Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.
Journal: International journal of transgender health
Volume: 23
Issue: Suppl 1
Year of Publication:
Affiliated Institutions:
Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
Callen-Lorde Community Health Center, New York, NY, USA.
Nottingham Centre for Transgender Health, Nottingham, UK.
James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA.
New Health Foundation Worldwide, Evanston, IL, USA.
Independent Practice, San Francisco, CA, USA.
Emory University Rollins School of Public Health, Atlanta, GA, USA.
Independent Scholar, Vancouver, WA, USA.
The George Washington University, Washington, DC, USA.
Department of Anthropology, California State University, Chico, CA, USA.
University of California San Francisco, San Francisco, CA, USA.
University of British Columbia, Vancouver, Canada.
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
New York State Psychiatric Institute, New York, NY, USA.
Ghent University Hospital, Gent, Belgium.
Transgender Infopunt, Ghent University Hospital, Gent, Belgium.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany.
Harvard Medical School, Boston, MA, USA.
Regents University London, UK.
Rush University Medical Center, Chicago, IL, USA.
Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA.
Bureau GenderPRO, Vienna, Austria.
School of Population Health, Curtin University, Perth, WA, Australia.
Howard Brown Health, Chicago, IL, USA.
University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada.
Asamblea Nacional de Venezuela, Caracas, Venezuela.
University of Nevada, Las Vegas, NV, USA.
La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
Monash Health Gender Clinic, Melbourne, Victoria, Australia.
Department of Psychiatry, Hacettepe University, Ankara, Turkey.
Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA.
Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina.
National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
Oregon Health & Science University, Portland, OR, USA.
NYU Langone Health, New York, NY, USA.
Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
GrS Montreal, Complexe CMC, Montreal, Quebec, Canada.
University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
The Facialteam Group, Marbella International Hospital, Marbella, Spain.
Independent Scholar.
Independent Practice, Oakland, CA, USA.
Nationwide Children's Hospital, Columbus, OH, USA.
School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada.
Penn State Health, PA, USA.
Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium.
Nelson Mandela University, Gqeberha, South Africa.
University of Victoria, Victoria, BC, Canada.
ANOVA, Karolinska University Hospital, Stockholm, Sweden.
UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas.
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Pacific University, Hillsboro, OR, USA.
Whitman Walker Health, Washington, DC, USA.
Transvisie, Utrecht, The Netherlands.
The Jed Foundation, New York, NY, USA.
Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy.
Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium.
Mermaids, London/Leeds, UK.
Duke University Medical Center, Durham, NC, USA.
Alberta Health Services, Edmonton, Alberta, Canada.
Independent Practice, New York, NY, USA.
RMIT University, Melbourne, Australia.
Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium.
Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA.
Denver Health, Denver, CO, USA.
Malouf Counseling and Consulting, Baltimore, MD, USA.
WPATH Global Education Institute.
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Professional Association for Transgender Health, South Africa.
Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA.
Gender Confirmation Center, San Francisco, CA, USA.
Johns Hopkins Center for Transgender Health, Baltimore, MD, USA.
Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
La Trobe University, Melbourne, Australia.
Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA.
Independent PracticeThessaloniki, Greece.
Talkspace, New York, NY, USA.
Institute of HIV Research and Innovation, Bangkok, Thailand.
Gender Identity Research and Education Society, Leatherhead, UK.
Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA.
FtM Phoenix Group, Krasnodar Krai, Russia.
Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Tavistock and Portman NHS Foundation Trust, London, UK.
Iranti, Johannesburg, South Africa.
University of Houston, Houston, TX, USA.
Children's National Hospital, Washington, DC, USA.
Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA.
Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium.
Independent Practice, Campbell, CA, USA.
School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK.
College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA.
North Memorial Health Hospital, Robbinsdale, MN, USA.
School of Medicine, University of Nottingham, Nottingham, UK.
Abstract summary
Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
Authors & Co-authors:
Coleman E E
Radix A E AE
Bouman W P WP
Brown G R GR
de Vries A L C ALC
Deutsch M B MB
Ettner R R
Fraser L L
Goodman M M
Green J J
Hancock A B AB
Johnson T W TW
Karasic D H DH
Knudson G A GA
Leibowitz S F SF
Meyer-Bahlburg H F L HFL
Monstrey S J SJ
Motmans J J
Nahata L L
Nieder T O TO
Reisner S L SL
Richards C C
Schechter L S LS
Tangpricha V V
Tishelman A C AC
Van Trotsenburg M A A MAA
Winter S S
Ducheny K K
Adams N J NJ
Adrián T M TM
Allen L R LR
Azul D D
Bagga H H
Başar K K
Bathory D S DS
Belinky J J JJ
Berg D R DR
Berli J U JU
Bluebond-Langner R O RO
Bouman M-B MB
Bowers M L ML
Brassard P J PJ
Byrne J J
Capitán L L
Cargill C J CJ
Carswell J M JM
Chang S C SC
Chelvakumar G G
Corneil T T
Dalke K B KB
De Cuypere G G
de Vries E E
Den Heijer M M
Devor A H AH
Dhejne C C
D'Marco A A
Edmiston E K EK
Edwards-Leeper L L
Ehrbar R R
Ehrensaft D D
Eisfeld J J
Elaut E E
Erickson-Schroth L L
Feldman J L JL
Fisher A D AD
Garcia M M MM
Gijs L L
Green S E SE
Hall B P BP
Hardy T L D TLD
Irwig M S MS
Jacobs L A LA
Janssen A C AC
Johnson K K
Klink D T DT
Kreukels B P C BPC
Kuper L E LE
Kvach E J EJ
Malouf M A MA
Massey R R
Mazur T T
McLachlan C C
Morrison S D SD
Mosser S W SW
Neira P M PM
Nygren U U
Oates J M JM
Obedin-Maliver J J
Pagkalos G G
Patton J J
Phanuphak N N
Rachlin K K
Reed T T
Rider G N GN
Ristori J J
Robbins-Cherry S S
Roberts S A SA
Rodriguez-Wallberg K A KA
Rosenthal S M SM
Sabir K K
Safer J D JD
Scheim A I AI
Seal L J LJ
Sehoole T J TJ
Spencer K K
St Amand C C
Steensma T D TD
Strang J F JF
Taylor G B GB
Tilleman K K
T'Sjoen G G GG
Vala L N LN
Van Mello N M NM
Veale J F JF
Vencill J A JA
Vincent B B
Wesp L M LM
West M A MA
Arcelus J J
Study Outcome
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