New Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

by Emilia Dunham

Program Associate

Just yesterday the World Professional Association for Transgender Health (WPATH) released it’s 7th Version of Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (SOC) in Atlanta (where we’re proud to have several members of Fenway Health presenting at and/or in attendance).

This was last updated in 2001, and if you know anything about LGBT health and especially trans health, A LOT has changed in ten years, and this document has demonstrates the evolution in understanding of trans health. This update will make a drastic difference in how trans people are able to access their care. It’s something that will make a huge difference on a global scale for trans health, but will also directly affect individuals which is fantastic and not something we always see in trans advocacy.

If you don’t know WPATH sets the world standards of care for transgender individuals seeking gender transition. Doctor’s use these standards to determine how they will treat trans people who come into their offices, such as in terms of under what conditions they can access hormones, surgeries and other forms of transition-related care (ex. months/years in therapy and in the “real-life experiences” in the desired gender). Many trans advocates and trans individuals themselves see these as harmfully gatekeeping, but there is general understanding there should be some regulation of care for an area of health services needing more research. This document represents that balance.

You can view the document in its entirety here, which has increased significantly:

In the meantime here are some of the highlights:

  • Gender Conversion Psychotherapies are Unethical
  • De-psychopathologisation of Gender Difference (basically meaning that trans people aren’t inherently crazy)
  • More reasonable criteria for accessing hormones and surgeries
  • Call for health providers to be culturally competent and treat clients sensitively
  • More empowerment of trans clients in their own care
  • Removal of the three-month requirement for either “real life experience” (living in a congruent gender role) or psychotherapy before access to hormonal care.
  • Clarification on the role of the SOC as flexible clinical guidelines that may be tailored for individual needs and local cultures.
  • Inclusion of other gender nonconforming folks, minors and other new areas.

Published by Emilia Dunham, MPP, MBA

Emilia Dunham is currently a Project Manager at MassHealth/Department of Public Health, and formerly the Project Manager of the Life Skills project at The Fenway Institute, an HIV intervention study for young transgender women. Emilia worked at Fenway for 7 years, first as a Quality Control and Regulatory Assistant mainly involved with biomedical HIV prevention trials, before serving as the Program Associate for The Network for LGBT Health Equity, a network instrumental in many national LGBT health policy improvements. She is also involved with the Massachusetts Transgender Political Coalition, serving as a Steering Committee member and the Policy Committee Co-Chair, an organization largely responsible for the recent passage of the Trans Rights Bill. Additionally she serves as a member of the Massachusetts Commission on Gay, Lesbian, Bisexual and Transgender Youth, Co-Chair of the Recommendations Committee. Emilia received a Bachelor’s degree from Northeastern University. There she served as President of the LGBTQ student group where she planned programs such as Pride Week, Transgender Day of Remembrance, and AIDS Week. In addition, she advocated for LGBTQ inclusive policies and programming on campus such as a Gender Neutral Housing program, an LGBTQ Center and the expansion of Women’s Studies to Women, Gender and Sexuality Studies. Emilia recently earned a Master of Public Policy and Master of Business Administration in health policy and management from the Brandeis Heller School School for Social Policy and Management.

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