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Notes -
I think the biggest takeaway here is exactly how little evidence is required for WPATH to declare something a "gender identity" requiring "medically necessary gender-affirming care". I've read academic papers from forum posters talking about their forum buddies before, but I've certainly never seen a case where the resulting paper was considered notable, let alone sufficient basis to create a medical standard of care. I previously wrote a post about otherkin/transracialism/plurals as a control-group for gender-identity, in the same way that parapsychology can serve as a control group for science. This serves a similar function, but on the medical institution side of things.
Also, take a moment and consider exactly how big the gap is between the quality of evidence and the boldness of the claim. Presumably the author thinks gender identities are fixed/inborn:
So apparently for all of human history some people have been born with a eunuch gender identity (separate from actual eunuchs who generally had no choice), and we're only now finding out thanks to the guys writing the WPATH standard of care happening to post on a related fetish forum. And that's just it as a scientific claim, but this isn't even about whether a hypothesis has a 51% chance of being true, it's about medical care. Medical care carrying severe and permanent side-effects demands use of the precautionary principle and very strong evidence that it will benefit the patient. But it goes beyond even that because of course this isn't him treating a specific patient he has met, it's him establishing a medical standard of care. His internet surveys of his forum buddies are sufficient for WPATH to declare that patients diagnosed as having a eunuch gender identity (which is presumably any patient who claims to identify as a eunuch, which I suspect would go up orders of magnitude if psychiatrists started telling patients about the idea or the it got any cultural traction) will benefit from "gender-affirming care".
This tells us very little about eunuchs, but it tells us a lot about WPATH's decision-making processes. It also tells us important information about the institutions that continue to reference other WPATH recommendations as if they're significantly more meaningful than a sheet of paper with "Yes X is a gender-identity, prescribe gender-affirming care." printed on it. Or for that matter institutions that would openly criticize something like a standard for prescribing chemotherapy if it was based on such dubious evidence, but stay silent when it's a standard for prescribing castration because of the political aspect.
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