These documents reveal how the World Professional Association of Transgender Health (WPATH) commissioned researchers from Johns Hopkins to conduct a systematic review of evidence, and then suppressed the publication of the reviews—because they didn't like the what the evidence showed: that there was almost no support for the efficacy of “gender-affirming care.” They then followed orders from their activist base to endorse pediatric gender affirmation with no age limits, despite knowing this is contrary to the evidence.