The World Professional Association for Transgender Health (WPATH) has released the Standards of Care for the Health of Transgender and Gender Diverse People, Version 8, following five-years of rigorous scientific effort by more than 120 health care clinical and academic professionals across the globe, including Professor Jon Arcelus of our Gender Identity, Sexuality and Wellbeing research group.

The Standards of care preparation committee consisted of more than 120 multidisciplinary subject matter experts, health care professionals, researchers, and stakeholders with diverse perspectives and global geographic representation. Led by Dr Eli Coleman, from the University of Minnesota, Dr Asa Raddix from NYU Grossman School of Medicine and Dr Jon Arcelus from the University of Nottingham and Nottinghamshire Healthcare Foundation NHS Trust, this guide provides clinical guidance to health care professionals to help transgender and gender diverse (TGD) people, with safe and effective pathways to achieve lasting personal comfort with their gender identities and maximize their overall health, psychological well-being, and self-actualization.

“The Standards of Care 8 represents the most comprehensive set of guidelines ever produced to assist health care professionals around the world in support of transgender and gender diverse adults, adolescents, and children who are taking steps to live their lives authentically,” said WPATH President Walter Bouman, MD, PhD, and WPATH President Elect Marci Bowers, MD. “Health care is a human right. All trans-identified people on this planet deserve the same opportunity to be their true selves and have access to the medically necessary affirming care that allows them to do just that. The field of transgender medicine is evolving rapidly, responsive foremost to the needs of patients and their families and guided by objectivity, compassion, and consensus. We are thrilled to provide this vital resource to support transgender and gender diverse people worldwide.”

In December 2021, a draft of the SOC8 was released to the public for review and comment. WPATH received thousands of comments on the guidelines. All were read and taken into consideration during the editing phase of SOC8.

“Watching with great pride and respect as the entire SOC8 revision committee worked in a collaborative way to develop these robust, and revised guidelines was a phenomenal experience,” said Blaine Vella, WPATH’s Executive Director. “The authors worked tirelessly, as volunteers, to ensure that their chapters were representative, balanced, and contained the most current scientific data and clinical experience available. All this in the knowledge that the SOC8 will continue to offer access and knowledge to the health and wellbeing of all transgender and gender diverse people across the globe.”

“The Standards of Care 8 is here to help people get the care they need so they can live healthy, happy lives. We are not starting from scratch. We are building upon decades of research and clinical experience,” said SOC8 Co-Chairs, Eli Coleman, PhD, Jon Arcelus, MD, PhD, and Asa Radix, MD, PhD, MPH. “The SOC8 is the most expert, nuanced, evidenced-based and consensus-based document internationally. The authors come from a variety of disciplines working in transgender health. All have done their utmost to serve a broad public and a broad area of health care providers with guidelines they can work with in different places around the world. We hope it serves the quality of care for transgender people.”

These Standards represent the most comprehensive set of guidelines ever produced to guide health care professionals around the world in  supporting transgender and gender diverse adults, adolescents, and children.  The field of transgender medicine is rapidly evolving, attempting to respond to the needs of patients and their families and guided them with objectivity, compassion and consensus.  Thus, the guidelines are intended to be flexible to meet diverse global health needs.

The consensus of the final recommendations was based on multiple rounds of Delphi processes and comprehensive literature reviews.

In December 2021, a draft of the Standards was made public  for review and comment.   WPATH received thousands of comments on the guidelines, all of which were read and taken into consideration.

The authors volunteered to ensure that the chapters were representative, balanced, and contained the most up-to-date scientific data and clinical experience available.  "I have been very proud to be one of the co-chairs of the new SOC. The entire review committee of  the eighth version of the Standards of care has worked collaboratively in order to develop these robust and revised guidelines, it has been a phenomenal experience," says Dr. Jon Arcelus, transgender  health specialist at the Nottingham Centre for Transgender Heath and Emeritus Professor of  Mental Health and Wellbeing at the University of Nottingham.

"We haven't  started from scratch, the guidelines are based on decades of research and clinical experience.  We hope it will improve the quality of care of transgender and gender diverse people," adds Dr. Arcelus.

Other members from Nottinghamshire Healthcare NHS Foundation Trust who were involved in the development of the guidelines included Dr Walter Pierre Bouman and Mrs Sally Robbins-Cherry.

Content of the eighth version of the Standards of care

A total of 18 chapters have been developed as part of the eighth version of the SOC. Each of the recommendations are followed by an explanatory text with the relevant references.

General health-related areas are covered in the chapters on Terminology, Global Applicability,  Population estimates and Education. Chapters developed for different populations of  transgender and gender diverse people  include  Assessment of adults,  adolescents, children, non-binary, Eunuchs and intersex people, and those living in institutions.  Finally, the chapters related to gender affirmation treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health and Mental Health.

Role of the World Professional Association for Transgender Health

Transgender health care 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 people seeking gender-affirming medical support and treatment. Inparallel, there has been a significant increase in the scientific literature in this area.  The World Professional Association for Transgender Health (WPATH) is  an international, multidisciplinary and professional organization whose mission is to promote evidence-based care, education, research, policy and  respect in transgender health. One of WPATH's primary functions  is to promote the highest standards of health care for transgender and gender diverse individuals  through the Standards of Care.

The Standards of Care 8 can be found at wpath.org