017.

The New Atlantis, which is not peer-reviewed or a medical journal, is a “public journal of ideas” that was published by the Christian conservative Ethics & Public Policy Center (EPPC) until 2018. Mayer and Hruz indeed went on to attack Murchison et al. (2016) for correctly pointing out that natal puberty causes irreversible physical changes (Hruz et al., 2017). Hruz, Van Meter, Malone, Laidlaw, and SEGM’s William Malone later wrote a brief letter to the editor in JCEM making a number of spurious arguments and endorsing “psychological therapy” to “alleviate GD in children” (Laidlaw et al., Nov 23, 2018).

Statements starting from a fixed and immovable opposition to gender affirmation appear to be familiar territory for ACPeds. In a 2017 email to a reader, Cretella states that the authors of the ACPeds statement “Gender Ideology Harms Children” — herself, Quentin Van Meter, and Paul McHugh — “are devout Catholics with a knowledge of and respect for the natural law” (5.23.17 MC to Dr. Thevathasan.docx). Cretella went on to explain her views on “the non-heterosexualizing and transgendering of children”:

Make no mistake that the non-heterosexualizing and transgendering of children is a grave evil with no basis in science. The sexual revolution has the world in the grip of a cult of radical individualism that worships autonomy as the greatest virtue; all the while this cult’s high priests (MDs and PhDs) and acolytes (mainstream & social media) have no clothes. This is the inevitable culmination of the hubris which gave birth to the Enlightenment; the hubris that claimed we could replace God with human reason alone and keep both objective science and morality intact. Theology is the Queen of the sciences; topple this and the tyranny of moral relativism takes over and poisons everything.

In an October 2017 presentation at ACPeds’ “educational conference”, Cretella elaborated on this theme with a call to “Challenge Religion of Radical Autonomy” and “Abort Gender from Medical/Psych discourse” (M. Cretella PPT the art of medicine.pptx).

“Highlights from the ADF Strategy Meeting”: ACPeds members meet with the ADF in late 2017

In minutes from an October 24, 2017 meeting where Michelle Cretella was in attendance, ACPeds’ executive committee described a “strategy meeting” with the hate group Alliance Defending Freedom that had recently taken place (EC_CC_minutes_10.24.17.pdf):

Planning and Development Committee:

Highlights from the ADF Strategy Meeting will be shared with the EC next month. Both Dr. Zanga and Dr. Van Mol attended this meeting.

On November 19, 2017, the blog Detransitioned Women Resist the ADF warned of the alliance’s most recent activities, including offering financial support to detransitioners:

We recently became aware that The Alliance Defending Freedom has been contacting high profile detransitioned people attempting to find potential plaintiffs to bankroll medical malpractice lawsuits. We strongly urge all detransitioned people to resist the temptation of ADF’s financial support.

Two days later, ACPeds’ executive committee provided further details on the ADF’s interest in their organization (Updated_Review of EC_CC_minutes_11.21.17.pdf):

Highlights from Dr. Cretella from the ADF Strategy Meeting as relayed to her from Dr. Van Mol and Dr. Zanga: Essentially, attorneys are using our position statement, interviews, etc to craft legal challenges. I’ve been invited onto conference call that will occur in December for further details.

In earlier depositions of Paul Hruz and AHCA expert report writer Patrick Lappert in Kadel v. Folwell, they described meetings with the ADF taking place during late 2017 for the purpose of cultivating anti-trans expert witnesses; Lappert later admitted he had never testified on transgender issues prior to this meeting (Ex. 4 in Brandt v. Rutledge, May 6, 2022). In addition to Hruz and Lappert, these meetings included Michelle Cretella, Andre Van Mol, Quentin Van Meter, ACPeds consultant Mark Regnerus, detransitioner and ACPeds consultant Hacsi Horvath, attorneys Gary McCaleb and Jeff Shafer of the ADF, Ryan T. Anderson of the EPPC, and detransitioner Walt Heyer. ACPeds explained it simply at their next executive committee meeting on December 19: “ADF Wants to help ACPeds” (FINAL EC_CC_minutes_12.19.2017.pdf).

Planning and Development Committee:

▪ ADF Wants to help ACPeds

▪ Action item: Dr. C to contact Jeff Shafer re: ADF presenting “1 hour legal update” on variety of issues once a year to our BOD

▪ PSA development?

▪ ADF has a program to test language and presentation

“We are real scientists following the evidence”

By March 2018, the ADF’s plans with ACPeds came into sharper focus, with Jeff Shafer and Gary McCaleb listed on the March 23–24 board meeting agenda as presenting an “update on threats to children & FOC [freedom of conscience]” (MARCH 2018 BOD AGENDA.pdf). However, the minutes of the board meeting, where both Cretella and Van Meter were present, reveal that the ADF’s freedom of conscience presentation was largely focused on “transgender ideology” and “transgenderism” (Minutes Board March 23–24_2018.pdf):

13. The Strategic Planning: Christian Employers Alliance & ADF

Dr. Cretella introduced Eric Welch from Christian Employers, Gary McCaleb from ADF, and Jeff Shafer from ADF.

Gery McCaleb spoke about ADF and what ADF has been seeing regarding transgenderism. Expressed concerns about Obamacare mandating affirmation in transgender ideology in order to get federal funding. The Transgender issue is urgent and happening now. ADF wants to see us triple and be successful. Currently, ADF is fighting cases in schools and federal prison. The Obama Administration allowed men who identify as women with male parts be put in women prison — ADF reported on the increasing number of cases of abuse and rape due to this.

…

ADF can promote the ACPeds in its member publication; ACPeds needs to draft article. They also offered to have a a Development Consultant advise our Executive Committee.

Dr. Artigues ask ADF if there is a liability issue for board members. Gary McCaleb stated that we don’t have to worry about being sued individually as board members. There is no liability unless you lie. If you are not sure if it’s legal or heading into dangerous water feel free to call ADF to seek advice.

Jeff Shafer spoke on the male and female reality and the larger picture of what is going on in society, such as obliterating the family. Everything is becoming legal judgement.

At the same meeting, Michelle Cretella declared that “Gay marriage was the tipping point for the transgender movement” and “The transgender topic is legally the next step and is very threatening.” In the 17th year of her organization’s existence, Cretella reassures attendees of “Who we are”: “We are real scientists following the evidence … We do need a reminder to take care of ourselves and have fun.”

The next executive committee meeting on April 17, 2018 describes working with Eric Crozet, ADF’s senior VP of development, on “fundraising 101” (4.17.18 EC minutes (1).docx). Cretella’s “weekly list” for May 11, 2018 goes on to list a new item under “Interview/speaking Requests”: presenting at an “ADF Academy” in Tucson “to teach Transgender Medicine to Law students” for an honorarium of $1,500. She adds: “Conversation on GD completed by Drs. Van Mol & Anderson; Dr. C to offer edits.” Previous drafts of a “conversation” on “GD” or “Gender Identity Disorder” were kept in a folder dated “9.7.17 NEW Conversations not yet published”; an April 12, 2016 draft by ACPeds board member Den Trumbull included notes added by Michelle Cretella and a reminder to “send to Dr. Joe Nicolosi for review” (4.12.16 DRAFT Conversation-Gender Identity Disorder.docx):

(From Catholic Med Association)

If a child exhibits symptoms of Gender Identity Disorder (GID), which include identification with the opposite sex, limited ability to bond with same-sex peers, lack of rough-and-tumble play in boys, cross-dressing, discomfort with their own sex, and social anxiety, he or she is at high risk. If GID in childhood is left untreated, approximately 75% of children will go on to develop same-sex attractions.

…

FROM CRETELLA:

The science on this topic is derived primarily from clinical case reports, especially from Drs. Zucker and Bradley out of Toronto.

On December 27, 2018, ACPeds members and collaborators Grossman, Laidlaw, Van Meter and Van Mol — all later involved in the AHCA anti-trans process or related policymaking and litigation — submitted an amicus brief in the appeal of Adams v. School Board of St. Johns County, represented by Gary McCaleb and the ADF (Brief of amici curiae Miriam Grossman et al., case 18–13592). (ACPeds’ internal documents show that Michael Laidlaw terminated his membership in the College on August 30, 2018, later serving as a “non-ACPeds collaborator” on the Committee for Adolescent Sexuality; see TL_DR_LAIDLAW_8_30_2018.pdf and American College of Pediatricians Mail — Survey and AmazonSmile 9 28 18.pdf.)

Their brief criticized the 2017 Endocrine Society guidelines and a 2018 trans-supportive statement by the AAP, referring to sources such as: a 2016 anti-trans article by Mayer and McHugh in The New Atlantis; their subsequent 2017 article with Hruz; “autogynephilia” proponent J. Michael Bailey; a paper in a low-quality journal by Michelle Cretella; Laidlaw et al.’s Nov 23 JCEM letter; an Oct 28, 2018 blog post by Laidlaw on gdworkinggroup.org; an Oct 17, 2018 blog post by future AHCA report contributor James Cantor; and “Clinical and Theoretical Parallels Between Desire for Limb Amputation and Gender Identity Disorder”. ADF attorney Gary McCaleb had previously implied that being trans was a “blight upon our human souls” caused by “autogynephilia” in an August 9, 2019 email to detransitioner Elisa Shupe (New York Times, “How a Few Stories of Regret Fuel the Push to Restrict Gender Transition Care”, May 16, 2023):

I raise this not to diminish the concept, but to seek help in ways to make it more sensible to the general public and (heaven help us) federal judges — how can we make it as simple and understandable as the “gender identity” term, and a plausible explanation for what we’re seeing? And I think this is well worth the effort, because I suspect that it is indeed a fundamental contributor to this blight upon our human souls.

“A white paper that refutes the WPATH Standards of Care”

The disclosed ACPeds documents show that by March of 2019, ADF’s involvement with the group had escalated to offers of direct financial report, including a proposed budget. An early draft of the executive committee’s meeting minutes for March 19, 2019 states: “Drs. Cretella and Van Meter spoke with ADF about applying to a specific grant.” (Minutes_EC_March_2019_V1.docx) A later version provides more detail on the ADF’s offer (Minutes_EC_March_2019_V2.pdf):

Executive Director Report

Dr. Cretella is not attending in-person, however, she will skype into the meeting to present her Executive Director report. Instead, she will be presenting the science in favor of banning transgender hormonal & surgical treatment at Catholic Hospitals to the United States Conference of Catholic Bishops, since Dr. McHugh (the original planned presenter) will not be able to be there.

…

Gary McCaleb, senior attorney with ADF, spoke with Dr. Cretella about having ACPeds apply for a grant from ADF to draft a white paper that refutes the WPATH Standards of Care. The project will require subcontracting, but the proposed budget allocates $10,000.00 to remain with the ACPeds.

Another document stored under /Fall Board Meeting October 5th and 6th 2018/Dr. Cretella/Transgender Research Requests (1).docx is addressed to Michelle (presumably Cretella) and Denise (possibly ADF’s Denise Burke), requesting that they find research to “substantiate” several common anti-trans arguments:

Michelle, Phillip, and Denise:

Below are the five topics related to transgender/gender identity issues our group has been discussing. As you know, Alliance Defending Freedom is seeking medical, biological, and/or psychological experts to research and write on these topics. We would like “white papers,” for lack of a better term, written on each topic. These papers should be empirically/data based, yet written in a manner that the general public can easily digest. Here is an example of the type of paper we have in mind. As I mentioned on our last call, topics 1, 2, and 3 are the most pressing. If there is any way to get papers completed on those topics by mid-November, that would be terrific. If they can get done earlier, even better.

Thank you in advance for your willingness to assist on this project, and to link us with others who may be able to assist as well. Please let me know if you have any questions.

1) Substantiate the psychological harm that can befall both sexes (but girls/women especially) by having their right to bodily privacy invaded by males. Can lead to fear; body image anxiety/complex; other long-term psychological harms.

2) Substantiate that it is normal during adolescence for children to go through a phase when they identify (to some degree) with the opposite sex. It is inappropriate (and could have psychological, medical, other harms?) to interpret this common stage as gender identity confusion that warrants treating a child as the opposite sex (in language, dress, appearance, etc), and pursuing more drastic measures like hormone therapy and genital change surgery.

3) Substantiate the physiological differences between males and females as they relate to sports. Explain that when transgender or gender identity confused boys are permitted to try out for girls’ sports teams that the girls are necessarily disadvantaged. We want to make the point that interpreting Title IX to include protections for “gender identity” will harm girls by allowing boys to displace girls on competitive sports teams.

4) For those who have undergone hormone therapy and genital change surgery, a paper that says they are no happier (and perhaps worse off if the research supports it) even though they took these drastic measures.

5) Biological/medical paper on the many differences (brain, anatomy, physiology, etc) between the sexes from the earliest stages of human development and moving forward. This would help substantiate the point that a person’s brain is not and cannot be hard-wired to be an opposite sex than the sex his or her chromosomes, DNA, and anatomy say he or she is.

- This paper could also deal with intersex and other anomalies and explain why these exceptions do not undermine the rule.

- This paper could also include the point that no matter how many hormones a person takes, and no matter if they have genital change surgery, they are still biologically, physiologically, etc their birth sex. For example, a transgender man will still go through menopause.

This is the very definition of “a handful of people dictating a result” that the American College of Pediatricians was expected to produce. If ACPeds had instead engaged in an open-ended and neutral process of evaluation of evidence, and had ultimately found that after a fair assessment the sum of the evidence supported the benefits of gender-affirming care, the ADF presumably would not pay for that. Why did the ADF want this whitepaper to refute rather than simply evaluate WPATH’s transgender standards of care? The purpose of this project was made explicit in the April 4, 2019 meeting minutes — and ACPeds decided to ask for $15,000 (Minutes Board April 2019.pdf):

▪ Special Project — ADF Grant

▪ Team of ACPeds physicians and consultants will analyze WPATH SOC-8 Guidelines

▪ ADF request this white paper for use in litigation and should also benefit many other allies at State and Federal Level

▪ $15K has been requested for ACPeds admin time/resources

The minutes add: “ADF may provide grant money for refueling [sic] transgender ideology”. At the same meeting, Michelle Cretella shared techniques from the ADF to shake their hate group label:

▪ Response to Hate Group Label

▪ Action Step: Dr. Cretella to ask our Radical Feminist Friends for testimonial to share on social media, newsletter, and website. ADF has done this to counter SPLC hate label.

And Quentin Van Meter admitted that ACPeds’ fringe anti-trans positions — that is, their radical gender ideology — made them a minority of one among other medical groups:

▪ Like it or not, Transgender lead the way

▪ We are the only medical professional group speaking on the topic

At the ACPeds joint “educational conference” immediately following the meeting on April 5 through 7, 2019, Denise M. Burke of the ADF hosted an “Expert Witness Workshop”. A faculty information form submitted by Burke describes the purpose and content of the Alliance Defending Freedom’s workshop:

This workshop is designed to provide in-depth preparation for expert witness work. The presentation will cover acting as an expert consultant, preparing expert reports, and testifying as an expert witness in both legislative hearings and in court.

Workshop attendees will also actively participate in scenarios designed to simulate testifying before a legislative committee and as an expert witness in court.

By June 18, 2019, the executive committee had an update on ADF’s specifications for the anti-WPATH whitepaper, as well as other requests by the alliance (Minutes_EC_June_2019_v2.pdf):

New Business [Dr. C]:

ADF requested Amicus Brief re: sex is innate and immutable which overlaps with Dr. Artigue’s Position Paper regarding the importance of sex in medicine. Action item: Dr. Artigues to send Dr. Cretella sources he received from Drs. Stigall & Huizen

…

ADF will not fund an analysis of WPATH Standards of Care 8, but willing to fund a white paper critiquing WPATH Standards of Care 7. White Paper for Standard of Care 7 possible authors Susan Berry, Dr. Cretella, and Dr. Van Meter

Susan Berry is a Breitbart writer with a doctorate in psychology, identified elsewhere by ACPeds as one of their conservative media contacts. At the time her name was suggested, Berry had written stories for Breitbart including “RuPaul’s Cartoon Show ‘Drag Tots’ Delivers Anti-Trump Message to Kids” (Berry: “Two new animated series are inserting the LGBTQ agenda into children’s programming”), “LGBT Advocates Praise Disney Preschool Cartoon for Featuring Lesbian Moms”, and “Panic! at the Disco Singer Brendon Urie Donates $1 Million to Bring LGBTQ Agenda to America’s Public Schools”. Cretella would go on to locate experts for AHCA’s fixed anti-trans rulemaking process, and Van Meter would provide expert reports for the AHCA’s proposed rule and the resulting lawsuit.

“There is another recently formed group focused solely on this issue”

American College of Pediatricians members and collaborators continued to work closely with the Alliance Defending Freedom throughout 2019, even as ACPeds’ grant applications were denied by at least eight conservative foundations. In another version of the June meeting minutes, Michelle Cretella stated that Trump appointee Roger Severino, then-director of the HHS Office of Civil Rights, asked ACPeds to submit a letter on “Freedom of Conscience” that “would be written by ADF” (Minutes_EC_June_2019.docx). In a July 22, 2019 letter to the Surgeon General, cc-ing Roger Severino, Cretella and Van Meter described gender-affirming care as both a conscience issue (for ACPeds) and “a grave public health concern impacting children and adolescents”:

Health professionals who deviate from this “gender affirming therapy” risk being marginalized, discriminated against or otherwise penalized. This is happening at a time when health professionals’ conscience rights are increasingly under threat. As a result, without your intervention, not only will increasing numbers of children come to suffer under this large-scale unethical medical experiment, but also many of us will be coerced to choose between harming some of our most vulnerable patients and leaving clinical practice.

…

▪ Call for meta-analyses of the pertinent psychiatric and medical literature which can be used to determine evidence-based standards of care and public policy rooted in the ancient medical ethics principle of first do no harm.

Members and associates also submitted amicus briefs in R.G. & G.R. Harris v. EEOC (Van Mol email to Vernadette Broyles et al., Aug 23, 2019; Shupe email to Broyles et al., Aug 24, 2019; Brief of national medical and policy groups; Brief of Walt Heyer et al.) with the Christian Medical & Dental Associations and National Catholic Bioethics Center, two extreme anti-LGBT groups supporting anti-gay conversion therapy and forced detransition. Minutes from a September 30, 2019 conference call with ACPeds and the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) show that their joint 2020 educational conference would host another expert witness workshop, with Quentin Van Meter and Michelle Cretella confirmed to be participating (9.30.19 MINUTES from AAPLOG ACPeds conf call re 2020 National Meeting.docx); Patrick Lappert and Walt Heyer were also scheduled to host their own anti-trans talks at the conference. Bizarrely, the participants note that Quentin Van Meter will look for a conference speaker on “medications to decrease libido” for autistic children:

Q. Van Meter will seek a speaker to address the use of medications to decrease libido and / or prevent pregnancy in severely autistic or other special needs children, and address what other options are available for parents to deal with this.

On November 5, 2019, ACPeds then-executive director Michelle Cretella answered an inquiry from detransitioner Elisa Shupe on developing a new “standards of care” separate from those of WPATH (Email from Cretella to Shupe, Nov 5, 2019, 2:33 PM):

Subject: Re: Request For A Standards Of Care Document By ACPeds

[Elisa],

Good to hear from you! No need to convince me of the need. Unfortunately, the American College of Pediatricians does not have the bandwidth to do this. However, there is another recently formed group focused solely on this issue that may attempt to draft alternative SOCs. Mike Laidlaw and Will Malone are active within it, I am less so.

Let me find out if the group is “out” yet.

Other emerging anti-trans groups known to involve Michael Laidlaw, such as the Kelsey Coalition and the Pediatric and Adolescent Gender Dysphoria Working Group (PAGDWG/gdworkinggroup.org), had already been “out” for several months by November 2019. However, Laidlaw’s coauthor William Malone is a founder of the Society for Evidence-Based Gender Medicine (SEGM), which registered their domain name segm.org on October 30, 2019, but did not begin their first GoFundMe fundraiser until December 14. The organization Cretella describes, in which she is “less” active, is consistent with the status of SEGM in early November 2019.

SEGM’s treasurer and apparent co-founder, Stephen Beck, has worked for years as an executive at the fifth-largest Catholic hospital network in the US, and made the earliest known reference to SEGM in an August 13, 2019 comment, voicing his support for the Trump administration’s rule interpretation that would define ‘transgender’ out of existence. Quentin Van Meter implicitly included himself among SEGM’s members at a May 2022 conference, describing the group’s shared mission: “What we all agree on is that the affirmation, from social to medical to surgical, is an abomination for these children, it is the wrong thing to do.”

How the American College of Pediatricians establishes their policy positions

At the March 30, 2020 ACPeds board of directors meeting, Cretella reported that the Committee on Adolescent Sexuality’s work with the ADF (as well as Kelsey Coalition and the “radical feminist” Women’s Liberation Front) now encompassed drafting language for trans youth care bans proposed in 13 states (Executive Director’s Report (Dr. Michelle Cretella).docx):

Vulnerable Child Protection Acts (VCPA) Dr. Cretella devoted many hours of many days during the past 6 months — 1 year working with Alliance Defending Freedom, Liberty Council, Women’s Liberation Front, Kelsey Coalition and members of our Adolescent Sexuality Committee to draft, promote and defend vulnerable child legislation protecting kids from harmful chemical and surgical transgender interventions. These acts have been introduced in 13 states around the country. Although most have been defeated, it is still considered a “win” for our side in that this process is one of the only ways to educate the general public on this issue. Also, the legislative process has been interrupted by COVID19 in GA, AL, KY and OH where ACPeds members have and/or will testify (Thank you, Drs. Susan & Scott Field, Trumbull, Van Meter, Hruz and Van Mol!).

And at the late hour of May 12, 2020, having already assisted in drafting anti-trans legislation in over a dozen states, Michelle Cretella created the file Instructions for Authors of the American College of Pediatricians.docx under the folder Scientific Policy Committee, setting forth a stringent new “General Peer Review/Editing Policy” for internal deliberations on the group’s position statements. Their policy for position statements includes the general concepts of having other people review your work, verifying accuracy, and correcting errors before publishing:

1. Any author wanting to create a Position Statement must submit a summary of the concept to the EC for approval. Once written the review process below is followed.

2. The entire review process is conducted openly with the author who must correct any citation and content errors, but is free to accept or reject stylistic edits.

3. Author will share the INITIAL DRAFT of a position statement in Google Docs with the Executive Administrator who will share with the Scientific Policy Committee (SPC) Chair. The SPC Chair will share with the rest of SPC.

4. SPC will proof references to ensure the scientific accuracy of the author’s claims and to avoid inadvertent quotation errors.

5. Once references are proofed, SPC Chair alerts the Executive Administrator who will share the statement with the entire BOD in Google Docs. At this time, the BOD will review the statement to offer suggested edits regarding organization, style & clarity using the “suggested edits” and/or “comment box” features of Google Docs. The BOD has one week to edit.

6. Once the author has reviewed and resolved all suggested edits and comments in Google Docs, the author notifies the Executive Administrator that the statement is ready for release to ENTIRE membership. The Executive Administrator will now format the statement with endnotes for release to the entire membership for comments for one week.

7. Author considers and resolves comments from step 6 and then notifies Exec. Administrator to send the statement out for vote for one week.

However, most of these requirements merely reiterate the logistics of sharing Google Drive documents with one another in an organization-wide “review” process that apparently takes three weeks. In contrast, the state of Alabama’s October 13, 2022 subpoena to WPATH (doc 208–2) included detailed requests regarding the development of version 8 of the Standards of Care, including the identities of the Delphi process participants, evidence tables used in systematic reviews, evidence search criteria and study selection results, evidence grades assigned using GRADE, and value factors used in the GRADE process.

It is unknown whether members of the American College of Pediatricians or participants in its committees engaged in a Delphi process, performed systematic reviews, assigned evidence grades using the GRADE methodology developed at McMaster University, or disclosed their value factors when drafting position statements such as “Gender Ideology Harms Children” — a two-page letter authored entirely by “devout Catholics with a knowledge of and respect for the natural law”, including Quentin Van Meter and Michelle Cretella. However, in November 2020, the esteemed Committee on Adolescent Sexuality provided a progress report on another position statement by Michelle Cretella and Andre Van Mol (Committee on Adolescent Sexuality Report.docx):

Goals for 2021:

…

▪ Complete a Homosexuality and Youth position statement

▪ Dr. Cretella drafted from scratch June 2020; Dr. Van Mol to assist with completion

At that meeting, the CAS reported that Cretella and Laidlaw worked with attorney Jane Robbins of the American Principles Project, a group whose long-term goal is to end all access to transition care at any age. With Robbins’ help, ACPeds planned to “expose” the Trans Youth Care Study preemptively, before the study had even produced or reported any findings:

10. Drs. Laidlaw/Cretella & atty Jane Robbins — Investigating and documenting the unethical and likely illegal components of a multimillion dollar trans study involving 4 academic children’s hospitals, and the misuse of NIH funds from that grant, in order to expose the study before its fraudulent conclusions further spread acceptance of the chemical and surgical sterilization of emotionally troubled youth. (Senator Lee to introduce legislation that will act as a retroactive appropriations rider to specify that none of the FY2020 funds shall be used to fund research relating to gender transition in minors, including any observational studies).

The next item on the committee’s report notes that Cretella, Van Mol, Hruz, and Laidlaw will review the latest version of “Navigating the Transgender Landscape: School Resource Guide”, with the doctors merely proofreading the anti-trans booklet originally authored by attorneys with the Child & Parental Rights Campaign including Jane Robbins and Vernadette Broyles. Broyles went on to represent former Washington University youth gender clinic worker Jamie Reed in 2023, promoting her widely disputed and apparently unsubstantiated allegations against the clinic. In a January interview with Quillette contributor Lisa Selin Davis, Broyles stated:

The real challenge for parents is that so many of the mental health professionals in these facilities have been trained in the gender ideology dogma and how to respond to a child with gender dysphoria, or feel intimidated by the portion of the practice that has been.

Last updated: May 17, 2023 by Zinnia Jones (zinnia@genderanalysis.net)