This is Part 3 of a three-part series examining why an Indiana judge found taxpayers should pay for an incarcerated man’s transgender surgery. Part 1 explored the inmate’s history, factors that disqualify him from receiving transgender surgery, and contradictions in his psychiatric evaluations. Parts 2 and 3 will evaluate the way corrupt, “gender-affirming” operators influenced the judge’s ruling.

A “gender affirming” activist group masquerading as a legitimate research organization convinced a federal judge that Indianans pay for a violent inmate’s transgender genital (“bottom”) surgery.

Let’s recap:

Outrage Number One: Federal District Judge Richard L. Young has ordered Indiana taxpayers to fund Jonathan C. Richardson’s “gender affirming” vaginoplasty and orchiectomy. Richardson is serving a 55-year-sentence for strangling his 11-month-old stepdaughter to death.

Outrage Number Two: Judge Young used research and Standards of Care (SoC) published by the World Professional Association of Transgender Health (WPATH) to justify dismissing two experts who testified that Richardson should not receive transgender surgery.

The judge should never have relied on WPATH as an objective resource. Its SoC no longer square with international guidelines. Their “evidence” been repeatedly debunked as scientifically unsound. Its members have ideological and financial incentives to recommend transgender medical interventions regardless of their necessity or scientific background.

In a third outrage, Judge Young’s trust in WPATH caused him to favorably evaluate testimony from “experts” on WPATH’s payroll.

Enter Dr. Loren Schechter, a plastic surgeon and WPATH contributor Young deemed qualified to comment on “the mental health benefits of gender-affirming surgery.” He considered Schechter an expert based on his “academic writing” and “contribution to the Seventh Version of WPATH’s Standards of Care.” Schechter has no apparent training in psychology or psychiatry.

The doctor’s affiliation with WPATH seems to have eliminated any concerns Young might have had about a plastic surgeon opining on mental health.

In contrast, the judge decided to give Dr. Stephen Levine’s testimony on the dangers of transgender surgery “very little weight” because the veteran psychiatrist “is not an expert in the nitty gritty of the nature, rate, or severity of surgical outcomes.”

Young further found Dr. Michael Farelljah’s evaluation of Richardson “[un]persuasive” because the psychologist did not specialize in treating gender dysphoria.

WPATH runs similar interference for Dr. Randi Ettner, a clinical and forensic psychologist who not only contributed to WPATH’s most recent SoC but works at Weiss Memorial Hospital Center for Gender Confirmation Surgery. Her job literally depends on transgender medical interventions.

Young considered Ettner’s career and work with WPATH evidence that she could “evaluate, diagnose and treat” gender dysphoria — not a conflict of interest. Perhaps that’s why the judge accepted Ettner’s telehealth evaluation of Richardson as authoritative but disqualified a similar evaluation by psychologist Farjellah.

Predictably, Ettner concluded Richardson should receive bottom surgery — but she had to tie herself in knots to show that Richardson met WPATH’s own requirements to be a surgical candidate.

Ettner had to show that Richardson’s need for elective surgery met the threshold of “medical necessity.” She testified that Richardson’s gender confusion “[caused him] significant distress and prompts thoughts of surgical self-treatment.” She predicted that refusing him the surgery “may lead to emotional decompensation, attempts to remove his genitals, or suicide or suicide attempts.”

After painting this dire picture, Ettner turned around and argued Richardson was mentally well enough to consent to surgery.

She argued Richardson’s depression and borderline personality disorder didn’t preclude him from consenting because, “He is currently stable, has not been on any psychotropic medications since 2011 … and has recently been noted as being free of any major mental health concerns beside his gender dysphoria.”

Wait a hot second — I thought Richardson’s gender confusion was so overwhelming he was at risk of killing himself without transgender surgery?

Apparently not. On Global Assessment of Functioning, a test Ettner administered measuring how much mental illnesses effects a person’s day-to-day life, Richardson scored a 72/100.

She even tried to frame Richardson’s attempts to castrate himself, which she calls “attempts at self-treatment,” as signs of a healthy mind:

[These actions] should not be considered a sign of “uncontrolled mental illness”; on the contrary, such behavior represents a rational intention to eliminate testosterone by removal of the androgen-producing target organ.

Ettner’s evaluation should raise even the most casual readers’ eyebrows. Richardson cannot be sick enough to need transgender surgery and well enough to consent to it at the same time. But Judge Young raises no objections, simply writing, “[I find] Dr. Ettner’s testimony and conclusions concerning [Richardson’s] need for gender affirming surgery to be credible and persuasive.”

A large amount of public information shows Ettner’s bizarre reasoning comes straight from WPATH’s stance on mental illness. The organization relies heavily on “the minority stress hypothesis”— the theory that all mental health problems gender confused people ever experience stem from “being a member of an oppressed minority.”

The WPATH Files, a 2024 analysis of a massive WPATH document leak by journalist Mia Hughes, finds this unverified hypothesis allows WPATH “experts” to claim transgender surgery can solve a gender confused person’s “depression, anxiety, suicidality or even autism.”

The WPATH Files further assess that when surgery fails to live up to the patient’s expectations, the minority stress hypothesis shields WPATH doctors from culpability by blaming poor surgical outcomes on societal intolerance.

Perhaps that’s why WPATH doctors so frequently allow patients with mental health issues to consent to transgender medical interventions.

When an unnamed nurse emailed Dr. Dan Karasic, one of WPATH’s SoC authors, about her reluctance to prescribe opposite-sex hormones to a patient with PTSD, major depressive disorder, observed dissociation and schizoid typical traits, Karasic replied:

I’m missing why you are perplexed…the mere presence of psychiatric illnesses should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh risks…so why the internal struggle as to “the right thing to do?”

An astonishing number of similar interactions are documented in the WPATH Files.

This case shows WPATH can have extensive influence on Americans’ everyday life — down to how the government spends our money. No activist organization should have this power, especially not when public information exposes it for a fraud.

WPATH, and gender ideology, fly under the radar because few people question it. The impulse to keep quiet is natural in such a charged culture, especially when you don’t feel educated. But if you have any doubt, let me assure you now: Evidence shows that gender ideology is a malignant farce, no matter what academic or empathetic jargon it’s dressed in.

We should absolutely have compassion for those struggling with sexual identity confusion, trauma and mental illness — but that doesn’t mean we acquiesce to gender dogma.

You don’t have to be a rocket scientist to learn and point out gender ideology’s flaws. Don’t indulge it, cater to it, or tiptoe around it. Be brave and, as always, do your own research (the articles below are a good place to start).

Need a refresher? Re-read Part 1 and Part 2.

Additional Articles and Resources

The WPATH Files Exposes ‘Surgical and Hormonal Experiments on Children’

The WPATH Files – Transgender Interventions Are ‘Unethical Medical Experiments’

U.K.’s Review of Child Gender Policy Reveals Profound Failures That U.S. Still Defends

Transgender Organization Suggests Hormones and Surgeries Should Start Even Earlier for Gender-Confused Teens

Denmark Joins Growing List of European Nations Limiting So-Called ‘Gender Affirming Care’

Do Not Fall for the ‘Affirm Them or They Will Die’ Lie

Judge Up for Promotion Moved Serial Rapist and Pedophile into Female Prison

New Docuseries Paints Chilling Picture of Women Forced to Live with Men in Prison

Female Prisoners Beg for Help in Light of California Law That Lets Men Who Identify as Women into Women-Only Prisons