Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

E Coleman¹, A E Radix^{2

3}, W P Bouman^{4

5}, G R Brown^{6

7}, A L C de Vries^{8

9}, M B Deutsch^{10

11}, R Ettner^{12

13}, L Fraser¹⁴, M Goodman¹⁵, J Green¹⁶, A B Hancock¹⁷, T W Johnson¹⁸, D H Karasic^{19

20}, G A Knudson^{21

22}, S F Leibowitz²³, H F L Meyer-Bahlburg^{24

25}, S J Monstrey²⁶, J Motmans^{27

28}, L Nahata^{29

30}, T O Nieder³¹, S L Reisner^{32

33}, C Richards^{34

35}, L S Schechter³⁶, V Tangpricha^{37

38}, A C Tishelman³⁹, M A A Van Trotsenburg^{40

41}, S Winter⁴², K Ducheny⁴³, N J Adams^{44

45}, T M Adrián^{46

47}, L R Allen⁴⁸, D Azul⁴⁹, H Bagga^{50

51}, K Başar⁵², D S Bathory⁵³, J J Belinky⁵⁴, D R Berg⁵⁵, J U Berli⁵⁶, R O Bluebond-Langner^{57

58}, M-B Bouman^{9

59}, M L Bowers^{60

61}, P J Brassard^{62

63}, J Byrne⁶⁴, L Capitán⁶⁵, C J Cargill⁶⁶, J M Carswell^{32

67}, S C Chang⁶⁸, G Chelvakumar^{69

70}, T Corneil⁷¹, K B Dalke^{72

73}, G De Cuypere⁷⁴, E de Vries^{75

76}, M Den Heijer^{9

77}, A H Devor⁷⁸, C Dhejne^{79

80}, A D'Marco^{81

82}, E K Edmiston⁸³, L Edwards-Leeper^{84

85}, R Ehrbar^{86

87}, D Ehrensaft¹⁹, J Eisfeld⁸⁸, E Elaut^{74

89}, L Erickson-Schroth^{90

91}, J L Feldman⁹², A D Fisher⁹³, M M Garcia^{94

95}, L Gijs⁹⁶, S E Green⁹⁷, B P Hall^{98

99}, T L D Hardy^{100

101}, M S Irwig^{32

102}, L A Jacobs¹⁰³, A C Janssen^{23

104}, K Johnson^{105

106}, D T Klink^{107

108}, B P C Kreukels^{9

109}, L E Kuper^{110

111}, E J Kvach^{112

113}, M A Malouf¹¹⁴, R Massey^{115

116}, T Mazur^{117

118}, C McLachlan^{119

120}, S D Morrison^{121

122}, S W Mosser^{123

124}, P M Neira^{125

126}, U Nygren^{127

128}, J M Oates^{129

130}, J Obedin-Maliver^{131

132}, G Pagkalos^{133

134}, J Patton^{135

136}, N Phanuphak¹³⁷, K Rachlin¹⁰³, T Reed¹³⁸, G N Rider⁵⁵, J Ristori⁹³, S Robbins-Cherry⁴, S A Roberts^{32

139}, K A Rodriguez-Wallberg^{140

141}, S M Rosenthal^{142

143}, K Sabir¹⁴⁴, J D Safer^{60

145}, A I Scheim^{146

147}, L J Seal^{35

148}, T J Sehoole¹⁴⁹, K Spencer⁵⁵, C St Amand^{150

151}, T D Steensma^{9

109}, J F Strang^{152

153}, G B Taylor¹⁵⁴, K Tilleman¹⁵⁵, G G T'Sjoen^{74

156}, L N Vala¹⁵⁷, N M Van Mello^{9

158}, J F Veale¹⁵⁹, J A Vencill^{160

161}, B Vincent¹⁶², L M Wesp^{163

164}, M A West^{165

166}, J Arcelus^{5

167}

Affiliations

¹ Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
² Callen-Lorde Community Health Center, New York, NY, USA.
³ Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
⁴ Nottingham Centre for Transgender Health, Nottingham, UK.
⁵ School of Medicine, University of Nottingham, Nottingham, UK.
⁶ James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
⁷ James H. Quillen VAMC, Johnson City, TN, USA.
⁸ Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
⁹ Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
¹⁰ Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA.
¹¹ UCSF Gender Affirming Health Program, San Francisco, CA, USA.
¹² New Health Foundation Worldwide, Evanston, IL, USA.
¹³ Weiss Memorial Hospital, Chicago, IL, USA.
¹⁴ Independent Practice, San Francisco, CA, USA.
¹⁵ Emory University Rollins School of Public Health, Atlanta, GA, USA.
¹⁶ Independent Scholar, Vancouver, WA, USA.
¹⁷ The George Washington University, Washington, DC, USA.
¹⁸ Department of Anthropology, California State University, Chico, CA, USA.
¹⁹ University of California San Francisco, San Francisco, CA, USA.
²⁰ Independent Practice at dankarasic.com.
²¹ University of British Columbia, Vancouver, Canada.
²² Vancouver Coastal Health, Vancouver, Canada.
²³ Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
²⁴ New York State Psychiatric Institute, New York, NY, USA.
²⁵ Department of Psychiatry, Columbia University, New York, NY, USA.
²⁶ Ghent University Hospital, Gent, Belgium.
²⁷ Transgender Infopunt, Ghent University Hospital, Gent, Belgium.
²⁸ Centre for Research on Culture and Gender, Ghent University, Gent, Belgium.
²⁹ Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
³⁰ Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
³¹ University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany.
³² Harvard Medical School, Boston, MA, USA.
³³ Harvard T. H. Chan School of Public Health, Boston, MA, USA.
³⁴ Regents University London, UK.
³⁵ Tavistock and Portman NHS Foundation Trust, London, UK.
³⁶ Rush University Medical Center, Chicago, IL, USA.
³⁷ Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
³⁸ Atlanta VA Medical Center, Decatur, GA, USA.
³⁹ Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA.
⁴⁰ Bureau GenderPRO, Vienna, Austria.
⁴¹ University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria.
⁴² School of Population Health, Curtin University, Perth, WA, Australia.
⁴³ Howard Brown Health, Chicago, IL, USA.
⁴⁴ University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada.
⁴⁵ Transgender Professional Association for Transgender Health (TPATH).
⁴⁶ Asamblea Nacional de Venezuela, Caracas, Venezuela.
⁴⁷ Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela.
⁴⁸ University of Nevada, Las Vegas, NV, USA.
⁴⁹ La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
⁵⁰ Monash Health Gender Clinic, Melbourne, Victoria, Australia.
⁵¹ Monash University, Melbourne, Victoria, Australia.
⁵² Department of Psychiatry, Hacettepe University, Ankara, Turkey.
⁵³ Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA.
⁵⁴ Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina.
⁵⁵ National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
⁵⁶ Oregon Health & Science University, Portland, OR, USA.
⁵⁷ NYU Langone Health, New York, NY, USA.
⁵⁸ Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA.
⁵⁹ Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
⁶⁰ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶¹ Mills-Peninsula Medical Center, Burlingame, CA, USA.
⁶² GrS Montreal, Complexe CMC, Montreal, Quebec, Canada.
⁶³ Université de Montreal, Quebec, Canada.
⁶⁴ University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
⁶⁵ The Facialteam Group, Marbella International Hospital, Marbella, Spain.
⁶⁶ Independent Scholar.
⁶⁷ Boston's Children's Hospital, Boston, MA, USA.
⁶⁸ Independent Practice, Oakland, CA, USA.
⁶⁹ Nationwide Children's Hospital, Columbus, OH, USA.
⁷⁰ The Ohio State University, College of Medicine, Columbus, OH, USA.
⁷¹ School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada.
⁷² Penn State Health, PA, USA.
⁷³ Penn State College of Medicine, Hershey, PA, USA.
⁷⁴ Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium.
⁷⁵ Nelson Mandela University, Gqeberha, South Africa.
⁷⁶ University of Cape Town, Cape Town, South Africa.
⁷⁷ Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
⁷⁸ University of Victoria, Victoria, BC, Canada.
⁷⁹ ANOVA, Karolinska University Hospital, Stockholm, Sweden.
⁸⁰ Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
⁸¹ UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas.
⁸² D M A R C O Organization, Nassau, The Bahamas.
⁸³ University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁸⁴ Pacific University, Hillsboro, OR, USA.
⁸⁵ Independent Practice, Beaverton, OR, USA.
⁸⁶ Whitman Walker Health, Washington, DC, USA.
⁸⁷ Independent Practice, Maryland, USA.
⁸⁸ Transvisie, Utrecht, The Netherlands.
⁸⁹ Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium.
⁹⁰ The Jed Foundation, New York, NY, USA.
⁹¹ Hetrick-Martin Institute, New York, NY, USA.
⁹² Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
⁹³ Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy.
⁹⁴ Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁹⁵ Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA.
⁹⁶ Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium.
⁹⁷ Mermaids, London/Leeds, UK.
⁹⁸ Duke University Medical Center, Durham, NC, USA.
⁹⁹ Duke Adult Gender Medicine Clinic, Durham, NC, USA.
¹⁰⁰ Alberta Health Services, Edmonton, Alberta, Canada.
¹⁰¹ MacEwan University, Edmonton, Alberta, Canada.
¹⁰² Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁰³ Independent Practice, New York, NY, USA.
¹⁰⁴ Northwestern Feinberg School of Medicine, Chicago, IL, USA.
¹⁰⁵ RMIT University, Melbourne, Australia.
¹⁰⁶ University of Brighton, Brighton, UK.
¹⁰⁷ Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium.
¹⁰⁸ Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium.
¹⁰⁹ Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
¹¹⁰ Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA.
¹¹¹ Department of Endocrinology, Children's Health, Dallas, TX, USA.
¹¹² Denver Health, Denver, CO, USA.
¹¹³ University of Colorado School of Medicine, Aurora, CO, USA.
¹¹⁴ Malouf Counseling and Consulting, Baltimore, MD, USA.
¹¹⁵ WPATH Global Education Institute.
¹¹⁶ Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
¹¹⁷ Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
¹¹⁸ John R. Oishei Children's Hospital, Buffalo, NY, USA.
¹¹⁹ Professional Association for Transgender Health, South Africa.
¹²⁰ Gender DynamiX, Cape Town, South Africa.
¹²¹ Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA.
¹²² Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.
¹²³ Gender Confirmation Center, San Francisco, CA, USA.
¹²⁴ Saint Francis Memorial Hospital, San Francisco, CA, USA.
¹²⁵ Johns Hopkins Center for Transgender Health, Baltimore, MD, USA.
¹²⁶ Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA.
¹²⁷ Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
¹²⁸ Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden.
¹²⁹ La Trobe University, Melbourne, Australia.
¹³⁰ Melbourne Voice Analysis Centre, East Melbourne, Australia.
¹³¹ Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA.
¹³² Department of Epidemiology and Population Health, Stanford, CA, USA.
¹³³ Independent PracticeThessaloniki, Greece.
¹³⁴ Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece.
¹³⁵ Talkspace, New York, NY, USA.
¹³⁶ CytiPsychological LLC, San Diego, CA, USA.
¹³⁷ Institute of HIV Research and Innovation, Bangkok, Thailand.
¹³⁸ Gender Identity Research and Education Society, Leatherhead, UK.
¹³⁹ Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA.
¹⁴⁰ Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
¹⁴¹ Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
¹⁴² Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA.
¹⁴³ UCSF Child and Adolescent Gender Center.
¹⁴⁴ FtM Phoenix Group, Krasnodar Krai, Russia.
¹⁴⁵ Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA.
¹⁴⁶ Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
¹⁴⁷ Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada.
¹⁴⁸ St George's University Hospitals NHS Foundation Trust, London, UK.
¹⁴⁹ Iranti, Johannesburg, South Africa.
¹⁵⁰ University of Houston, Houston, TX, USA.
¹⁵¹ Mayo Clinic, Rochester, MN, USA.
¹⁵² Children's National Hospital, Washington, DC, USA.
¹⁵³ George Washington University School of Medicine, Washington, DC, USA.
¹⁵⁴ Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA.
¹⁵⁵ Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium.
¹⁵⁶ Department of Endocrinology, Ghent University Hospital, Gent, Belgium.
¹⁵⁷ Independent Practice, Campbell, CA, USA.
¹⁵⁸ Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹⁵⁹ School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
¹⁶⁰ Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
¹⁶¹ Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁶² Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK.
¹⁶³ College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA.
¹⁶⁴ Health Connections Inc., Glendale, WI, USA.
¹⁶⁵ North Memorial Health Hospital, Robbinsdale, MN, USA.
¹⁶⁶ University of Minnesota, Minneapolis, MN, USA.
¹⁶⁷ Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.

PMID: 36238954
PMCID: PMC9553112
DOI: 10.1080/26895269.2022.2100644

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

E Coleman et al. Int J Transgend Health. 2022.

. 2022 Sep 6;23(Suppl 1):S1-S259.

doi: 10.1080/26895269.2022.2100644. eCollection 2022.

Authors

Affiliations

¹ Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
² Callen-Lorde Community Health Center, New York, NY, USA.
³ Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
⁴ Nottingham Centre for Transgender Health, Nottingham, UK.
⁵ School of Medicine, University of Nottingham, Nottingham, UK.
⁶ James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA.
⁷ James H. Quillen VAMC, Johnson City, TN, USA.
⁸ Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
⁹ Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
¹⁰ Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA.
¹¹ UCSF Gender Affirming Health Program, San Francisco, CA, USA.
¹² New Health Foundation Worldwide, Evanston, IL, USA.
¹³ Weiss Memorial Hospital, Chicago, IL, USA.
¹⁴ Independent Practice, San Francisco, CA, USA.
¹⁵ Emory University Rollins School of Public Health, Atlanta, GA, USA.
¹⁶ Independent Scholar, Vancouver, WA, USA.
¹⁷ The George Washington University, Washington, DC, USA.
¹⁸ Department of Anthropology, California State University, Chico, CA, USA.
¹⁹ University of California San Francisco, San Francisco, CA, USA.
²⁰ Independent Practice at dankarasic.com.
²¹ University of British Columbia, Vancouver, Canada.
²² Vancouver Coastal Health, Vancouver, Canada.
²³ Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
²⁴ New York State Psychiatric Institute, New York, NY, USA.
²⁵ Department of Psychiatry, Columbia University, New York, NY, USA.
²⁶ Ghent University Hospital, Gent, Belgium.
²⁷ Transgender Infopunt, Ghent University Hospital, Gent, Belgium.
²⁸ Centre for Research on Culture and Gender, Ghent University, Gent, Belgium.
²⁹ Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
³⁰ Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
³¹ University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany.
³² Harvard Medical School, Boston, MA, USA.
³³ Harvard T. H. Chan School of Public Health, Boston, MA, USA.
³⁴ Regents University London, UK.
³⁵ Tavistock and Portman NHS Foundation Trust, London, UK.
³⁶ Rush University Medical Center, Chicago, IL, USA.
³⁷ Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
³⁸ Atlanta VA Medical Center, Decatur, GA, USA.
³⁹ Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA.
⁴⁰ Bureau GenderPRO, Vienna, Austria.
⁴¹ University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria.
⁴² School of Population Health, Curtin University, Perth, WA, Australia.
⁴³ Howard Brown Health, Chicago, IL, USA.
⁴⁴ University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada.
⁴⁵ Transgender Professional Association for Transgender Health (TPATH).
⁴⁶ Asamblea Nacional de Venezuela, Caracas, Venezuela.
⁴⁷ Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela.
⁴⁸ University of Nevada, Las Vegas, NV, USA.
⁴⁹ La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
⁵⁰ Monash Health Gender Clinic, Melbourne, Victoria, Australia.
⁵¹ Monash University, Melbourne, Victoria, Australia.
⁵² Department of Psychiatry, Hacettepe University, Ankara, Turkey.
⁵³ Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA.
⁵⁴ Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina.
⁵⁵ National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
⁵⁶ Oregon Health & Science University, Portland, OR, USA.
⁵⁷ NYU Langone Health, New York, NY, USA.
⁵⁸ Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA.
⁵⁹ Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
⁶⁰ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁶¹ Mills-Peninsula Medical Center, Burlingame, CA, USA.
⁶² GrS Montreal, Complexe CMC, Montreal, Quebec, Canada.
⁶³ Université de Montreal, Quebec, Canada.
⁶⁴ University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
⁶⁵ The Facialteam Group, Marbella International Hospital, Marbella, Spain.
⁶⁶ Independent Scholar.
⁶⁷ Boston's Children's Hospital, Boston, MA, USA.
⁶⁸ Independent Practice, Oakland, CA, USA.
⁶⁹ Nationwide Children's Hospital, Columbus, OH, USA.
⁷⁰ The Ohio State University, College of Medicine, Columbus, OH, USA.
⁷¹ School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada.
⁷² Penn State Health, PA, USA.
⁷³ Penn State College of Medicine, Hershey, PA, USA.
⁷⁴ Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium.
⁷⁵ Nelson Mandela University, Gqeberha, South Africa.
⁷⁶ University of Cape Town, Cape Town, South Africa.
⁷⁷ Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
⁷⁸ University of Victoria, Victoria, BC, Canada.
⁷⁹ ANOVA, Karolinska University Hospital, Stockholm, Sweden.
⁸⁰ Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
⁸¹ UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas.
⁸² D M A R C O Organization, Nassau, The Bahamas.
⁸³ University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁸⁴ Pacific University, Hillsboro, OR, USA.
⁸⁵ Independent Practice, Beaverton, OR, USA.
⁸⁶ Whitman Walker Health, Washington, DC, USA.
⁸⁷ Independent Practice, Maryland, USA.
⁸⁸ Transvisie, Utrecht, The Netherlands.
⁸⁹ Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium.
⁹⁰ The Jed Foundation, New York, NY, USA.
⁹¹ Hetrick-Martin Institute, New York, NY, USA.
⁹² Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
⁹³ Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy.
⁹⁴ Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁹⁵ Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA.
⁹⁶ Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium.
⁹⁷ Mermaids, London/Leeds, UK.
⁹⁸ Duke University Medical Center, Durham, NC, USA.
⁹⁹ Duke Adult Gender Medicine Clinic, Durham, NC, USA.
¹⁰⁰ Alberta Health Services, Edmonton, Alberta, Canada.
¹⁰¹ MacEwan University, Edmonton, Alberta, Canada.
¹⁰² Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁰³ Independent Practice, New York, NY, USA.
¹⁰⁴ Northwestern Feinberg School of Medicine, Chicago, IL, USA.
¹⁰⁵ RMIT University, Melbourne, Australia.
¹⁰⁶ University of Brighton, Brighton, UK.
¹⁰⁷ Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium.
¹⁰⁸ Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium.
¹⁰⁹ Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands.
¹¹⁰ Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA.
¹¹¹ Department of Endocrinology, Children's Health, Dallas, TX, USA.
¹¹² Denver Health, Denver, CO, USA.
¹¹³ University of Colorado School of Medicine, Aurora, CO, USA.
¹¹⁴ Malouf Counseling and Consulting, Baltimore, MD, USA.
¹¹⁵ WPATH Global Education Institute.
¹¹⁶ Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
¹¹⁷ Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
¹¹⁸ John R. Oishei Children's Hospital, Buffalo, NY, USA.
¹¹⁹ Professional Association for Transgender Health, South Africa.
¹²⁰ Gender DynamiX, Cape Town, South Africa.
¹²¹ Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA.
¹²² Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.
¹²³ Gender Confirmation Center, San Francisco, CA, USA.
¹²⁴ Saint Francis Memorial Hospital, San Francisco, CA, USA.
¹²⁵ Johns Hopkins Center for Transgender Health, Baltimore, MD, USA.
¹²⁶ Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA.
¹²⁷ Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
¹²⁸ Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden.
¹²⁹ La Trobe University, Melbourne, Australia.
¹³⁰ Melbourne Voice Analysis Centre, East Melbourne, Australia.
¹³¹ Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA.
¹³² Department of Epidemiology and Population Health, Stanford, CA, USA.
¹³³ Independent PracticeThessaloniki, Greece.
¹³⁴ Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece.
¹³⁵ Talkspace, New York, NY, USA.
¹³⁶ CytiPsychological LLC, San Diego, CA, USA.
¹³⁷ Institute of HIV Research and Innovation, Bangkok, Thailand.
¹³⁸ Gender Identity Research and Education Society, Leatherhead, UK.
¹³⁹ Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA.
¹⁴⁰ Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
¹⁴¹ Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
¹⁴² Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA.
¹⁴³ UCSF Child and Adolescent Gender Center.
¹⁴⁴ FtM Phoenix Group, Krasnodar Krai, Russia.
¹⁴⁵ Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA.
¹⁴⁶ Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
¹⁴⁷ Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada.
¹⁴⁸ St George's University Hospitals NHS Foundation Trust, London, UK.
¹⁴⁹ Iranti, Johannesburg, South Africa.
¹⁵⁰ University of Houston, Houston, TX, USA.
¹⁵¹ Mayo Clinic, Rochester, MN, USA.
¹⁵² Children's National Hospital, Washington, DC, USA.
¹⁵³ George Washington University School of Medicine, Washington, DC, USA.
¹⁵⁴ Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA.
¹⁵⁵ Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium.
¹⁵⁶ Department of Endocrinology, Ghent University Hospital, Gent, Belgium.
¹⁵⁷ Independent Practice, Campbell, CA, USA.
¹⁵⁸ Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
¹⁵⁹ School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa.
¹⁶⁰ Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
¹⁶¹ Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
¹⁶² Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK.
¹⁶³ College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA.
¹⁶⁴ Health Connections Inc., Glendale, WI, USA.
¹⁶⁵ North Memorial Health Hospital, Robbinsdale, MN, USA.
¹⁶⁶ University of Minnesota, Minneapolis, MN, USA.
¹⁶⁷ Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.

PMID: 36238954
PMCID: PMC9553112
DOI: 10.1080/26895269.2022.2100644

Abstract

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

Keywords: SOC8; Standards of Care; adolescents; assessment; children; communication; education; endocrinology; eunuch; gender diverse; health care professional; institutional settings; intersex; mental health; nonbinary; population; postoperative care; primary care; reproductive health; sexual health; surgery; terminology; transgender; voice.

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Conflict of interest statement

Conflict of interests were reviewed as part of the selection process for committee members and at the end of the process before publication. No conflicts of interest were deemed significant or consequential.

Comment in

Male and Female Sexual Function and Dysfunction; Andrology.
Seftel AD. Seftel AD. J Urol. 2023 May;209(5):1013-1014. doi: 10.1097/JU.0000000000003382. Epub 2023 Feb 22. J Urol. 2023. PMID: 37026648 No abstract available.

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Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

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Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

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Conflict of interest statement

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