The ‘Standards of Care for Gender Identity Disorders’, the document used to justify the gatekeeping of transsexual and transgender people’s treatment and historically used to bar nonbinary, genderqueer and gender nonconforming people from access to hormones and surgeries, is to become considerably more progressive. The new document will be called ‘Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People’ and features a number of revisions:
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 centers 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 centers. 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.