APA Dumps WPATH

[Guest sophia.gentry58]

This is over a year old, but I was unable to locate this story anywhere here at LP. Has anyone read the July, 2012 story that APA has essentially renounced WPATH because they feel they are not empirically based!? Is this why the APA changed the DSM diagnosis of GID to GD? If the APA, up to this point been was following the lead of WPATH, but now has renounced them, what does that mean for us? I have nothing but questions and no answers. Help please!!!

Sophia

[Guest KimberlyF]

APA makes recommendations. The psych community can do what they please. Some will follow WPATH. Some never did.

This is a report from last year from the APA:

http://www.psych.org/File%20Library/Learn/Archives/rd2012_GID.pdf

[Guest Leah1026]

APA makes recommendations. The psych community can do what they please. Some will follow WPATH. Some never did.

This is a report from last year from the APA:

http://www.psych.org/File%20Library/Learn/Archives/rd2012_GID.pdf

Having scanned that link I get the impression the difference is more political than scientific. They are using the lack of studies as a tool to try to undermine WPATH. My feeling is the APA doesn't like the fact that their precious DSM is becoming increasingly less relevant as far as our care is concerned. So this is an indirect attack on WPATH. WPATH may lack official studies, but we have tons of actual real world experience of working with real trans people (not test subjects). WPATH also has many members that are actually trans themselves and that fact probably sticks in the craw of some psychiatrists as the "imates running the asylum". So yeah it sounds a bit like sour grapes to me.

[Guest KimberlyF]

On this issue, they're both (gender part of DSM at least) becoming irrelevant. When therapy becomes strongly suggested and not a requirement and HRT on demand is already the norm with calls for SRS on demand, what purpose will WPATH have in that future?

On the other hand, gender issues only make up a small percentage of all the disorders covered in DSM. I think with the shift, the APA will survive.

[Guest LizMarie]

I'm actually very uncomfortable with SRS on demand as there is statistical validation that the WPATH SOC and the one year RLE have significantly reduced the regret factor among trans people. I don't object to informed consent for HRT but even there my recommendation is to work with a therapist. If you're going to transition, you are going to turn some aspects of your life upside down and having a confidant and a guide through that process seems wise to me.

And yes, APA will survive but will it be relevant to the treatment of trans folk? That remains to be seen.

[VickySGV]

Well, there is a small distinction between the two groups, APA is American Psychological Association, and WPATH is World Professional Association for Transgender Health. WPATH is getting a lot of input from more than just U.S. professionals, and some of my friends who attend its functions do find that it is significant in Europe, and Pacific Rim areas, so do not write WPATH off the charts too soon, in addition WPATH is sponsoring better research in those countries, so some of our stuck up U.S. types may not have the last or best word yet.

[Drea]

WPATH is highly political which has become more and more stacked with trans folks involved in setting standards and pushing their agendas.

So it isn't surprising if APA, as a professional organization, would distance itself from an organization that is more and more political based rather than science based such as WPATH,

So I agree with Leah that it is a political difference.

[Guest LizMarie]

And the APA is littered with people who still want to practice reparative therapy, Drea. Let's not forget that little detail, shall we? So while you deliberately demean WPATH simply because trans people are members (why shouldn't they be?) you also say nothing about people who want to continue to practice a form of "counseling" that has been shown to be unethical and actually harmful. I would choose WPATH over the APA with regards to my health care, given the APA's track record thus far.

[Drea]

I saw nothing in the APA promoting reparative therapy. Can you provide a reference?

As I recall there are some in WPATH who are very unpopular because of their views. No question the organization has been picking and choosing research based upon what supports the view it wishes to have. That is one of the APA objections I recall, the selective choosing of information (including accepting questionable information) by WPAATH that supports the conclusions it wishes to present and rejecting information that regardless of merits that doesn't.

I am one that tends to live in the world of facts. I can live with the good and the bad. I think there is reason to see this as a medical condition which I don't think is inconsistent with APA but is in many ways inconsistent with WPATH which is more and more focused on choice.

[Guest LizMarie]

I said members, Drea,

Members, like:

Joseph Nicolosi

Charles Socarides

Benjamin Kaufman

Robert Spitzer (who recanted his position in 2012 and apologized for making unproven claims about the efficacy of reparative therapy)

And of course, the infamous Kenneth Zucker.

If you wish, I'll go dig up more but the point is made. There are APA members who still adhere to practices that have been shown to be harmful, so let's not forget that little fact, shall we? The APA could censure these people or even remove them but it doesn't.

[Guest KimberlyF]

It's hard to make a case for medical necessity without a diagnosis-including a diagnostic code-which is all some insurance companies start with. I don't have a single diagnosis or code from WPATH that has helped my insurance with the treatment services they recommend. I can thank the APA for my HRT and both for the legitimacy to get insurance approved for surgery.

This to me ironically fits in well with Sarah's topic. Many of the people in the APA are also in WPATH. One group wanting the other to do what is best or being critical sure seems to be getting them tossed under the bus, while they were all the talk when the decided to change GID to GD. What have you done for us lately?

[Guest LizMarie]

The APA is the American organization, Kimberly. Usually American organizations are given precedence in America, especially by insurers who do not wish to support transgender medical treatment any more than is necessary. This is why the US insurance industry still classifies transgender surgeries as "experimental" even after 80 years of success stories.

My observation was simply that Drea was deliberately demeaning WPATH while ignoring that members of the APA still practice harmful methods and even have vocally argued in favor of those methods. APA could censure or remove those members but does not.

I think it's wise to realize that both organizations have their pluses and minuses and casting one as the "hero" and the other as the "villain" is not a fair evaluation of either organization.

[Drea]

...And of course, the infamous Kenneth Zucker.

If you wish, I'll go dig up more but the point is made. There are APA members who still adhere to practices that have been shown to be harmful, so let's not forget that little fact, shall we? The APA could censure these people or even remove them but it doesn't.

You mean the same infamous Ken Zucker on WPATH's Standards of Care Workgroup? The same one who WPATH hasn't kicked out? That is even trusted on the SOC working group, one of the key purposes of the group?

Now I remembered this from memory and cross checked. He is listed last on the list so maybe they don't like him? Maybe it is intent to push him off? Or wait...it is an alphabetical list, I guess the "Zu" gets him that distinct position. I bet he found that annoying growing up too.

Now I can't say what others you list that may also be WPATH members. As I said I knew this one off the top of my head.

So I don't see either group doing the sort of housekeeping you expect and I am not sure the mechanisms even exist.

What I haven't seen is how these individuals, who coincidentally are members of APA, have caused the APA to advocate reparative therapy as primary means of treatment nor other treatments which have been proven harmful.

And just to clarify, where you said

So while you deliberately demean WPATH simply because trans people are members (why shouldn't they be?)

I said:

As I recall there are some in WPATH who are very unpopular because of their views.[example given above] No question the organization has been picking and choosing research based upon what supports the view it wishes to have. That is one of the APA objections I recall, the selective choosing of information (including accepting questionable information) by WPAATH that supports the conclusions it wishes to present and rejecting information that regardless of merits that doesn't.

I do not "demean". I pointed out what I see as a structural problem. The picking and choosing of research based upon it supporting the view. An issue that exists in the broader trans community. And yes I think WPATH is becoming more of an advocacy group. In fairness even in the HBIGDA that was one of it's function. It does seem to becoming less science based and more advocacy based. The picking and choosing of research being one symptom and I do think more trans folk becoming members are part of the change. Is this not fact that more trans folks have become members? By the way I have no doubt that there are plenty of trans folk who are APA members too.

If I were to "demean" I would not be discussing the issues involved but using demeaning characterizations such as "idiot", "stupid".

Now it is curious to note that I could qualify for full voting membership in WPATH but couldn't even be an associate in APA.

Now I really don't have any big issues with the WPATH standards. They are pretty tame actually. I think putting blinders on, using bad research to support the cause and not acknowledging good research that doesn't fit so well is an issue that can threaten WPATH's legitimacy. I am sure there are individual members that do speak to unpopular things, but as an organization they aren't taken seriously.

It is very much like this topic about how anyone speaking something that the majority in the community doesn't like gets dumped on. http://www.lauras-playground.com/forums/index.php?showtopic=57683

[Tejana]

...And of course, the infamous Kenneth Zucker.

If you wish, I'll go dig up more but the point is made. There are APA members who still adhere to practices that have been shown to be harmful, so let's not forget that little fact, shall we? The APA could censure these people or even remove them but it doesn't.

You mean the same infamous Ken Zucker on WPATH's Standards of Care Workgroup? The same one who WPATH hasn't kicked out? That is even trusted on the SOC working group, one of the key purposes of the group?

Now I remembered this from memory and cross checked. He is listed last on the list so maybe they don't like him? Maybe it is intent to push him off? Or wait...it is an alphabetical list, I guess the "Zu" gets him that distinct position. I bet he found that annoying growing up too.

Now I can't say what others you list that may also be WPATH members. As I said I knew this one off the top of my head.

So I don't see either group doing the sort of housekeeping you expect and I am not sure the mechanisms even exist.

What I haven't seen is how these individuals, who coincidentally are members of APA, have caused the APA to advocate reparative therapy as primary means of treatment nor other treatments which have been proven harmful.

And just to clarify, where you said

So while you deliberately demean WPATH simply because trans people are members (why shouldn't they be?)

I said:

As I recall there are some in WPATH who are very unpopular because of their views.[example given above] No question the organization has been picking and choosing research based upon what supports the view it wishes to have. That is one of the APA objections I recall, the selective choosing of information (including accepting questionable information) by WPAATH that supports the conclusions it wishes to present and rejecting information that regardless of merits that doesn't.

I do not "demean". I pointed out what I see as a structural problem. The picking and choosing of research based upon it supporting the view. An issue that exists in the broader trans community. And yes I think WPATH is becoming more of an advocacy group. In fairness even in the HBIGDA that was one of it's function. It does seem to becoming less science based and more advocacy based. The picking and choosing of research being one symptom and I do think more trans folk becoming members are part of the change. Is this not fact that more trans folks have become members? By the way I have no doubt that there are plenty of trans folk who are APA members too.

If I were to "demean" I would not be discussing the issues involved but using demeaning characterizations such as "idiot", "stupid".

Now it is curious to note that I could qualify for full voting membership in WPATH but couldn't even be an associate in APA.

Now I really don't have any big issues with the WPATH standards. They are pretty tame actually. I think putting blinders on, using bad research to support the cause and not acknowledging good research that doesn't fit so well is an issue that can threaten WPATH's legitimacy. I am sure there are individual members that do speak to unpopular things, but as an organization they aren't taken seriously.

It is very much like this topic about how anyone speaking something that the majority in the community doesn't like gets dumped on. http://www.lauras-playground.com/forums/index.php?showtopic=57683

I stumbled onto this thread just out of curiosity, and followed the link provided in the the above quoted-post (i.e., "Pedestals, a commentary", a thread initiated by Faith Gibson). I read the each of the posts contained in these two threads.

I am incredibly impressed with the commentaries of Drea and Ms. Gibson, at least those posted in this thread and the Pedestals... thread. Thank you for sharing your intellect and for your searching analysis of these issues contained in these threads..

Again, I am very impressed...so much so that I chose to resurrect this almost three year-old thread as a means of expressing my appreciation.

Best wishes, and thanks again to you both for sharing your perspectives in these two threads. Via con dios.