Psychological Eval...

[christinakristy2021]

Does WPATH still recommend a psychological evaluation in the USA, especially the Commonwealth of Virginia?

[VickySGV]

The WORLD Professional Association for Transgender Health (WPATH) and its daughter organization (USPATH) the United States Professional Association for Transgender Health both recommend the inclusion of a Gender Therapist and other Behavioral Health professionals without regard to different political boundaries (states) for the treatment of gender issues.  They cannot themselves REQUIRE the standards be used in ANY Location, but they are considered authority by the state medical policies set by professional licensing boards or (sadly) legislators.  Medical insurance providers of several types also affect the standards for medical coverage both for patient (payment for medical procedures), doctors and hospitals (malpractice insurance) and may require adherence to WPATH standards apart from what the Law allows. 

 

In some areas the WPATH standards for counseling may be replaced by Informed Consent if you are over 18 (26 in two states) but in those areas the doctors and surgeons may give you a mini-counseling experience of their own before accepting your "informed" consent.  Our policy here on the Forums is always to recommend that our members get counseling from people who are at least familiar with the WPATH Standards Of Care, because you will get the highest quality of care and personal safety from those people.  Each individual doctor though is ultimately the only source of your information as asked.

[AllieJ]

Here is the current WPATH Criteria (SOC-8)

 

Appendix D SUMMARY CRITERIA FOR HORMONAL AND SURGICAL TREATMENTS FOR ADULTS AND ADOLESCENTS

The SOC-8 guidelines are intended to be flexible in order to meet the diverse health care needs of TGD people glob- ally. While adaptable, they offer consensus-based standards derived from the best available scientific evidence for pro- moting optimal health care and guiding the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria put forth in this document for gender affirming interventions are clinical guidelines; individual health care professionals and programs, in con- sultation with the TGD person, may modify them. Clinical departures from the SOC may occur due to a TGD person’s unique anatomic, social, or psychological situation; an ex- perienced health care professional’s evolving method of handling a common situation; a research protocol; lack of resources in various parts of the world; or the need for specific harm-reduction strategies. These departures should be recognized as such, discussed with the TGD person, and documented. This documentation is also valuable for the accumulation of new data, which can be retrospectively examined to allow for health care—and the SOC—to evolve. This summary criteria needs to be read in conjunction with the relevant chapters (see Adult Assessment and Adolescent chapters).

SUMMARY CRITERIA FOR ADULTS Related to the assessment process

• Health care professionals assessing transgender and gender diverse adults seeking gender-affirming treat- ment should liaise with professionals from different disciplines within the field of trans health for con- sultation and referral, if required*

• If written documentation or a letter is required to recommend gender affirming medical and surgical treatment (GAMST), only one letter of assessment from a health care professional who has competen- cies in the assessment of transgender and gender diverse people is needed.

  Criteria for hormones

  1. Gender incongruence is marked and sustained;

  2. Meets diagnostic criteria for gender incongruence prior to gender-affirming hormone treatment in regions where a diagnosis is necessary to access

     health care;

  3. Demonstrates capacity to consent for the specific

     gender-affirming hormone treatment;

  4. Other possible causes of apparent gender incon-

     gruence have been identified and excluded;

  5. Mental health and physical conditions that could negatively impact the outcome of treatment have

     been assessed, with risks and benefits discussed;

  6. Understands the effect of gender-affirming hor- mone treatment on reproduction and they have

Criteria for surgery

1. Gender incongruence is marked and sustained;

2. Meets diagnostic criteria for gender incongruence prior to gender-affirming surgical intervention in regions

   where a diagnosis is necessary to access health care;

3. Demonstrates capacity to consent for the specific

   gender-affirming surgical intervention;

4. Understands the effect of gender-affirming surgical intervention on reproduction and they have

   explored reproductive options;

5. Other possible causes of apparent gender incon-

   gruence have been identified and excluded;

6. Mental health and physical conditions that could negatively impact the outcome of gender-affirming surgical intervention have been assessed, with risks

   and benefits have been discussed;

7. Stable on their gender affirming hormonal treat-

   ment regime (which may include at least 6 months of hormone treatment or a longer period if required to achieve the desired surgical result, unless hormone therapy is either not desired or is medically contraindicated).*

*These were graded as suggested criteria