A Brief Analysis of WPATH SOC8
by Collin Wynter
The World Professional Association for Transgender Health is an international organization that sets standards of care (SOC) to be disseminated to country based organizations down to the grassroots level. These standards affect all aspects of what is known as “trans health care” and influences all persons involved, even the general public. They released a preliminary version of their SOC version 8 for review, and requested feedback. Below are just some of my thoughts on the document, which you can learn more about here. For those not fully abreast of the organization and its mandate, the sections may appear disjointed. I will be releasing a more detailed analysis when their final version is released next summer. Suffice to say, there are many concerning recommendations; the least of which being, the apparent argument going on within the document itself, between a narrative of development medical professionals concerned about the medicalization of children, versus activists willing to sacrifice the childhood for their ideological belief in the transgender identity.
The Lack of Proper Definitions
SOC8 does not provide clear definitions for some terms that are expected to be used in a clinical setting. These include, but are not limited to gender, gender diverse, gender identity, gender dysphoria. There is a concern that clinicians may use these terms in a flexible manner to suit their therapeutic practices rather than to a regulated standard. It appears that WPATH is implementing these terms as valid clinical concepts without having these terms defined through a rigours process. WPATH states they will be providing an appendix with the final published version, but it is unclear if that will include a glossary of terms.
Delaying puberty is not reversible
SOC8 blatantly states that puberty blocking is reversal, with the citation of one study. Delaying puberty may in fact be a driving mechanism to worsening mental and physical health. WPATH clearly notes that adolescence is a time for cognitive and brain development wherein a persons sense of abstraction grows. This may be the necessary process a youth goes through to integrate their gender incongruence into a stable adult psychology. Contrary to the belief in this document, children and adolescents do not understand long term consequences, for the very reason that their mind is still developing; into their 20s as SOC8 notes.
Illogically, there is a claim that puberty is irreversible, and thus an immoral act to make a child go through. This belief is centred around the concept of a transgender child, which Dr David Bell, formerly of Tavistock, refutes unequivocally. He is on record stating that categorizing a child as trans places them on a path to medicalization. Children have a right to go through their biological puberty.
Parental, peer and grooming influence
SOC8 does not take into account the possibly that adults may be proactively directing their child towards a transgender identity. This may occur for several reasons: a false belief that the child communicated to them that they are a member of the opposite sex; homophobia from parents in regards to gender non-conformity; or something more serious, such as a Munchausen by proxy syndrome. These issue need to be highlighted and underlined so therapists can understand the very serious possibility of adult influence.
Peer social influence is a well known phenomena in adolescence for a variety of behaviours, including self harm such as cutting and eating disorders. A new phenomena in light of social media has appeared called rapid onset gender dysphoria (ROGD) by Dr Lisa Littman. It is concerning that instead of taking Littman’s study seriously, WPATH uses SOC8 in an attempt to discredit it. Online grooming is a well known aspect of the internet. This is being completely ignored by SOC8. Clinicians need to be trained to understand if youth are being conditioned by influencers on social media.
The claims of suicide
The denial of homosexuality
The most pertinent to us is that we believe gender clinicians may be misconstruing homosexuals for persons who require “transgender health care.” There is no mention in SOC8 that gender non-conforming children and youth may grow up to be gay. Nor is it mentioned for clinicians to investigate this. Pushing children towards transitioning when they may grow up to be homosexual is a form of conversion therapy.
Appropriating conversion therapy, SOC8 claims it is an attempt to change one’s personal identity (implying gender identity) and should be considered unethical. However, exploratory therapy to integrate one’s gender and their sex does not involve irreversibly medicalizing someone. The ability to speak to a therapist and receive feedback is the right of any patient.
SOC8 also makes the absurd claim that:
“HCPs [health care professionals] must be sensitive to the history of (mis)use of sexual identity and orientation should not be used as a gate keeping function to exclude transgender people from transition-related care.”
This may suggest to gender clinicians to downplay, possibly ignore, sexual orientation in favour of transition.
The fact that heterosexual persons transition has created an issue in the gay community when they identify as gay (for example, a woman who has male identifying surgery and then claims to be a gay man). Gay men and lesbians are being harassed by such individuals. Since WPATH has not included a glossary, it is unclear if they define gay as same sex attracted. Transgender organizations often mis-define the word by stating the word means same gender attraction. This needs to be addressed, so all gender clinicians are aware that it is inappropriate for a heterosexual person to transition and then consider themselves to be a homosexual member of the sex they identify as.
That Detransitioning should have their own chapter
There are more and more detransitioners. This is because many children and adolescents discover that they did not want to live their lives as members of another gender. Instead, they were simply gender non-conforming, had comorbidities such as neuro-divergence or body dysmorphia. Perhaps they just thought being trans was cool. Not understanding the life long implications of steroids and surgeries, many will never be able to have sexual function. There are also those who will be required to have external urinary catheters and colostomy bags. Double mastectomies might be paid for by the state, but is breast augmentation for women who detransition included?