The assessment of gender dysphoria left me feeling exposed, naked, and dehumanised. Although the assessment process is alone a difficult experience, it is only made worse by the apparent conflation of gender dysphoria under the WPATH Standards of Care and Gender Dysphoria as a psychiatric diagnosis defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)."

Florence Ashley, transfeminine Jurist and Bioethicist

The current prevailing model 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 clinical guidelines for assessing and referring trans people for hormones and transition-related surgeries.3 The WPATH-SOC is intended to provide clinical guidance, and it is designed to be flexibly interpreted across clinical specialties. Here, the Path to Patient-Centred Care resource provides WPATH-SOC instruction through an informed consent and patient centred care model.4

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. ↩︎

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