WPATH / USPATH Public Statements

March 22, 2023

USPATH and WPATH Confirm Gender-Affirming Health Care is not Experiemental; Condemns Legislation Asserting Otherwise

The United States Professional Association for Transgender Health (USPATH) and the World Professional Association for Transgender Health (WPATH) denounces the emergency regulation halting gender-affirming healthcare for transgender and gender diverse (TGD) children and adolescents issued by Missouri Attorney General Andrew Bailey as lacking scientific grounding. . .

March 8, 2023

Statement of Opposition to Legislation Banning Access to Gender-Affirming Health Care in the US

Both the World Professional Association for Transgender Health (WPATH) and the US affiliate, the United States Professional Association for Transgender Health (USPATH), vehemently oppose the broad and sweeping legislation being introduced and ratified in states across the country to ban access to gender-affirming health care to transgender and gender diverse (TGD) people. WPATH’s long-standing Standards of Care for Transgender and Gender Diverse People, now in its eighth version (SOC8), explain in detail the science- and evidence-based benefits of gender affirming care for TGD people. Any legislation that restricts or prohibits access to this care is against best practice medical standards and is condemned by WPATH and USPATH.

“Anti-transgender health care legislation is not about protections for children but about eliminating transgender persons on a micro and macro scale,” said WPATH President, Dr. Marci Bowers. “It is a thinly veiled attempt to enforce the notion of a gender binary.” . . .

November 25, 2022

WPATH, ASIAPATH, EPATH, PATHA, and USPATH Response to NHS England in the United Kingdom (UK)

Statement Regarding The Interim Service Specification For The Specialist Service For Children And Young People With Gender Dysphoria (Phase 1 Providers) By Nhs England*

Following the publication of the interim report of the Cass Review of gender identity services for children and young people in England in March 2022 NHS England has now issued an interim service specification for “Phase 1” services pending establishment of new regional services in England.

See https://www.engage.england.nhs.uk/specialised-commissioning/gender-dysphoria-services/

WPATH, ASIAPATH, EPATH, PATHA, and USPATH have major reservations about this interim service specification.

1. The document fails to state that gender diversity is a normal and healthy aspect of human diversity (Coleman et al., 2022), and that many transgender people experience gender incongruence from childhood or adolescence (James et al., 2016). Transgender and gender diverse (TGD) people have a human right to access the highest achievable standard of health care, including gender-affirming care (World Health Organization, (2017; Yogyakarta Principles.org., 2007).  WPATH, ASIAPATH, EPATH, PATHA, and USPATH are concerned that rather than emphasising the importance of equitable access to medically necessary support and treatment for children, adolescents and young adults experiencing gender incongruence, the service specification appears designed to place unnecessary barriers in their way. Additionally, we state that when gender affirming medical treatment is provided with a standardised multidisciplinary assessment and treatment process, thorough informed consent, and ongoing monitoring and psychosocial support, the rate of regret of gender-affirming medical treatment commenced in adolescence has been observed to be very low and the benefits of treatment in adolescence are potentially greater than the benefits of gender-affirming treatment commenced in adulthood (Coleman et al., 2022). Hence, the harms associated with obstructing or delaying access to wished-for and indicated treatment for the majority, appear greater than the risks of regret for the few (Coleman et al., 2022), when transgender and cisgender people are correctly regarded as equal.
2. The document makes assumptions about transgender children and adolescents which are outdated and untrue, which then form the basis of harmful interventions. Amongst these is the supposition that gender incongruence is transient in pre-pubertal children.  This document quotes selectively and ignores newer evidence about the persistence of gender incongruence in children (Olson et al., 2022). Many older studies regarding the stability of gender identity enlisted children who did not have gender incongruence or gender dysphoria, but rather, had culturally non-conforming gender expression. The findings of these older studies should only carefully be applied to children and young people who are presenting to gender identity clinics seeking gender-affirming treatment: it may be a different population (Temple Newhook et al., 2018). The document also makes unsupported statements about the influence of family, social, and mental health factors on the formation of gender identity. WPATH, ASIAPATH, EPATH, PATHA, and USPATH believe that children and young people can have agency and can express their gender identity, and that the best course of action is to work collaboratively with the child or young person and family to support the TGD person (Coleman et al., 2022).

November 22, 2022

USPATH And WPATH Respond To Ny Times Article “They Paused Puberty, But Is There A Cost?” Published On November 14, 2022

The recent New York Times article, “They Paused Puberty, But Is There a Cost?”, furthers the atmosphere of misinformation and subjectivity that has grown to surround the area of gender affirming medical interventions for transgender youth. The methods of the authors of this piece come up short in their interpretation and application of available data; the article supports inaccurate narratives that puberty blocking medicines are conclusively harmful to long-term bone density or other health outcomes, and that transition reversal/regret is a common outcome for these treatments. Additionally lacking in the article is an explicit statement that any harms which may exist are outweighed by the substantial benefits these treatments confer to transgender youth, and we wish to respond below to certain specific statements and references made in this article.

The cited bone expert from Mayo Clinic, Dr. Sundeep Khosla, MD, is an adult endocrinologist who does not work clinically with transgender youth and has only a single publication on transgender health.  This publication is not a research study, but a brief review commentary on the issue of bone density in adult transgender people. Transgender youth are not addressed in the commentary.  In this paper, data are reviewed and discussed, and it is concluded that in the context of hormone therapy, “bone mineral density is generally preserved in both trans women and trans men”.

The anecdote provided of an adolescent who began, and then stopped pubertal suppression due to bone density loss lacks important details, including age and pubertal stage at initiation of puberty blockers, length of time on blockers, baseline bone density (“Z-score”), and whether the bone density comparison was made to identified gender or birth-assigned sex. Additional important information not provided includes calcium intake, and vitamin D intake and level, as well as level of physical activity, all of which play a substantial role in maintenance of bone mineral density.

The single expert who performed the literature review, Dr. Farid Foroutan, PhD, is an epidemiologist with no experience in clinical medicine, child and identity development, bone density, or any aspect of the field of transgender health. Nearly the entirety of his professional experience lies in population health studies of heart disease.  The interpretation of clinical studies, especially those with findings that are nuanced, inconclusive, or have a small effect size, require interpretation through a clinical lens, with clinician-scientists experienced in the translation of research data into clinical practice. In fact, Dr. Foroutan recently co-authored a paper which highlighted this very concern, so it is unclear why he did not advocate for a more nuanced and clinically grounded analysis, and an expanded roster of expertise on the review team.

We were surprised to see reference to a subjective statement from Dr. Catherine Gordon, MD regarding “getting behind” on bone density,…

November 11, 2022

WPATH/USPATH Statement Of Opposition To Florida Draft Rule Banning Gender Affirming Care For Adolescents

​The World Professional Association for Transgender Health (WPATH) and the United States Professional Association for Transgender Health (USPATH) stand in staunch opposition to the unwarranted ban on adolescent gender affirming care approved November 4, 2022, by the Florida Boards of Medicine. Gender affirming care improves quality of life and has been endorsed by major medical associations. The Florida Boards, rather than following the science and consensus-based guidelines established and recently updated by WPATH, have chosen politics over science to deny families and their children vital medical care. Lack of access to gender affirming care adds to a patient’s psychosocial stress and is associated with increased suicidality. The proposed ban will result in pain and potential harm for the very constituents it claims to protect. We denounce the proposed draft rule as cruel, counter to medical evidence and discriminatory.

WPATH Executive Committee

USPATH Executive Committee

September 23, 2022

WPATH Condemns Dangerous Misinformation

The World Professional Association for Transgender Health (WPATH) condemns recent misinformation targeting Dr. Amy Tishelman, PhD, the lead author of the Child Chapter of the Standards of Care 8. Defamatory reports have not only misidentified her WPATH role but also completely misrepresented comments she made at the recent WPATH Symposium.

September 19, 2022

USPATH/WPATH Joint Statement

USPATH WPATH Joint Statement Opposes Political and Legal Processes across the US Limiting Lifesaving Interventions for TGD People . . .

April 22, 2022

USPATH Position Statement On Legislative And Executive Actions Regarding The Medical Care Of Transgender Youth

The US Professional Association for Transgender Health (USPATH) believes that decision making regarding the use of hormone therapy or puberty blocking medicine in transgender adolescents should involve physicians, psychologists, and other health personnel, parents or guardians, adolescents, and other community stakeholders identified on a case-by-case basis. Decision making should be informed by current guidelines from the World Professional Association for Transgender Health (WPATH), and the Endocrine Society. This standard of care has been endorsed by the American Academy of Pediatrics, the American Medical Association, the American Psychiatric Association, the American Academy of Child & Adolescent Psychiatry, and the US Department of Health and Human Services Office of Population Affairs.

USPATH opposes recent efforts in several states to restrict parental rights and direct the practice of medicine through legislative or executive action. These efforts lack scientific merit, and in..

April 21, 2022

WPATH/USPATH Denounce Florida Department Of Health For Harmful Guidelines Targeting Trans Youth

The World Professional Association for Transgender Health (WPATH) and United States Professional Association for Transgender Health (USPATH) denounce guidance from the Florida Department of Health aimed at stopping medically necessary health care for transgender youth. The Florida guidelines were issued in response to a fact sheet on gender-affirming care put forth by the U.S. Department of Health and Human Services.

“Florida’s Health Department should be looking out for the interests of trans youth instead of misrepresenting the science on how to care for them. This so-called guidance is dangerous and will contribute to putting Florida’s trans youth population, their families, and their care providers in harm’s way. It is shameful to see yet another attack from a state that is laser-focused on targeting trans and LGBQ people for political gain.”

Visit https://www.wpath.org/policies to view our public documents.

Visit https://www.tandfonline.com/loi/wijt20 to view the International Journal of Transgender Health with open access to our editorials.

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February 24, 2022

USPATH Statement Regarding Texas Govenor Abbott Attempt to Label Treatment as Child Abuse

USPATH Statement regarding TX Gov. Abbott attempt to label treatment as child abuse. “The United States Professional Association for Transgender Health (USPATH) is strongly opposed to Gov. Greg Abbott and the State of Texas’ intention to identify gender affirming care for trans and gender diverse youth as “child abuse”,

October 12, 2021

USPATH and WPATH Letter to Members – Appropriate Care for Trans(gender) and Gender Diverse Youth

September 30, 2021

Letter to WPATH Members Residing in Australia

May 6, 2021 – Update

WPATH is pleased to announce the release of the following International Journal for Transgender Health (IJTH) article

Bell v Tavistock and Portman NHS Foundation Trust [2020] EWHC 3274: Weighing current knowledge and uncertainties in decisions about gender-related treatment for transgender adolescents

Annelou L. C. de Vries, Christina Richards, Amy C. Tishelman, Joz Motmans, Sabine E. Hannema, Jamison Green & Stephen M. Rosenthal

March 31, 2021

WPATH Recognizes Transgender Day of Visibility

Today, the World Professional Association for Transgender Health (WPATH) honors all the transgender and gender diverse people around the world to recognize March 31, 2021, as International Transgender Day of Visibility.

WPATH will continue to work with professional healthcare providers as allies and advocates to show support for transgender and gender diverse people around the world, especially, people of color, and those living in rural, or conservative areas.

Despite progress made towards our mission to ensure people of all gender identities and expressions have access to evidence-based, affirming healthcare, there remains work to be done, as discrimination and violence are still prevalent in our world.

WPATH and the United States Professional Association for Transgender Health (USPATH) strongly oppose the legislation being passed and considered in many states. Please read our statement on these legislative attacks.

WPATH is also pleased to share the timely announcement by the United States Department of Defense regarding transgender persons serving in the military. Today, the Department has revised and restored the 2016 policy which prohibits discrimination based on gender identity. Read the complete DoD Memo and links to the Instructions by clicking here.

WPATH celebrates International Transgender Day of Visibility with our members and supporters on behalf of transgender and gender diverse people around the world.

March 17, 2021

USPATH Statement on the Surge of Anti-Trans Legislation Occurring Within the US

The United States Professional Association for Transgender Health (USPATH) strongly opposes the recent wave of legislation seeking to criminalize health care for young people who are transgender. This legislation prevents young people from accessing life-saving services. Currently 25 states have at least one of these bills moving through the legislature or have already been signed by their governor. These bills are based on misinformation and would cause great harm to transgender young people.

The preponderance of scientific evidence indicates that gender affirming healthcare can greatly help transgender people. Further, the World Professional Association for Transgender Health (WPATH) Standards of Care provide widely accepted guidelines for health care professionals to work with young people and their families. The guidelines are a conservative document that supports all children in exploring their gender and offers team-based approaches to determine the best course of action for each child.

Proposed anti-transgender legislation threatens health care providers with risk for fines, loss of license to practice, and imprisonment. Most importantly, these laws will prevent young people from receiving beneficial, often life-saving services, that have strong evidence of success and are supported by mainstream healthcare professional associations including the American Medical Association, Endocrine Society, American Academy of Pediatrics, Society for Adolescent Health and Medicine, American Psychiatric Association, American Academy of Family Physicians, and American Psychological Association.

USPATH calls on all people to oppose bills that will not only punish physicians, psychologists, and others providing evidence-based care to young transgender people but will also further threaten their health and well-being. These legislative actions will keep young transgender people, who are experiencing great distress due to discrimination and prejudice because they are transgender, from accessing help from expert medical and mental health providers at the exact time they desperately need professional care and support.

USPATH also calls on our members to educate their communities on the need for gender affirming care to not only help all transgender people thrive but prevent the devastating consequences that come from denying life-saving care.

December 17, 2020

Statement Regarding Medical Affirming Treatment including Puberty Blockers for Transgender Adolescents

WPATH, EPATH, USPATH, AsiaPATH, CPATH, AusPATH, PATHA Response to Bell v. Tavistock Judgement

The Boards of Directors of the World Professional Association for Transgender Health (WPATH), the European Association for Transgender Health (EPATH), the United States Professional Association for Transgender health (USPATH), the Asian Association for Transgender Health (AsiaPATH), the Canadian Association for Transgender Health (CPATH), the Australian Professional Association for Trans Health (AusPATH), and the Professional Association for Transgender Health Aotearoa (PATHA) all strongly disagree with the recent judgment of the London High Court in Bell v. Tavistock. We believe this decision will result in significant harm to the affected children and their families. We oppose this ruling and urge that this ruling be appealed and overturned.

August 3, 2020

WPATH Board of Directors and Ethics Committee Statement Opposing Legislation that Endangers Health

The members of the WPATH Ethics Committee applaud the June 15, 2020 ruling issued from the United States Supreme Court that rejects discrimination based on gender identity or sexual orientation in the workplace. The rationale for this ruling put forth by the majority articulates plainly that a person’s gender identity and sexual orientation cannot be parsed from personhood.

We strongly condemn the current United States Department of Health and Human Services (HHS) new rule that eliminates protections from discrimination based on gender identity and sexual orientation in the healthcare setting afforded by Section 1557 of the 2010 Affordable Care Act (ACA).

Section 1557 is a civil rights provision in the ACA that prohibits discrimination by covered health programs and activities on the basis of race, color, national origin, sex, age, and disability.

July 31, 2020

WPATH Statement Regarding Russian Legislation that Threatens Health of Vulnerable Populations

July 1, 2020

WPATH Sends Letter of Support to Republic of Kazakhstan

June 18, 2020

USPATH, WPATH, EPATH Statement: Black Lives Matter – A Call to Action

USPATH, WPATH and EPATH stand in solidarity with those protesting the violent deaths of George Floyd, Breonna Taylor, Nina Pop, Tony McDade, and many other people of color who lost their lives needlessly from police violence. These names are just a few among countless who have lost their lives. We say their names to remember their lives and see their deaths as unacceptable acts of racist violence, contrary to our values. We demand that those responsible be held fully accountable for their actions.

People of color around the globe are rising up to have their voices heard, because they are disproportionately singled out for violence at the hands of law enforcement as well as experiencing systematic racism within all societal institutions. In these circumstances, we urge all our members to publicly condemn actions that harm and dehumanize people of color.

May 8, 2020

WPATH / USPATH Statement on Resumption of Gender-Affirming Surgery During COVID-19 Pandemic

WPATH recognizes the adverse effects of COVID-19 on the physical and mental health of individuals across the globe. Due to the stress placed on healthcare systems as well as the uncertainty associated with the pandemic, many people have had medically necessary procedures postponed. As the medical community resumes elective surgical procedures, WPATH reaffirms the medical necessity of gender-affirming surgery and its importance to patients’ overall health. WPATH understands the impact of delayed access to medically necessary care and encourages surgeons to work with their local public health officials so as to resume providing surgical care as soon as public health conditions allow.

January 28, 2020

Statement in Response to Proposed Legislation Denying Evidence-Based Care for Transgender People Under 18 Years of Age and to Penalize Professionals who Provide that Medical Care

The World Professional Association for Transgender Health (WPATH) and its US chapter, the United States Professional Association for Transgender Health (USPATH), vehemently oppose the legislation being proposed in Florida (HB 1365), South Carolina (HB 4716), South Dakota (HB 1057), Colorado (HB 20-1114), and similar legislation in other states. These bills seek to deny evidence-based care for transgender people under 18 years of age and to penalize professionals who provide that medical care. These bills will punish practitioners of gender affirming care with revocation of their medical license, or up to 15 years in prison in some states. These bills will treat health care providers as if they committed manslaughter or arson.

Many of the procedures mentioned by these bills are not even offered to transgender youth, revealing these bills to be alarmist expressions of ill-informed opinion. Guidance for the provision of medical care for transgender youth is outlined within the 7th edition of Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender-Nonconforming People created by the World Professional Association for Transgender Health (Coleman et al. 2012). The guidelines differentiate between children and adolescents with regard to the provision of care

November 22, 2019

WPATH, USPATH, EPATH Statement in Response to Calls for Banning Evidence-Based Supportive Health Interventions for Transgender and Gender-Diverse Youth

Diversity in gender expression and variations in gender identity represent normative developmental processes for children and adolescents and are not inherently pathological aspects of the human experience. They are also not uniformly indicative of a future gender transition. These facts are substantiated by many reputable professional associations representing thousands of pediatric providers. Clinical guidelines for youth experiencing an incongruence between their gender identity and sex assigned at birth have been published, are widely used nationally, and are based on the current evidence. These guidelines support the use of interventions for appropriately assessed minors. The following organizations have pediatric clinical guidelines and/or policy statements on these issues: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Psychological Association, and the Endocrine Society. In response to recent critiques of supportive health interventions for transgender and gender-diverse youth, the boards of directors of the World Professional Association for Transgender Health (WPATH), its US chapter (USPATH) and its Europe chapter (EPATH) have authorized the following statement.

September 26, 2019

WPATH Statement on Yogyakarta Principles plus 10 and Healthcare Delivery

The Board of Directors of the World Professional Association for Transgender Health (WPATH) recognizes the Yogyakarta Principles plus 10 as operational policy guidelines that governments should follow in order to ensure the health and rights of all persons under internationally accepted human rights declarations. In states and under laws that are in conflict with the Yogyakarta Principles plus 10, WPATH recommends that health professionals work within existing regulations and available mechanisms to advance the health and rights of all people in ways that move treatment closer to that advocated by the Yogyakarta Principles plus 10, with the primary objective of the immediate best interests of the patient or client.

June 4, 2019

WPATH Submits Letter to Japanese Government Officials re Identity Recognition

May 17, 2019

WPATH Board Responds to Health Care Policies and Practices Imposed by Certain Religious Institutions

September 4, 2018

WPATH Position Statement On “Rapid-Onset Gender Dysphoria (ROGD)”

June 28, 2018

WPATH Recommended Benefits Policy Document: Created In Partnership With Starbucks

May 30, 2018

WPATH Response to Open Letter

Dear Open Letter Signers:

The WPATH Board of Directors thanks you for your constructive open letter. We begin by writing that we stand with you. The mission of the WPATH is to promote evidence-based care, education, research, advocacy, public policy, and respect in transgender health. WPATH strives to promote high quality care, in the context of a culture devoted to competent, ethical, and compassionate care. And while we are proud of the progress that has been made, we know there remains much work ahead.

(To continue reading, please download the full document below)

November 15, 2017 | For Immediate Release

WPATH Identity Recognition Statement

This statement replaces WPATH’s Identity Recognition Statement of January 19, 2015.

July 26, 2017 | Elgin, IL

WPATH Opposes Transgender Military Ban

The Executive Board of the World Professional Association for Transgender Health (WPATH) deplores President Trump’s tweet this morning, in which he declared that transgender people will not be allowed to serve in the U.S. military “in any capacity.” Citing “tremendous” costs of care and “disruption,” the President said he had consulted with “my Generals and military experts” in reaching his decision, but this reversal of policy is itself disruptive and wasteful.

“Many thousands of dollars have already been spent studying the matter,” said Gail Knudson, M.D., WPATH President, “and creating detailed analyses reaching the conclusion that transgender people are already serving, and have been serving in secret for decades. There’s no appreciable increase in cost associated with allowing transgender people to serve openly, which is what the current policy, as stated in Directive-Type Memorandum (DTM) 16-005, ‘Military Service of Transgender Service Members’ (issued June 30, 2016) is designed to achieve. Instead, this reversal will waste all of the previous studies and the investment in training the Armed Forces have made in the estimated up to 250 currently-serving transgender-identified soldiers and sailors who have already come forward under the assumption it was safe to do so. Thousands more who haven’t come forward will have to go back into hiding to continue serving their country.”

George Brown, M.D., a former WPATH board member and author of numerous scholarly papers focused on transgender military veterans and active duty personnel, wrote in an email to the WPATH Directors, “the policies (issued last year) are currently in effect unless and until officially rescinded by the Secretary of Defense, General Jim Mattis. The 6-month hold on new accessions (“enlistments”), effective June 30, 2017, is the last official statement in the form of a memorandum from SecDef Mattis.”

WPATH members in the US region (and globally) are professionals who work with transgender people every day. Transgender people are not a mystery to WPATH, nor is the science concerning transgender care. As a professional and educational association, WPATH is committed to promoting health, research, education, respect, dignity, and equality for transgender people in all settings, including the U.S. Armed Services.

Transgender troops have proven themselves to be capable and dependable soldiers. They should be judged on their performance of their duties, like any other service member, and not denied medically necessary care or otherwise discriminated against or because of their gender identity. The President’s tweet is a shameful attack on a group of our fellow citizens who are right now risking their lives to protect our society and way of life. The damage done by this morning’s tweet is an outright threat to unit cohesion and military readiness as it reinforces stigma and contributes to uncertainty, leading to depression and anxiety, undermining troop morale. Along with the American Medical Association, the American Psychological Association, the HIV Medicine Association, GLMA—Health Professionals Advancing LGBT Equality, and many other healthcare, legal advocacy, and civil rights organizations, WPATH stands in staunch opposition to this proposed policy reversal.

Forthcoming Icd-11 Proposed Draft May Contain Hope For Transgender Health

In an unprecedented move, the World Professional Association for Transgender Health (WPATH) has joined the World Association for Sexual Health (WAS) in delivering three joint statements to the World Health Organization (WHO) as the latter group is engaged in the ongoing revision of its International Classification of Diseases (ICD). Both Associations consider proposals for a new chapter on sexual health, and the relocation of relevant trans-related diagnoses to that chapter, as being of the utmost importance. Both Associations are aware that there has been debate around these proposals, and they have therefore issued the following three joint statements, all dated 30/6/2017:

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to inclusion of a chapter on Conditions Related to Sexual Health in ICD-11 in the version to be presented for approval at the World Health Assembly. We also urge WHO member states to support the proposed chapter.

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to locating the proposed diagnosis of Gender Incongruence of Adolescence and Adulthood within the chapter on Conditions Related to Sexual Health. We also urge member states to support the proposed placement.

The World Association for Sexual Health and the World Professional Association for Transgender Health call on WHO to consider further the proposed Gender Incongruence of Childhood diagnosis, including through comprehensive consultation with the transgender community.

August 15, 2017

Letter to Director Roger Severino

Dear Director Severino:

Thank you for your consideration in reading this letter. The World Professional Association for Transgender Health (WPATH) is the only medical association dedicated to the study, care, and treatment of transgender and gender-nonconforming people. Founded in 1979, ours is a
non-profit, interdisciplinary association of over 1400 physicians, mental health professionals, legal professionals, and academic and clinical researchers whose work directly impacts the health of transgender people. We are based near Chicago, and while we are an international association, the majority of our members practice in the U.S. As such, we have a firm stake in the provisions of § 1557 of the Affordable Care Act, and we were grateful for the opportunity to submit our comments during the prior review of § 1557 last year. We are the source of the internationally accepted Standards of Care for the Health of Transsexual, Transgender, and
Gender-nonconforming People which is referenced extensively in medical education, research, and policy statements.

We are concerned that the Trump administration has adopted an antagonistic position with regard to transgender people. It may be helpful to HHS to know that transgender people are not a modern invention, but they have been part of the human family in every race, class, and culture since the start of recorded history. The term “transgender,” though, is relatively new, as both science and culture have struggled for centuries to define people whose gender and sex do not correspond, or may be seen as untypical. Regardless of terminology, our research and clinical experience has shown that being a transgender person does not in itself constitute
mental illness (this is confirmed by the American Psychiatric Association). However, being transgender can lead to experiences of ridicule, intolerance, adverse discrimination in workplaces and even when accessing basic medical and emergency care, and various forms of abuse, both psychological and physical. No one should have to experience adverse discrimination when they are in need of health care. Such discrimination is known to lead to worse health outcomes for anyone, not just transgender people. We unequivocally support nondiscrimination protections for transgender people, and also for others with marginalizing characteristics such as race, age, disability, national origin, etc.

We also attest to the fact that medical and mental health treatments related to gender transition have been demonstrated to be beneficial and medically necessary for many transgender patients. Treatments are cost-effective and, when averaged into a large pool of covered individuals, are typically less expensive than many common, routine procedures, such as appendectomy or childbirth. We oppose health insurance exclusions targeting transition-related care. Accordingly, we support the gender identity nondiscrimination provisions of the § 1557 final rule and oppose reopening the rule. To the extent that HHS seeks to clarify the application of § 1557 and the final rule in certain respects and to address issues raised inlitigation, we urge HHS to do so through issuing interpretive guidance. However, if HHS chooses to reopen the rule, we ask HHS to first seek input from stakeholders through a Request for Information and public comment period prior to issuing a proposed rule. This is appropriate given the importance and scope of the rule, and the fact that the rule was originally developed using this process.

Please do not hesitate to contact us should you require further information.
Sincerely,

Gail Knudson, M.D.
President, WPATH

July 2017

Forthcoming Icd-11 Proposed Draft May Contain Hope For Transgender Health

WPATH/WAS Joint In an unprecedented move, the World Professional Association for Transgender Health (WPATH) has joined the World Association for Sexual Health (WAS) in delivering three joint statements to the World Health Organization (WHO) as the latter group is engaged in the ongoing revision of its International Classification of Diseases (ICD). Both Associations consider proposals for a new chapter on sexual health, and the relocation of relevant trans-related diagnoses to that chapter, as being of the utmost importance. Both Associations are aware that there has been debate around these proposals, and they have therefore issued the following three joint statements, all dated 30/6/2017:

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to inclusion of a chapter on Conditions Related to Sexual Health in ICD-11 in the version to be presented for approval at the World Health Assembly. We also urge WHO member states to support the proposed chapter.

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to locating the proposed diagnosis of Gender Incongruence of Adolescence and Adulthood within the chapter on Conditions Related to Sexual Health. We also urge member states to support the proposed placement.

The World Association for Sexual Health and the World Professional Association for Transgender Health call on WHO to consider further the proposed Gender Incongruence of Childhood diagnosis, including through comprehensive consultation with the transgender community.

May 2017

WPATH Opposes the Trump Administration’s Effort to Curtail Enforcement of Section 1557 of the Affordable Care Act (ACA)

February 2017

WPATH Supports Students Health and Safety

The World Professional Association for Transgender Health (WPATH) today affirms its commitment to the health and safety of transgender students in the U.S. and across the world.

January 2017

WPATH Timeline Guide for United States Armed Service Members Going Through Transgender Hormonal or Surgical Transition

This guide is intended to assist in determining relative deployability of transgender service members during hormonal and surgical transition. Customization of the specific treatment plan should be discussed by the medical provider and the service member informed by duty requirements and the below timeline guidance.

December 21, 2016

Position Statement on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage in the U.S.A.

July 15, 2016

WPATH Statement about Medical Necessity of Electrolysis

June 23, 2016

WPATH Statement Against Forced Anal Exams

The United Nations’ “Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment” prohibits health personnel from “participation in, complicity in, incitement to, or attempts to commit torture or other cruel, inhuman or degrading treatment or punishment.” Further, the 1975 Tokyo Declaration of the World Medical Association strictly forbids medical personnel from engaging in acts of torture or other forms of cruel, inhuman or degrading treatment and requires them to protect the confidentiality of medical information. However, since 2011, in at least eight countries, medical personnel have participated in forced anal examinations of men and transgender women who are charged with consensual same-sex conduct. The UN Special Rapporteur on Torture and other forms of Cruel, Inhuman and Degrading Treatment has described forced anal examinations as “medically worthless.” The Independent Forensic Experts Group, composed of forensic medicine specialists from around the world, has determined that “the examination has no value in detecting abnormalities in anal sphincter tone that can be reliably attributed to consensual anal intercourse.”

The Board of Directors of the World Professional Association for Transgender Health (WPATH) is deeply disturbed by the complicity of medical personnel in these involuntary examinations that have absolutely no medical or scientific value, and are a violation of a person’s bodily integrity. That medical personnel would also prepare “medical reports” which are used in trials to convict men and transgender women of sexual offenses is an unethical and inhumane abuse of medical authority.

The WPATH Board of Directors calls on the medical profession as a whole to abstain from participation in forced anal examinations, urges WPATH members to advocate for their own National Medical Councils to officially prohibit doctors from participating in such examinations, and calls upon the World Health Organization to adopt an official stance opposing forced anal examinations as unscientific and in violation of medical ethics.

July 15, 2014 | For Immediate Release

WPATH Statement Concerning Cross-dressing, Gender-Nonconformity, and Gender Dysphoria

The World Professional Association for Transgender Health (WPATH) calls for the repeal of laws criminalizing gender non-conformity and expression of transgender identity.

May 26, 2010 | For Immediate Release

WPATH De-Psychopathologisation Statement

The World Professional Association for Transgender Health has prepared and released a statement urging the de-psychopathologisation of gender variance worldwide. The statement is as follows:

The WPATH Board of Directors strongly urges the de-psychopathologisation of gender variance worldwide. The expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon which should not be judged as inherently pathological or negative. The psychopathologisation of gender characteristics and identities reinforces or can prompt stigma, making prejudice and discrimination more likely, rendering transgender and transsexual people more vulnerable to social and legal marginalisation and exclusion, and increasing risks to mental and physical well-being. WPATH urges governmental and medical professional organizations to review their policies and practices to eliminate stigma toward gender-variant people.”

May 25, 2010 | For Immediate Release

WPATH Reaction to DSM-V Criteria for Gender Incongruence

The WPATH Board of Directors and the Chairs of the DSM Consensus Building Process Work Group of the World Professional Association for Transgender Health, would like to thank all those who contributed their expertise to draft our formal response to the proposed DSM 5 Criteria for Gender Incongruence.

WPATH Responds to Alberta, Canada’s Decision to Delist Sexual Reassignment Surgery as a Covered Medical Benefit.