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:
• 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.
Won’t stop individual gatekeeping assholes entirely, but it will help. This is awesome.
this seems more like WPATH struggling to catch up and stay relevant when they know most non-surgeon trans health providers who really know and understand trans people (this does not necessarily include providers who are trans themselves because sometimes they are super invested in their own narrative blah blah) already stopped giving a shit about them.
but idk, i’m not really thrilled about the reaction i’ve seen on tumblr. yes this is still a medicalizing discourse and it’s still gatekeeping, but i’ve worked with a friend on shopping new doctors for trans people who can’t afford/do not want therapy, and this will make a big difference for them. if it means fewer trans people on black market mones (not talkin about inhouse pharmacy) then great. if it means fewer people going without and having to deal with the consequences then great. if it means less of a sense of hopelessness which is a basic threat to a lot of trans people’s mental and physical health, then great. idk, a very tumblresque real world/ideal disconnect going on here.