It has been ten years since the World Professional Association for Transgender Health (WPATH) revised its standards of care (SOC). The latest version, released on 25 September 2011, explicitly states that “being transsexual, transgender or gender nonconforming is a matter of diversity, not pathology”.”This is a momentous occasion,” said WPATH Revision Committee Chair and University of Minnesota Professor, Eli Coleman, as he launched the new SOC. Continue reading…
"We've made a clear statement that gender nonconformity is not pathological . . . This is no longer about hormones and surgery — it's about health in a holistic sense," Coleman said.
Christine Burns, one of the trans community representatives on WPATH’s International Advisory Committee summed up the significant progress made over the last decade. “The previous versions of the SOC were always perceived to be about the things that a trans person must do to satisfy clinicians, this version is much more clearly about every aspect of what clinicians ought to do in order to properly serve their clients. That is a truly radical reversal . . . one that serves both parties very well.”
WPATH recognises that many trans people live comfortable lives without having to seek therapy or medical interventions. Its clinical guidelines are about meeting the health care needs of those trans people who do seek medical support because their gender identity does not match the sex they were assigned at birth.
The 2011 SOC acknowledge that these “are first and foremost the client’s decisions – as are all decisions regarding healthcare. However mental health professionals have a responsibility to encourage, guide and assist clients with making fully informed decisions and becoming adequately prepared”.
In this interview Walter Bockting, the outgoing WPATH president, said the latest standards of care represent a significant departure from the past. "Some of the changes we've made really incorporate the latest science," Bockting said. "Research in this area is really increasing so . . . our standards of care are more evidence based."
"Oftentimes the standards of care were perceived as a barrier even though they were meant as access to care for hormone therapy and surgery," he said before going on to identify some key revisions in the new SOC. One major change is, that the standards "allow for a broader spectrum of identities – they are no longer so binary." For the first time the standards consider the health needs of people who are gender queer.
"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.
Trans people are increasingly involved in WPATH itself and in local and national projects such as that coordinated by CMDHB in New Zealand. Aucklander Jaimie Veale is chair of GenderBridge and has attended the last two WPATH symposia. She was in Atlanta for the launch of the SOC, presenting a paper about her PhD research.
“I'm pleased to see that WPATH have moved away from using pathologising language and having rigid steps that trans people need to take in order to convince health professionals to grant them access to treatment. These revised standards enable trans people to access medical procedures and focus on informed consent. I look forward to seeing these standards implemented in New Zealand”.
Dr Janet Say from the Auckland Sexual Health Service was one of the New Zealand health professionals at the WPATH conference.
"Attending the WPATH meeting with its launch of the new SOC document was a major education for me as a physician, realising the comparatively small but sometimes essential role we provide to transgender people. I realise that advocacy locally and internationally from health professionals, with the community defining their needs, is imperative. Destigmatisation and depathologisation is what we all have to work towards.”
In October 2011 the New Zealand Sexual Health Society held a Transgender update session lead by Dr John Newman and his team who provide health services for trans youth. Last week Dr Say attended the International Union against Sexually Transmitted Infections (IUSTI) World Congress in New Delhi. Her talk "Improving the quality of life for transgender people: the role of Sexual Health clinics” included an update about WPATH and the new SOC.
If health professionals, trans people and community groups around the country are interested in holding a discussion about the new WPATH standards, the Human Rights Commission is happy to host this using its video-conference facilities in Auckland, Wellington and Christchurch. This session would need to be held during office hours. Those interested should contact Jack Byrne on firstname.lastname@example.org