WPATH, SOC ver. 7.
International Guidelines.
Launch of New Version of WPATH (World Professional Association for Transgender Health), [Formerly known as the Harry Benjamin International Gender Dysphoria Association], Standards of Care, Version 7, International Guidelines.
Some key revisions:
• Psychotherapy is no longer a requirement to receive hormones and surgery, although it is suggested.
"It used to be a minimum amount of psychotherapy was needed. An assessment is still required but that can be done by the prescribing hormone provider," Bockting explained.
• A number of community health centres in the U.S. have developed protocols for providing hormone therapy based an approach known as the Informed Consent Model. These protocols are consistent with version 7 revisions of WPATH's standards of care.
"The SOC are flexible clinical guidelines; they allow for tailoring of interventions to the needs of the individual receiving services and for tailoring of protocols to the approach and setting in which these services are provided," Coleman explained.
"Access is more open and acknowledges transgender care is being provided in community health centres. This certainly makes it easier to access hormones," Bockting added.
• There are now different standards for surgery, as well. For example, a transgender man who wants a hysterectomy no longer has to live one year as a male in order to receive the surgery. Likewise, a transgender woman who wants her testicles removed does not have to live one year as a female.
For people who want genital reconstructive surgery, however, the standards of care recommend living a year in the role of the gender they are transitioning.
• Another major change, Bockting explained, is that the standards "allow for a broader spectrum of identities – they are no longer so binary."
"There is no one way of being transgender and it doesn't have to mirror the idea of a change of their sex," Bockting explained.
"These standards allow for a gender queer person to have breasts removed without ever taking hormones," he said.
The WPATH conference in Atlanta, along with the Southern Comfort Conference and the conference of the Gay & Lesbian Medical Association, was a joint effort to show the world what is being done in the area of LGBT health.
But, Bockting added, the new WPATH standards of care also show the tremendous effort that transgender people themselves are doing to ensure their access to healthcare.
"Often times the standards of care were perceived as a barrier even though they were meant as access to care for hormone therapy and surgery,"
"The new standards showcase the important role [transsexual, transgender, and gender nonconforming people] have played in changing the landscape of transgender health in the U.S.," Bockting added.
Other Positive Changes:
The tone and language of the SOC7 are more positive than in previous versions, with more emphasis on care and less emphasis on barriers to care. Some highlights include:
• Concise and more cogent criteria for access to hormonal and surgical transition care.
• Relaxation of the age 18 restriction for access to hormonal transition care.
• Removal of the three month requirement for either “real life experience” (living in a congruent gender role) or psychotherapy before access to hormonal care.
• Clarification that “the presence of co-existing mental health concerns does not necessarily preclude access to feminising/ masculinising hormones .”
• Removal of barriers to surgical care because of family intolerance or interpersonal issues.
• An expanded role for medical health professionals in granting access to hormonal therapies.
• Acknowledgement of informed consent model protocols, developed at community health centers worldwide for hormonal transition care.
• Emphasis of cultural competence and sensitivity for care providers.
• Expanded and clarified information on puberty delaying treatment for gender dysphoric adolescents.
• Clarification on the role of the SOC as flexible clinical guidelines that may be tailored for individual needs and local cultures.
Issues for Future Revisions: Although the 7th Version of the SOC is significantly improved over previous versions, there remain issues of concern to trans communities and their allies. One issue is promotion of a widely held myth that Gender Dysphoria in children will persist in only a small minority by adolescence, in other words, that gender identity in children is malleable and impersistent.
Full version of latest WPATH SOC version 7 guidelines. http://admin.associationsonline.com/uploaded_files/140/files/Standards%20of%20Care,%20V7%20Full%20Book.pdf
From the GIRES website, WPATH – Standards of Care: Now in its seventh edition, the standards of care are based on the best available science and expert professional consensus. The new edition reflects the current attitude that transgender people are not inherently disordered.
One of the British gender identity clinics has stated in response to a Freedom of Information request: “Specifically, our Care Pathway follows the stages laid down within The Harry Benjamin International Standards of Care (this differs from the WPATH guidance), as we believe that hormone treatment is best undertaken after real life experience has begun”. The clinic is using an out of date document to justify its questionable practice. WPATH has therefore made it clear in a recent letter that the new Standards of Care take precedence over all earlier versions.
WPATH are currently working on version 8. I will make it available when the final version is published.
