Standard variation – Gender Clinic News| Sandra Pertot

Medical and surgical interventions for those who wish to live as the other gender have always been controversial. However, a major difference between WPATH’s current standards of care and the very first set of standards (SOC-1) is that the early authors were aware of and open about the difficulties inherent in helping gender-questioning people.

Those first standards, published in 1979, cautioned that hormonal and surgical “sex reassignment” was extensive, invasive and not readily reversible; therefore, it should not be performed on an elective basis; it could be sought by people experiencing short-termed delusions or beliefs which might not persist; and there were known cases of regret.

These strong words of caution in SOC-1 were repeated in standards published by the organisation now known as WPATH in 1980, 1981 and 1994—but this prudence was removed thereafter. Children and adolescents were first included in SOC-4 (1994).

When health professionals first offered what is now known as “gender-affirming” medical and surgical treatment last century, gender dysphoria was considered a mental disorder. However, in the early 2000s, there was a movement to depathologise those whose “gender identity” is different to their biological sex. This began in SOC-7 (2012) with a shift of emphasis in requirements for treatment eligibility.

In 2013, Hidalgo et al, a group of clinicians who worked with gender-questioning young people in the US, outlined what they called the “Gender-Affirmative Model

In 2018, an argument was made for “informed consent” to be sufficient for adults to access cross-sex hormone treatment with no requirement for a mental health assessment or a diagnosis of gender dysphoria.

It is a significant departure from accepted clinical practice to assume, without a comprehensive assessment, a specific outcome for a complex set of signs and symptoms. For this reason, a new narrative to support the model of GAC with informed consent was developed, and this is found in SOC-8.

In contrast to SOC-7, WPATH’s current standards strongly emphasise the risk of suicide, which is weaponised by trans activists and GAC health professionals with the unethical line, “Do you want a dead cis [or non-trans] child or a live trans child?” to convince reluctant parents to agree to treatment. SOC-8 repeatedly stresses that GAC is “medically necessary” and, for the first time in the history of WPATH standards, describes it as “lifesaving”.

To summarise the SOC-8 position on mental health concerns—a person seeking GAC is likely to have significant mental health problems but, ignoring all other possibilities, we should conclude these are most likely caused by untreated gender dysphoria, so mental health problems should not be a reason to withhold GAC.

Significantly, the authors of SOC-8 acknowledge that little research has been conducted to systematically examine variables that correlate with poor or worsened biological, psychological, or social conditions following transition.

Never in my decades working in health care have I experienced such an arrogant refusal to acknowledge flaws in a health policy and to dismiss any adverse outcomes as rare and not worthy of consideration.

Source: Standard variation – Gender Clinic News

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