All roads lead back to WPATH
Historical Overview
Next week we will be bringing you a retrospective look at publications by the World Professional Association for Transgender Health (WPATH).
In considering why the medical transitioning of children and adolescents continues it is necessary to understand three key medical associations: WPATH, the Endocrine Society, and the American Academy of Pediatrics. These three associations hold up the stool that the house of cards has been built on.
WPATH is best known for publishing a treatment protocol for “transgender and gender diverse people” that it calls “Standards of Care,” now in its 8th edition (SOC-8).
A standard of care is defined by the National Cancer Institute as “treatment that is accepted by medical experts as a proper treatment for a certain type of disease and is widely used by healthcare professionals.” SOC-8 may be a misnomer because currently many medical experts are challenging whether it represents a “proper treatment.” There is also a dispute even within WPATH about what, exactly, is being treated. Does SOC-8 imply that being trans is a disease or disorder?
WPATH was named after Harry Benjamin (1885-1986), a German endocrinologist and sexologist. He was friends with the sexologist Magnus Hirschfield and hung out with Margaret Sanger and Alfred Kinsey, who were known as radicals at the time.
Benjamin was interested in sex hormones and their supposed power to reverse the aging process. He was a proponent of a procedure called “Steinach vasoligation,” in which a doctor would remove a patient’s healthy testicle. It was believed to restore sexual potency and youthful vigor.
Benjamin also studied and advocated for transsexuals. After publishing The Transsexual Phenomenon in 1966, he went on to found the Harry Benjamin International Gender Dysphoria Association (HBIGDA), the predecessor to WPATH, in 1978. HBIGDA published its first Standards of Care (SOC-1) in 1979.
We will publish SOC-1 on Monday. Despite the controversy over whether the “Standards of Care” actually represent a proper treatment protocol, we will reference them as SOCs because that is the name by which they are known.
Few people today are familiar with the earlier SOCs. Some LGBT CC members remember transitioning under SOC-6, others SOC-7. But earlier SOCs are not well-known, and it took significant searching just to find SOC-1 and SOC-2.
Milestones in the Development of Trans Healthcare Protocols
This timeline is based on information from WPATH:
1979: SOC-1 is published
1980: SOC-2
1981: SOC-3
1990: SOC-4
1998: SOC-5
2001: SOC-6
2007: GeMS (Gender Multispecialty Program) opens in Boston as the first pediatric and adolescent gender program in the United States.
2007: HBIGDA is renamed WPATH.
2012: SOC-7
2017: The Endocrine Society publishes a “clinical practice guideline” in collaboration with WPATH. The ten authors of this guideline include seven WPATH leaders. Only one of the authors has no known affiliation with WPATH. (The full list of authors can be found at the end of this post.)
2018: American Academy of Pediatrics publishes a policy statement on youth gender transition written by Jason Rafferty.
2022: SOC-8
What other key timepoints would you suggest that we add?
At LGBT CC, we have discussed how much change has occurred over time in the SOCs’ recommended assessments, “gatekeeping,” and length. Here is a link to a paper that analyses the SOCs over time. While there is room for disagreement with the authors’ conclusion, we are sharing the paper because they reviewed all of the versions.
The authors created a table based on their analysis:
As we bring you the SOCs we are particularly interested in the changes over time regarding children, adolescents, and young people. They raise important questions.
When were children and adolescents first referenced?
How did the recommendations for children and adolescents change over time?
Was there an SOC in the past that might assist future recommendations for children and adolescents?
What about young adults (age 18-25)?
Was a “real life” test helpful in anyway?
Is “informed consent” the best model for any age?
We hope that as we bring you these key documents we can collectively begin to have a better understanding of the history that has brought us to this current place in time.
As always, we welcome your submissions. Send them to lgbtcouragecoalition@gmail.com
This is going to be very helpful. There is an excellent affidavit from a Wisconsin lawsuit challenging a school's secret social transition. Dr. Erika Anderson is the expert and was president of wpath at one point.
The key to her affidavit is that social transition is an affirmative psychotherapeudic treatment and that it has significant implications as to the desistance rates of kids. She also states that it is crucial to have family involvement in these treatments.
What the schools are doing is criminal. They are engaging in medical treatment.
I think is important to stop letting people control the conversation on social transition. It's not just "kids exploring" and it's not harmless. It locks them into their transition which makes desistence much less likely.
https://en.m.wikipedia.org/wiki/Michael_Dillon
Not an SOC, per se, but Dr. Michael Dillon (a British trans man) wrote the first book, Self: A Study in Ethics and Endocrinology, detailing the course of taking cross-sex hormones for the purpose of medically transitioning that was published in 1946.