WPATH, the World Professional Association for Transgender Health, recently released Version 7 of its Standards of Care (SOC) at its Symposium in Atlanta, the first time that the SOC have been revised since 2001. The WPATH SOC are used by health care professionals internationally to guide their work with transgender people. Version 7 of the SOC represents a significant, positive shift in providing health care to transgender people.
The new SOC acknowledge that “gender dysphoria” may exist, and may be classified as a mental disorder in order to facilitate access to health care. However, transgender, transsexual, and gender non-conforming individuals are not inherently disordered, and gender dysphoria is not necessarily a life-time diagnosis.
The new SOC clearly state that “reparative therapies” are unethical, affirm the value of harm reduction approaches, and call for health care providers to play a greater role in advocating for increased tolerance and equity, and the elimination of prejudice, discrimination, and stigma.
Another major shift is the tone of the new SOC. The new standards are focused on what health care providers can do to assist transgender individuals with affirming their gender identity, exploring different options for expression of that identity, and making decisions about treatments to alleviate gender dysphoria, rather than what “hoops” transgender individuals need to “jump through” to prove that they are eligible to access treatment. The dreaded term “real life test” or “experience” has been removed, although 12 continuous months of living in a gender role that is congruent with their gender identity is required for genital surgery.
The new SOC also contain key changes in the qualifications of mental health professionals. Assessment of individuals for hormone therapy can be done by a health professional that has appropriate training in behavioural health and is competent to assess gender dysphoria (including family physicians and nurse practitioners), especially when working as part of multi-disciplinary teams. Surgery requires independent assessment by two mental health professionals with a master’s degree or its equivalent in clinical behavioural science.
And in addition to hormonal and surgical treatments and mental health services, the new SOC also address issues related to primary care, gynecologic and urologic care, reproductive options, and voice and communication therapy for transgender people.