New Version of Standards of Care

[Beth-Lock]

I have just learned that there is a new version of the standards of care out just now, which represents a greater degree of flexibility and some more liberal versions of various requirements. For example, it may not be necessary in some cases to have hormone therapy before gender correction surgery now. These are however exceptions to the rule. The requirements for a real life experience living as a woman, (the RLE), have also apaprently been liberalized.

These changes may give renewed hope to some TS folk, and certainly do for me.

[Rianna Humble]

After clarification, it seems that I had misinterpreted what Beth was trying to say, for which I apologise.

I welcome the new SOC because of the shift in emphasis from what we must do to merit the treatment that we need to how health professionals should treat our health needs as a whole.

The RLE was not a requirement prior to Hormone Therapy in the previous version of the Standards of Care and still is not.

However, in the Summary of Criteria for Hormone Therapy and Surgeries they still include for vaginoplasty

12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones);

12 continuous months of living in a gender role that is congruent with their gender identity.

They go on to say

The criterion noted above for some types of genital surgeries – i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity – is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role, before undergoing irreversible surgery.

[Katesback]

There is no standards of care written for a woman. They are written to address the care of a trans person. Since I knew I was a woman I ignorred the standards of care. Never went to a therapist and did it my way because I did not need to pay people to tell me things I already knew.

To each their own but the standards of care meant nothing to me in my journey.

[Melody Moore]

Kate,

you are not the only woman here and just because you didn't follow the Standards of Care, those
of us who are going through our transition through a gender clinic ran under our public health system
have no choice but to adhere to the Standards of Care. I don't know how you got approval for SRS
without following them. So it sounds to me like someone told a few tall stories somewhere to get
approved for SRS. Personally I would rather follow the SoC than to do something stupid which may
jeopardise my whole transition and put my health at risk. So I think Kate some of your advice is very
dangerous and very misleading. Anyway, I am not here to talk about your path, I am here to talk about
the paths that others must follow.

The thing that I liked about the new Standards of Care is that they are more inclusive and highlight
the need that other gender variants also suffer from similar issues to transsexuals and that some of
the treatments may be used to help them as well. This has angered those who followed the original
Harry Benjamin Standards of Care & those people who believe that it should support only those with
transsexualism, and who are really offended now because 'gender non-conforming people' who might
have 'Transvestic Fetishism' are now managed under the same set of guidelines for gender disorders.

I had a run in a few days ago with Charlotte Goiar on Facebook over this after she added me to her group
and posted a link to the new site I am setting up for our support group which also follows the WPATH SoC.

After she posted a link to my site, there discussion was taking place about the site and the new WPATH SoC
which obviously will play a huge part in how I structure the new site and about what information I publish on it.
There was some debate starting to allude to the site's definitions of the gender variants, but it was explained that
it is only a new site & that content was still being drafted up to be added that used the same terminologies as
are outlined in the new SoC. But when I pointed out why 'inclusion' was so important to our group my comments
got a lot of support from other group members, but I got kicked from the group after I made the comment. So I
contacted Charlotte to enquire as why she did that and here is the response...

We don't feel that the WPATH speak for us nor represent us regarding HBS because we consider
it to be a very serious medical condition instead of a "gender non-conforming" state of mind.

The first comment that Charlotte Goiar makes proves that she is taking offence to terms like "gender non conforming".
Charlotte has obviously taken offence because transsexuals have been put in the same group as these other gender
types and that our needs should always remain exclusive of everyone else's is the feeling I get here. But the truth is
many gender variants are affected by Gender Dysphoria which is a mood condition that relates to gender identity issues
and this is how it has now been outlined in the new WPATH SoC. Gender Identity Disorder (GID) is a totally different
condition to Gender Dysphoria (GD), however GD can affect those who are diagnosed with GID, but GD can also affect
all other gender non-conforming (GNC) people.

Charlotte graciously "invited me to re-join again after there is more clear differentiation of the different conditions"
on my site. But I told her not to bother - my whole opinion of that woman has been changed in the blink of an eye
after her very crazy response to these new Standards of Care.

[Katesback]

Melody. I did not offer any advice. I offered my opinion on the standards of care.

Kate,

you are not the only woman here and just because you didn't follow the Standards of Care, those
of us who are going through our transition through a gender clinic ran under our public health system
have no choice but to adhere to the Standards of Care. I don't know how you got approval for SRS
without following them. So it sounds to me like someone told a few tall stories somewhere to get
approved for SRS. Personally I would rather follow the SoC than to do something stupid which may
jeopardise my whole transition and put my health at risk. So I think Kate some of your advice is very
dangerous and very misleading. Anyway, I am not here to talk about your path, I am here to talk about
the paths that others must follow.

The thing that I liked about the new Standards of Care is that they are more inclusive and highlight
the need that other gender variants also suffer from similar issues to transsexuals and that some of
the treatments may be used to help them as well. This has angered those who followed the original
Harry Benjamin Standards of Care & those people who believe that it should support only those with
transsexualism, and who are really offended now because 'gender non-conforming people' who might
have 'Transvestic Fetishism' are now managed under the same set of guidelines for gender disorders.

I had a run in a few days ago with Charlotte Goiar on Facebook over this after she added me to her group
and posted a link to the new site I am setting up for our support group which also follows the WPATH SoC.

After she posted a link to my site, there discussion was taking place about the site and the new WPATH SoC
which obviously will play a huge part in how I structure the new site and about what information I publish on it.
There was some debate starting to allude to the site's definitions of the gender variants, but it was explained that
it is only a new site & that content was still being drafted up to be added that used the same terminologies as
are outlined in the new SoC. But when I pointed out why 'inclusion' was so important to our group my comments
got a lot of support from other group members, but I got kicked from the group after I made the comment. So I
contacted Charlotte to enquire as why she did that and here is the response...

The first comment that Charlotte Goiar makes proves that she is taking offence to terms like "gender non conforming".
Charlotte has obviously taken offence because transsexuals have been put in the same group as these other gender
types and that our needs should always remain exclusive of everyone else's is the feeling I get here. But the truth is
many gender variants are affected by Gender Dysphoria which is a mood condition that relates to gender identity issues
and this is how it has now been outlined in the new WPATH SoC. Gender Identity Disorder (GID) is a totally different
condition to Gender Dysphoria (GD), however GD can affect those who are diagnosed with GID, but GD can also affect
all other gender non-conforming (GNC) people.

Charlotte graciously "invited me to re-join again after there is more clear differentiation of the different conditions"
on my site. But I told her not to bother - my whole opinion of that woman has been changed in the blink of an eye
after her very crazy response to these new Standards of Care.

[Frances]

I am a firm believer in the RLE. I do not understand why anyone would rush to SRS. Social transition is the biggest hurdle, not whether you have a penis or a vagina. The SoC are fine. It is the DSM that needs revising.

[JennyA]

There is no standards of care written for a woman. They are written to address the care of a trans person. Since I knew I was a woman I ignorred the standards of care. Never went to a therapist and did it my way because I did not need to pay people to tell me things I already knew.

To each their own but the standards of care meant nothing to me in my journey.

EXACTLY! thats how i am doing things

[Melody Moore]

Irrespective of the fact that you know you are a woman - in most places you have no choice
but to follow the SoC because they have been adopted my health services around the world.

While I no longer am affected by GD, I have been affected by it in the past, but
I know I am a woman already as well - but does that make me "Super-Woman?"

If you like taking huge risks and gambling with your own life, that's fine, but do not think
that your path is the right path when it is flawed with so many possible pitfalls - there is
no substitute for proper professional help for gender transition. And I think it is extremely
irresponsible for us to promote or to tell others not to follow the WPATH Standards of Care
regardless of what anyone says.

[Kaitlyn Michele]

Real women don't brag about how they know everything, know how to do everything, and know better than every one else.. we just don't


just sayin...

[Fractured]

I respect the fact the SOC is being utilized as a treatment path for so many people. And I think Ver 7 is a large improvement compared to the 2001 release. The new document, besides changing the perspective of treatment, also provides more detailed information on the risks of treatment - the possible side effects of HRT and complications that can arise from SRS. I'm not sure if that is an effort to dissuade those treatment options or if it is trying to place more information at a physician's fingertips more easily. Regardless of the reasoning, I appreciate having that additional info in a easily located reference for both health care providers and for the public.