Dear Royal College of Physicians,

I would like to raise with you what I consider to be a medical scandal. I have sent the below email to the Royal College of Surgeons, however I would also like to send it to you, as I think my concerns affect the medical profession in general.

I am a man with what the DSM-5 calls "late-onset gender dysphoria" (adults and adolescents).

I have been concerned for some time, that surgical procedures are being carried out unnecessarily on young women, who have misdiagnosed themselves with what the DSM-5 calls "gender dysphoria", e.g. “The mothers left distraught after the NHS removed their daughters’ healthy breasts because the girls said they were transgender” (Daily Mail, 27th February 2025), “Revealed: More than 1,000 patients a year have trans chest surgery on the NHS” (Telegraph 10th February 2025) “Father's letter begging top surgeon to cancel trans operation on ‘depressive’ 20-year-old: ‘Please don't remove my daughter's breasts ...in just one day you'll ruin her life for ever’” (Daily Mail, 27th July 2024).

As I have personal experience of what gender dysphoria actually is, I can see that these women do not have gender dysphoria, and are rather suffering from a social contagion, they have misdiagnosed themselves, and these surgical interventions are being undertaken for no reason.

I think that the problem is, is that the public, and evidently members of the medical profession, have come to the false belief that there are a class of people who literally have the "gender identity" or "essence" of the opposite sex, and that this is supposedly something that this class of people infallibly know. I have included what the DSM-5 actually says about cross-sex identification (gender dysphoria) below this email, which shows that this narrative is untrue, and cross-sex identification is in fact a matter of having an atypical sexual orientation/sexuality. 

I see that as the medical profession is apparently operating under this false belief, this is giving rise to atrocities, as primarily young women are having body parts amputated for no medical reason. This isn't just my opinion, it is shared by Dr. Ray Blanchard, who served on the DSM-4 gender identity disorder subcommittee: 

Blanchard writes: "To us, the most tragic group, along with their families, includes those who have acquired rapid-onset gender dysphoria. That condition appears to be the tragic interaction of the current transgender zeitgeist (“It’s everywhere, and it’s great!”) and social media with the vulnerability of troubled adolescents, especially adolescent girls. They are at risk for unnecessary, disfiguring, and unhealthy medical interventions." [1]

These "unnecessary, disfiguring, and unhealthy medical interventions" are of course, now happening, and in great number.

I have written a short, referenced, memo, which gives further context behind the problems that I raise above: transpolicy.substack.co…

I have also had an article regarding this topic published by the the UK charity HealthSense, who promote "science and integrity in healthcare": healthsense-uk.org/publ…

[1] 4thwavenow.com/2017/12/…

Yours,

Orlando Woolf

In the DSM-5, gender dysphoria amongst pre-pubertal children, both in boys and girls, is associated with later being attracted to the same sex: “For both natal male and female children showing persistence, almost all are sexually attracted to individuals of their natal sex.” The DSM-5 calls this pathway “early-onset” gender dysphoria. In most cases, this pathway of gender dysphoria will cease at the onset of puberty.

There is another pathway, which the DSM-5 calls “late-onset” gender dysphoria, which in males “occurs around puberty or in later life". Like early-onset gender dysphoria, this is also connected to sexuality, as individuals, “frequently engage in transvestic behavior with sexual excitement”, however unlike the early-onset group, are otherwise heterosexual, “A substantial percentage of adult males with late-onset gender dysphoria cohabit with or are married to natal females. After gender transition, many self-identify as lesbian”. Furthermore, the DSM-5 says in men with transvestic disorder a phenomenon called “autogynephilia”, which the DSM-5 defines as the “Sexual arousal of a natal male associated with the idea or image of being a woman”, increases the likelihood of of gender dysphoria.