To me, a gatekeeper in the traditional sense is kind of like a check [list] of things you need to say, or think, or be, in order to be what they think is appropriate for someone to start hormone therapy, or have surgery."

Marti Abernathey, a trans woman and the founder of Trans Advocate

The current prevailing model being used by clinicians to inform health care provision to transgender patients is the World Professional Association of Transgender Health Standards of Care.1 WPATH is a non-profit health professional body that advocates for “high quality care for transsexual, transgender, and gender non-conforming individuals internationally”.2 WPATH publishes universal standardized protocols for assessing and referring trans people for hormones and transition-related surgeries.3 However, while many developments in care standards for transgender patients have been advanced through the WPATH-SOC model, there remains the opportunity to interpret the WPATH-SOC guidelines through a patient-centred4 model.

The Informed Consent Model (ICM) offers a more collaborative and patient-centred approach that addresses debates surrounding exactly how and when trans people should access these gender-affirming medical treatments that persist amongst clinicians and researchers.

Using ICM in gender-affirming medicine allows for trans people to access hormones and transition-related surgeries with self-determination and autonomy, without the need for: a gender dysphoria diagnosis, mandatory pre-transition psychosocial readiness assessments, and unwanted mental health treatments.

Footnotes
  1. World Professional Association for Transgender Health (WPATH) (2012). Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (Version 7). ↩︎
  2. World Professional Association for Transgender Health (WPATH) (2012). Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (Version 7). ↩︎
  3. Coleman, E. (2009). Toward version 7 of the World Professional Association for Transgender Health’s Standards of Care. International Journal of Transgenderism 11, 1-7. DOI: 10.1080/15532730902799912 ↩︎
  4. M.J., & Edgman-Levitan, S. (2012). Shared decision making – The pinnacle of patient-centred care. New England Journal of Medicine 366(9), 780-781. ↩︎