Time to abolish WPATH

[Guest]

Health care is a personal choice. The patient is the customer. If one is 18 and legally competent, informed consent should be the one and only care model for both HRT and surgery.

 

Why WPATH is supported by anyone in the transgender community is beyond me. That’s an outdated care model, written by cis gender elitists who have no clue whatsoever with transgender issues. 

 

It’s time to claim our issue and our healthcare rather than being the subject of institutionalized gate keeping.

[Susan R]

Just now, Nebulous said:

Why WPATH is supported by anyone in the transgender community is beyond me. That’s an outdated care model, written by cis gender elitists who have no clue whatsoever with transgender issues. 

After watching this 2 hour medical conference lecture recently held by Dr. William Powers, I have to agree with you completely.  New research, new studies are changing the face of this entire TG paradigm.  It may be one of two accepted standards right now but that's about to change very soon.  This is the best and most current information I've been given on the subject and I can follow right along with most of it even though it is a bit technical in some parts.  Well worth the watch IMHO.

 

https://www.youtube.com/watch?v=fefu33e8O-0

Susan R?

[Jani]

I think another issue may be that there are doctors and clinicians that are seeing transgender patients for the first time and this will give them something to learn from.  That said, I've read that transgender health (to some degree) is being taught in some medical schools now.  While I see a doctor at an LGBT health center for HRT (informed consent), my primary is full on with me but admitted he knew nothing about transgender health or patients when I started.  My BIL is a doctor and he's asked numerous questions as well.   I still think there is a place for it but as a guideline not strict roadmap.

 

Jani

[VickySGV]

OK, have you thoroughly read the Standards Of Care V7 completely to see what they have opened up from 6 to 7?    Version 8 is being considered even now and is about ready for adoption. (A friend would like me to go with them to their next convention and is willing to buy me associate membership.  I was at their 2010 convention where SOC 7 was adopted.) 

 

What does V7 say about Conversion Therapy?  Laws banning Conversion Therapy for us have used V7 as a scientific reference wherever that type of law has been adopted. 

 

WPATH has probably seen and its members have peer reviewed over 150 research papers submitted to it each year, so the stuff cited by many detractors actually came through them.

 

WPATH members are also members of the major APA's and are on the boards of the WHO who recently made some good findings for European Trans people.

 

I can go on with other points as well, but where the work needs to be done is on the Health Insurance and hospital and physician malpractice liability insurance companies.  That is one of the most heavy roadblocking sources even for doctors and hospitals where surgery can be performed.  Most are using the SOC 6 for their contracts.  Just a bit more complicated than often comes out.  Have fun with your protests, but be safe and learn what you are doing.

[Maid In Bedlam]

1 hour ago, Nebulous said:

Health care is a personal choice. The patient is the customer. If one is 18 and legally competent, informed consent should be the one and only care model for both HRT and surgery.

 

 

While i agree if you 18 you should be able to choose. I do not agree that the choice you make would be the correct one. Thats why wpath is there to ensure you are making the right one.  If you do not make this desion correctly then the concequences are dramatic and irreversable.

 

This is what the standards are for. Its a checklist to ensure this is right for you.

 

It would be also your choice to have a frontal labotomy because you have a headache. is this the model you would like?

 

Where does this choice end?

 

Ill cut my nose off to spite my face?

 

You need gatekeepers. Self identity is just a road to anachy when it comes to being transgendered. Yes its not the best but its at least its a pause point to ensure you are making the right desion. Its not a case of how old you are. Its a case of it being correct for you.

 

So many storys of people that have had all the surgerys then relised it wasnt the right one.

 

 

1 hour ago, Nebulous said:

Why WPATH is supported by anyone in the transgender community is beyond me. That’s an outdated care model, written by cis gender elitists who have no clue whatsoever with transgender issues.

 

 

Its surported because it stops the transtrenders and those who are not really trans but want to be fashionable. Who in a few years will just turn to the next trend. and make a mistake they cannot be released from

It stops those who are not making the right desion.

It also stops those who want to have the title with little or no effort. I have read storys of those who have made no effort whatsoever and can call themselves female with the flick of a pen. Then expect to be accepted without question to female oreintated places.

Im very sorry but if im in the ladies bathroom and someone walks in with a full beard. They would be politly informed they are in the wrong room. Even if they are swearing they are a woman because thats how they feel today.

You earn that right to use the relavent bathroom to your portrayed gender it isnt just given when you wake up in the morning feeling like a woman today.

With all respect. being transsexual transgender whatever you want to use is not just  words. Its a way of life. A dramatic way of life completly diffrent to your past life. it isnt just a land of milk and honey. Its almost a term of indearment and should be given some sort of gatekeeping.

 

Dont even get me started on overdosed on hormones. Just another risk of it being open to all. They are not sweets. Because they can destroy aswell as create. No standards then expect them to be avaliable at the local pharamcy. Take as many as you like and to hell with the concequences.

 

I would like to believe the gender elistists as you call them. Would have some sort of clue on gender issues and not just any doctor from anytown with there standards written on a beer mat on a friday night in the bar.

 

 

Quote

The World Professional Association for Transgender Health promotes the highest standards of health care for individuals through the articulation of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People. The SOC are based on the best available science and expert professional consensus.

The overall goal of the SOC is to provide clinical guidance for health professionals to assist
transsexual, transgender, and gender nonconforming people with safe and effective pathways to achieving lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment.

 

There it is. To promote. Not to law over. If it wasnt for this guide then good luck with that as no doctor or gender specialist would have a clue. You would just get past from pillar to post. perhaps back to shock therapy to cure this mental disorder you would be percieved to have.

 

It may not be perfect but its better than nothing.

 

1 hour ago, Nebulous said:

It’s time to claim our issue and our healthcare rather than being the subject of institutionalized gate keeping.

 

I hope not. If anyone could just claim it then what a truly scary world this would be.

 

 

 

Quote

!The Standards of CareVERSION !World Professional Association for Transgender HealthIPurpose and Use of the Standards of CareThe World Professional Association for Transgender Health (WPATH)I is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, advocacy, public policy, and respect in transsexual and transgender health. The vision of WPATH is a world wherein transsexual, transgender, and gender-nonconforming people benefit from access to evidence-based health care, social services, justice, and equality.

 

this is page 1 standards of care. Evidence based is the key here.  Show us your transgender and we will give you the tools you need to live your life to the fullist.

 

If you do have gender dysphoria then you will have no problem. So you wouldnt as i said early "Cut your nose off to spite your face"

 

I do honestly invite you to give us some evidence of how the standards do not work. We will listen to this and not just a statement. How did you come to this conclusion?

 

I willl agree its not perfect but its better than none at all.

[Guest]

1 hour ago, Maid In Bedlam said:

 

While i agree if you 18 you should be able to choose. I do not agree that the choice you make would be the correct one. Thats why wpath is there to ensure you are making the right one.  If you do not make this desion correctly then the concequences are dramatic and irreversable.

 

This is what the standards are for. Its a checklist to ensure this is right for you.

 

It would be also your choice to have a frontal labotomy because you have a headache. is this the model you would like?

 

Where does this choice end?

 

Ill cut my nose off to spite my face?

 

You need gatekeepers. Self identity is just a road to anachy when it comes to being transgendered. Yes its not the best but its at least its a pause point to ensure you are making the right desion. Its not a case of how old you are. Its a case of it being correct for you.

 

So many storys of people that have had all the surgerys then relised it wasnt the right one.

 

 

 

 

Its surported because it stops the transtrenders and those who are not really trans but want to be fashionable. Who in a few years will just turn to the next trend. and make a mistake they cannot be released from

It stops those who are not making the right desion.

It also stops those who want to have the title with little or no effort. I have read storys of those who have made no effort whatsoever and can call themselves female with the flick of a pen. Then expect to be accepted without question to female oreintated places.

Im very sorry but if im in the ladies bathroom and someone walks in with a full beard. They would be politly informed they are in the wrong room. Even if they are swearing they are a woman because thats how they feel today.

You earn that right to use the relavent bathroom to your portrayed gender it isnt just given when you wake up in the morning feeling like a woman today.

With all respect. being transsexual transgender whatever you want to use is not just  words. Its a way of life. A dramatic way of life completly diffrent to your past life. it isnt just a land of milk and honey. Its almost a term of indearment and should be given some sort of gatekeeping.

 

Dont even get me started on overdosed on hormones. Just another risk of it being open to all. They are not sweets. Because they can destroy aswell as create. No standards then expect them to be avaliable at the local pharamcy. Take as many as you like and to hell with the concequences.

 

I would like to believe the gender elistists as you call them. Would have some sort of clue on gender issues and not just any doctor from anytown with there standards written on a beer mat on a friday night in the bar.

 

 

 

There it is. To promote. Not to law over. If it wasnt for this guide then good luck with that as no doctor or gender specialist would have a clue. You would just get past from pillar to post. perhaps back to shock therapy to cure this mental disorder you would be percieved to have.

 

It may not be perfect but its better than nothing.

 

 

I hope not. If anyone could just claim it then what a truly scary world this would be.

 

 

 

 

this is page 1 standards of care. Evidence based is the key here.  Show us your transgender and we will give you the tools you need to live your life to the fullist.

 

If you do have gender dysphoria then you will have no problem. So you wouldnt as i said early "Cut your nose off to spite your face"

 

I do honestly invite you to give us some evidence of how the standards do not work. We will listen to this and not just a statement. How did you come to this conclusion?

 

I willl agree its not perfect but its better than none at all.

 

 

I hope this response is a joke^^^

 

The bottom line is if you’re an adult your health is your health. If you believe you need your hand held, fine. That doesn’t mean the rest of us aren’t capable of making our own decisions.

 

WPATH was written by cis gendered who have no real understanding of what we go through.

 

Again, just because you want to be told what’s best for you, doesn’t mean I should be bound by the same nanny state rules.

 

 

[Guest]

2 hours ago, MaryMary said:

I would not be in favor of abolishing it but I'm certainly in favor of improving it.

 

 

WPATH is like a government program. The only way to improve it is to DESTROY it.

[Dev]

The tone of some of the comments in this thread is perilously close to combative.  Disagreement is fine - encouraged, even - but mutual respect and a civil tongue are required.  We will lock this thread if any more borderline (or outright) insulting comments are made.

[VickySGV]

44 minutes ago, Nebulous said:

WPATH was written by cis gendered who have no real understanding of what we go through.

 

Not true at all.  Considering the table partners I had at the Convention where SOC 7 was ratified in 2010 and people I spoke to there youo are just plain wrong.  Many researchers that contribute to the studies that are considered in forming the SOC's are Trans or Enby. Friends of mine who are psychologists working on the problems of Trans youth  are fully transitioned Trans folk themselves.  My own surgeon who is a Trans Woman is a member of it and contributes to their discussions of changes in the SOC.  One of the ways people get into the field of Transgender care is by being Trans and trying to find out about themselves.  I only have a BA in Behavioral Science but my experience at the Convention was sought and listened to.  I attend professional conferences several times a year where once again my presence and status are honored and ideas and positions re thought or outright changed.  . 

 

I gave you the real direction that things need to take above and you seem to have not seen them or given them any regard.  OK, so they do not give you what you want when you want it and they have used the SOC 7 as a reason and so destruction of the whole is your only solution based on your haste to get something that may well kill you. . 

 

1 hour ago, Nebulous said:

WPATH is like a government program. The only way to improve it is to DESTROY it.

 

Again not at all true, it is an organization that has brought order and hope to the Trans and NB community over its half century existence beginning with the Harry Benjamin Society for Transgender Health and research and without WPATH's status  you will be finding that NB people as you claim to be have fewer medical choices for our lives.  Without WPATH and several other organizations the medical care you are seeking will dry up.  You mention destruction of government but if our government had its choices we would not even get an aspirin tablet to help us. 

[Guest]

26 minutes ago, MaryMary said:

You are aware that they are on version 7 and going on version 8? We will have to agree to disagree here. I think it's a good thing and especially after talking to someone who knows what she's talking about like VickySGV. Besides, even if my therapist have been less then ideal I choose to view them as ally and help and not gatekeeper. My story would not be as happy as it is if it was not for other transgender woman who helped me and my healthcare professionals.

 

Guidelines are one thing- I think they’re good to have when used as ...guidelines . The issue I have is when they’re treated as rules and thus leads to gate keeping which is the case with WPATH.

 

 

[VickySGV]

Just now, Nebulous said:

gate keeping which is the case with WPATH.

 

Not true again.  It is in the hands of the individual health care providers and their local medical communities, and as I said before, their malpractice insurance companies.  WPATH has no legal power over any entity.

[Guest]

Just now, VickySGV said:

 

Not true at all.  Considering the table partners I had at the Convention where SOC 7 was ratified in 2010 and people I spoke to there youo are just plain wrong.  Many researchers that contribute to the studies that are considered in forming the SOC's are Trans or Enby. Friends of mine who are psychologists working on the problems of Trans youth  are fully transitioned Trans folk themselves.  My own surgeon who is a Trans Woman is a member of it and contributes to their discussions of changes in the SOC.  One of the ways people get into the field of Transgender care is by being Trans and trying to find out about themselves.  I only have a BA in Behavioral Science but my experience at the Convention was sought and listened to.  I attend professional conferences several times a year where once again my presence and status are honored and ideas and positions re thought or outright changed.  . 

 

I gave you the real direction that things need to take above and you seem to have not seen them or given them any regard.  OK, so they do not give you what you want when you want it and they have used the SOC 7 as a reason and so destruction of the whole is your only solution based on your haste to get something that may well kill you. . 

 

 

Again not at all true, it is an organization that has brought order and hope to the Trans and NB community over its half century existence beginning with the Harry Benjamin Society for Transgender Health and research and without WPATH's status  you will be finding that NB people as you claim to be have fewer medical choices for our lives.  Without WPATH and several other organizations the medical care you are seeking will dry up.  You mention destruction of government but if our government had its choices we would not even get an aspirin tablet to help us. 

 

if one has done their research and has had all the risks and benefits spelled out, they should be free to live with their decision.

Many of us don’t need or want to talk to a therapist who may or may not truly understand our issues. 

 

 

[Guest]

Just now, VickySGV said:

 

Not true again.  It is in the hands of the individual health care providers and their local medical communities, and as I said before, their malpractice insurance companies.  WPATH has no legal power over any entity.

 

Medical malpractice insurance is another reason we need to get government out of health care.

 

WPATH is largely fear based, a byproduct of government involvement 

[Charlize]

1 hour ago, Nebulous said:

WPATH was written by cis gendered who have no real understanding of what we go through.

I'm sorry dear but this is quite wrong.  i know several trans folks who are very involved as doctors in the review and use of WPATH.

I personally have no problem with any of the "barriers" good medical care may have to someone's rush to transition.

It is a scientific based approach whose only fear is that the best, safest care is provided.

As you mentioned we are all able as adults to care for ourselves.  Hopefully that allows for a respect for those who spend their lives working with and studying this journey.

 

Hugs,

 

Charlize

[Dev]

43 minutes ago, Nebulous said:

Medical malpractice insurance is another reason we need to get government out of health care.

 

There's an adjunct issue here that hasn't yet been considered in this thread.  First, I'll qualify the above: malpractice insurance is wholly separate from any government involvement in health care.  As litigious as people are, particularly where their health is concerned, it's just a cost of doing business for the entire medical profession.

 

That said, it does have an extremely large bearing on the treatment of trans patients for good reason.  Akin to dysphoria is a condition called dysmorphia.  The last statistic I read said it occurs in about as many people as does dysphoria, but it's not a condition that can (or should) be treated medically.  It's not specifically focused on sex and gender characteristics, for one thing; it can manifest with regard to just about any physical feature.  This is the underlying condition behind people who want, for no clear reason, to be amputees.  A news article about a woman who blinded herself went viral not long ago; that's another example.  

 

The trouble is that it can manifest as a desire to have different - or, in some very rare cases, no - sex attributes.  Those cases often masquerade as gender dysphoria, particularly in patients with co-morbid Borderline Personality Disorder.  The existence and validation of gender dysphoria can contribute to people with dysmorphia thinking they'll be happy if a doctor alters their sex characteristics in some way, when in fact such a physical change would be disastrous; even hormone therapy tends to make things worse.

 

There's also the matter of the small percentage of gender dysphoric people who, while legitimately identifying and possibly presenting as a gender other than they were assigned at birth, don't realize that surgery isn't the right step for them until it's too late.  I've had the gut-wrenching experience of talking with several of those people after their surgeries were complete.  Those in the medical profession are absolutely right to look for some kind of solid professional confirmation that surgery is the right treatment option.  

 

If a doctor were to prescribe hormones or surgically alter the body of anyone I've described in this post, there is a very real chance a court would consider it to be malpractice.  Because of that, the insurance companies have a vested interest in minimizing their risk.  That letter from therapists is one of the ways they do this.

 

Ideally, yes, it would be easy to spot gender dysphoria and be confident that the medical transition the patient requests is the right way to go.  There are just too many confounding factors that have to be ruled out before that can happen, though.  This is unfortunate for those who do need to go through with medical transition, but one can hardly blame any involved party for wanting to be as certain as they possibly can before they make a permanent, life-altering change for someone.

[VickySGV]

1 hour ago, Nebulous said:

Medical malpractice insurance is another reason we need to get government out of health care.

 

So, all of our legal history needs to be re-written?   Interesting!  Do you even understand the connection between the two?  From that statement it appears you do not understand the way that works.  Government does provide some regulation of the insurance carriers as to prices they can charge, and what coverage they must provide for markets within certain jurisdictions.  Government also provides the court systems and does have laws as to the rights of the parties in a lawsuit.  Malpractice insurance covers judgments and keeps the loser from being forever chased out of the medical profession if the doctor loses.  The insurance companies bet the patient will lose.  Actually it makes it easier for you  to get medical care at a price you can afford.  Imagine paying $10 thousand or $11 THOUSAND for a single doctor visit so the doctor can self insure against legal judgments, or imagine that if a doctor negligently injures you that you have no way to get him to correct the injury and make you whole again because there are no courts.  That is what it seems you mean here.   Your reasoning is a bit confused here and while I will write it off to your not having gotten a good education in the U.S. and Common Law I hope it is for that reason and not other impairment.

[Guest]

3 hours ago, VickySGV said:

 

So, all of our legal history needs to be re-written?   Interesting!  Do you even understand the connection between the two?  From that statement it appears you do not understand the way that works.  Government does provide some regulation of the insurance carriers as to prices they can charge, and what coverage they must provide for markets within certain jurisdictions.  Government also provides the court systems and does have laws as to the rights of the parties in a lawsuit.  Malpractice insurance covers judgments and keeps the loser from being forever chased out of the medical profession if the doctor loses.  The insurance companies bet the patient will lose.  Actually it makes it easier for you  to get medical care at a price you can afford.  Imagine paying $10 thousand or $11 THOUSAND for a single doctor visit so the doctor can self insure against legal judgments, or imagine that if a doctor negligently injures you that you have no way to get him to correct the injury and make you whole again because there are no courts.  That is what it seems you mean here.   Your reasoning is a bit confused here and while I will write it off to your not having gotten a good education in the U.S. and Common Law I hope it is for that reason and not other impairment.

 

 

Medical malpractice insurance exists because of a government that promotes the litigious culture we’re in.

 

WPATH exists due to the regulatory environment that is created by the medical profession and government regulation.

 

 

[Guest]

6 hours ago, Charlize said:

I'm sorry dear but this is quite wrong.  i know several trans folks who are very involved as doctors in the review and use of WPATH.

I personally have no problem with any of the "barriers" good medical care may have to someone's rush to transition.

It is a scientific based approach whose only fear is that the best, safest care is provided.

As you mentioned we are all able as adults to care for ourselves.  Hopefully that allows for a respect for those who spend their lives working with and studying this journey.

 

Hugs,

 

Charlize

 

If that’s the case, why does WPATH contain outdated guidelines like the need for therapy letters for HRT?

 

A standard question that therapist like to ask is- Have you played with dolls as a kid?

 

If you believe the decision to allow care should be based on such outdated and ignorant questions, that explains your belief that we shouldn’t be in control of our  own healthcare .

[MaryEllen]

I don't know the actual stats but I do know that many who have gone the "informed consent" route have later regretted their decision and have transitioned back to their original gender.  I would much rather counsel with a therapist and be absolutely sure before making such a life altering decision. As out dated as WPATH is, it is a much better policy to follow than to do it on your own.

 

MaryEllen

[Guest]

Just now, MaryEllen said:

I don't know the actual stats but I do know that many who have gone the "informed consent" route have later regretted their decision and have transitioned back to their original gender.  I would much rather counsel with a therapist and be absolutely sure before making such a life altering decision. As out dated as WPATH is, it is a much better policy to follow than to do it on your own.

 

MaryEllen

 

 

Counsel is all well and good- But that should be up to the individual. 

 

Gate keeping is not a prevention of bad choices

[Guest]

I didn’t set a good tone in a few of my responses to the responses and this has devolved into an argument I didn’t intend.

 

I therefore ask that this thread be deleted and that we move on.

[Josie Beth]

I’m personally grateful for informed consent but will not negate the value of a therapist who can help work through issues that HRT is not going to address fully. I’m not entirely in agreement that those who go through the informed consent route are prone to detransitioning. What seems to be more common is they are caught up in pressure from hostile mentors or peers and who take advantage of their vulnerability and they bend to that pressure. I can think of two examples off hand where that’s definitely the case and they don’t look happy at all with detransitioning. They seem to be parroting the negativity directed at them by people who didn’t respect their identity and they have no way to get away from it. Usually because they are completely dependent on these people financially. So in this type of situation I can definitely see why WPATH is valuable. 

[VickySGV]

The discussion in this thread is becoming much too circular, and one element has not been addressed here: that of Individual Professional Judgment on behalf of medical care providers which even in a non-government regulated environment will still exist  Even physicians go to another physician for their own health care and put their lives into the other physician's hands.  Even with informed consent, the decision is still up to the individual therapeutic agent; doctor, chemist/pharmacist, Behavioral Health professional as to whether they will give care on demand of the patient.  Back-alley "providers" such as the ones that use industrial silicone "injections" for a variety of body modifications are available but the harm done is phenomenal and often deadly.  In the recent past this site has rejected information on "do it yourself" castration and our rules on the discussion of medication dosages and specific protocols is not going to change since there are even those of us on the staff here that have had full medical supervision have had adverse effects from our medications. 

I am going to LOCK this topic for further discussion but feel that there has been enough edifying information presented here by staff and members that it should not be deleted in its entirety.