Posing as a Professional Organization, SEGM Seeks to Mislead
Opinion: How SEGM’s bad education for doctors harms trans people.
Opinion, by Veronica Esposito
According to reporting by Erin In the Morning, Washington State University has given the Society for Evidence-Based Gender Medicine (SEGM) accreditation to teach continuing education (CE) to medical professionals. This accreditation has been widely condemned, as SEGM is designated by the Southern Law Poverty Center as a hate group due to its vitriol and propaganda efforts against the transgender community. (Subsequent reporting indicates that a formal inquiry has been made into SEGM’s accreditation and that the CME courses are currently on hold.)
Among other things, SEGM has advocated for using conversion therapy against trans people, a widely discredited approach that has been demonstrated to be extremely harmful. The organization has also promulgated the pseudoscientific theory of Rapid Onset Gender Dysphoria.
Due to these and other harmful actions against trans people, SEGM’s work has been denounced by authorities on transgender healthcare. A 2022 Yale Law School research paper into inaccurate claims used to justify bans on gender-affirming healthcare described SEGM as “an ideological organization without apparent ties to mainstream scientific or professional organizations” and noted that it held no meetings, did not screen members, did not publish a journal, and “appears to be nothing more than a website” with shoddy citations. In a paper titled “The Anti-Transgender Medical Expert Industry” Harvard law professor and trans activist Alejandra Caraballo labeled SEGM “the most prominent of the pseudo-scientific organizations in the anti-trans space.”
It is harmful for SEGM to teach continuing education to medical professionals in best practices for trans clients because CEs are a crucial part of how medical and mental health professionals stay up to date in their fields. Typically, in order to renew licensure to continue practicing, professionals must show proof of dozens of hours of continuing education, demonstrating that they are learning beyond their graduate studies and becoming more and more aware of how to best work with all populations.
CEs are particularly important for emergent demographics such as transgender people—Masters and PhD programs often provide insufficient education into such demographics. As groups such as trans people become better and better and better understood, best practices can change quite dramatically, and CEs are a vital part of disseminating that knowledge.
When it comes to treating transgender people, there is certainly room for medical and mental health practitioners to improve. For instance, a 2022 systematic review by Jason van Heesewijk and colleagues examining 46 papers that assessed implementation of trans-inclusive curriculum in medical schools found “there are still systemic barriers to structurally and sustainably implement transgender health content into medical education.” They argued that the inadequacy in education on trans health is “enabling physicians’ lack of knowledge and reinforcing discriminatory attitudes in patient-provider interactions,” in turn leading to barriers to care and poor outcomes for trans people seeking medical care.
Andie Leslie, a nonbinary therapist with 9 years of experience supporting the mental health of trans people, has personally experienced the results of inadequate training. Many years ago, when they first sought their own mental health support as a therapy client, they began working with a therapist who had little to no knowledge of transgender people.
“The problem I ran into was there was no initiative on her part to educate herself on the community,” Leslie told me. “At the time I was struggling financially and paying [this therapist] out of pocket. For many weeks in a row, I’d spend the entire hour educating her about the trans community. It wasn’t until after I terminated services with her that I realized this was not ok.”
Leslie reported that their therapist charged them $150 per session—at that time a very steep fee for Leslie, who struggled to pay for therapy. Instead of receiving dearly needed mental healthcare in exchange for that fee, they ended up offering impromptu lessons on trans competency.
Leslie’s experience is one of many examples of how even well-meaning professionals can cause harm to trans people. A 2025 research paper on bad medical experiences shared by trans people via the Twitter hashtag #TransHealthFail found dozens of forms of systematic transphobia and barriers to healthcare, including routine deadnaming and misgendering, lack of basic knowledge of transgender healthcare, microaggressions, gatekeeping, coercion, sexualization, and many more.
Continuing education is a vital way to ensure that experiences like Leslie’s and those documented in #TransHealthFail occur less often. But allowing anti-trans hate groups like SEGM to teach such classes will in fact make healthcare providers even less competent to serve trans people, and prevent them from connecting with actual educational opportunities.
A curious training that Leslie experienced in 2023 sheds light on just what a SEGM CE course might be like. At the time, they were working as a predoctoral intern at a university when they were requested to attend one of two mandatory trainings. Being trans, Leslie opted for the gender training.
According to Leslie, the event started out more or less normally, as the presenter talked about genetics, which his education was in. As he strayed further and further into “gender ideology” as Leslie put it, things got weirder, and he began to echo right-wing talking points about trans people, such as arguing that there is a legitimate scientific debate over the efficacy of trans healthcare. According to Leslie, this presenter “provided SEGM as primary sources for his arguments. It seemed like there was some association between him and SEGM.”
Leslie and others stood up to rebut him, making for an uncomfortable encounter. “It went from a lukewarm afternoon talk to a pretty hot tub temperature conversation,” they recalled. “I’d estimate that roughly 40% of the room was against me, and 60% was with me. It helped that the psych services department was there with me. People seemed interested, it definitely woke people up.”
Based on an audio recording of the session that Leslie uploaded to YouTube, the trainer made some extremely questionable statements. He repeatedly took the right-wing tack of questioning the quality of data for transgender healthcare. At one point he compared gender-affirming medical interventions to Native Americans attempting to reduce the suicide rate in their community by attempting to transition away from being an “Indian” by trying to “lighten their skin.” As these statements are made, it’s possible to hear audible murmuring among the class attendees and even some outbursts, such as when participants repeatedly challenge the speaker, “Why don’t you ask a trans person?”
Leslie spent some time speaking with the presenter one-on-one in an attempt to persuade him to improve his training materials, but they unfortunately later heard from a friend that the trainer gave essentially the same presentation about a month later.
“People like this aren't interested in science for fact,” Leslie concluded, “it’s just a mask for an organization that is really focused on a particular perspective and making the life of trans people difficult. They’re undermining work that good clinicians have been doing for decades.”
If this is the sort of continuing education that SEGM would teach to medical practitioners in Washington, it certainly would fly in the face of what trans people know about ourselves and what we believe is best for our ability to thrive. It also is incorrect according to the data and best practices of those who specialize in trans healthcare. Unfortunately, however, many attendees of such CE classes would certainly not know better and take such presentations as fact, potentially leading to extreme harms for trans patients down the line.
Veronica Esposito (she/her) is a writer and therapist based in the Bay Area. She writes regularly for The Guardian, Xtra Magazine, and KQED, the NPR member station for Northern California, on the arts, mental health, and LGBTQ+ issues.