New WPATH Guidelines - SOC8

[ItsAllGoingToBeFine]

I thought I'd start a new thread on this specifically given that some of the WPATH high-ups have been speaking out recently.

All the details of the review are here:

www.wpath.org/soc8

Their chapter list includes some interesting new chapters:

6. Assessment, Support and Therapeutic Approaches for Adolescents with Gender Variance/Dysphoria NEW

12. Sexual Health Across the Lifespan NEW

18. Applicability of the Standards of Care to Eunuchs NEW

19. Competency, Training, Education NEW

20. Ethics NEW

I think these new guidelines (due the end of this year) may mark a bit of a turning point?

This version of the Standards of Care is the first to be developed using an evidence-based approach. Evidence-based guidelines include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. This document provides an overview of the methodological approach for updating the Standards of Care

Thread about Marci Bowers here:

www.mumsnet.com/Talk/womens_rights/4366709-Abigail-Shrier-Marci-Bowers-critical-of-puberty-blockers?msgid=111399829

This version of the Standards of Care is the first to be developed using an evidence-based approach.

What approach were they using before, if not an evidence based one...

Wait what? Ethics is new?

What approach were they using before, if not an evidence based one...

Experimental. On children.

@OhHolyJesus

Wait what? Ethics is new?

I raised an eyebrow at that too... And at it being the first evidence based version...

I do wonder / hope though if people like Bowers are signalling that these guidelines might be different in the way they deal with children.

I wonder if it will simply be the old jacket bedecked with a new lace collar.

What is the benchmark for ‘evidence based’?

Although, I did read that the Baker review on mental health improvements due to hormonal treatment paths was linked to WPATH and so there may be hope.

If these new guidelines were known to be coming, why was there such a rush by GIDS to push through to seek to overturn the High Court ruling so quickly ???

Baker, K. E., et al, (2021) Hormone Therapy, Mental Health and Quality of Life Among Transgender People: A Systematic Review. Journal of the Endocrine Society.

academic.oup.com/jes/article/5/4/bvab011/6126016

WPATH provided the research question and reviewed the protocol, evidence tables, and report.

It certainly sounds as if it may form part of the evidence base.

This systematic review of 20 studies found evidence that gender-affirming hormone therapy may be associated with improvements in QOL scores and decreases in depression and anxiety symptoms among transgender people. Associations were similar across gender identity and age. The strength of evidence for these conclusions is low due to methodological limitations (Table 6). It was impossible to draw conclusions about the effects of hormone therapy on death by suicide

(Bolding mine) I hope it does as it points out how poor the evidence is.

---

If these new guidelines were known to be coming, why was there such a rush by GIDS to push through to seek to overturn the High Court ruling so quickly

That is a very interesting question. As I recall WPATH weren't involved in the case at all?

They may not have been involved, but it is unlikely that GIDS did not know about this review of guidelines coming through.

I hope that there are more major reviews like this one from Baker et al being done. It would be good to have a better idea of where we are across the board on research.

I guess it depends if the new SOC are going to be genuinely evidence based, or evidence-that-supports-our-crusade based.

If US doctors have any sense of self-preservation I'd very much hope it is the former, given how litigious the US is.

Re GIDS and the High Court - I think that what GIDS wanted was to be able to pass the buck to the endocrinologists?

For, you know, when the suing for damages starts.

In the Marci Bowers / Abigail Shrier interview, Bowers uses the word 'sloppy' to describe much practice in this area - it's really worth reading. Thousands of children affected.

It makes you wonder what the US health insurance companies have been playing at.

Of course, Bowers is trying to peddle back from the interview now on twitter...

I guess it depends if the new SOC are going to be genuinely evidence based, or evidence-that-supports-our-crusade based.

Yes.

@Helleofabore

Of course, Bowers is trying to peddle back from the interview now on twitter...

Surprisingly not that much. She seems to be saying her comments were shortened and taken out of context, but she also seems to be saying that she has concerns about puberty blockers and loss of potential sexual function.

I suspect there will be a lot of fighting going on in the creation of these guidelines.

@ArabellaScott

I guess it depends if the new SOC are going to be genuinely evidence based, or evidence-that-supports-our-crusade based.

Yes.

I'm not in the least bit apprehensive about the impact of advocacy based guidelines rather than evidence based ones when it comes to irreversible and substantial changes to children .

Not the least.

They really have just been making it up as they go along.

It's scandalous

Eunuchs? They're talking about eunuchs now? Wow.

Wait, if you referred to a post-op transwoman as a eunuch, wouldn't the sky fall on you? Surely that's transphobic?

I suspect there will be a lot of fighting going on in the creation of these guidelines

Surely it's too late for fighting as haven't they been writing these for over 3 years? They must be pretty much there or even finished the final draft.

I just googled 'eunuch wpath' (yeah, I'm reckless) and found a forum with over 14,000 users discussing their eunuch issues. Not transwomen just regular eunuchs. I guess wpath doesn't like to miss a market.

Abstract of paper from 2010:
www.tandfonline.com/doi/full/10.1080/15532731003749095?scroll=top&needAccess=true

"Currently, the WPATH Standards of Care (SOC) provide guidelines for the treatment of male-to-female (MtF) transsexuals suffering from a gender identity disorder (GID). However, a large number of men with gender dysphoria who desire to be emasculated do not fit the classical pattern of MtF transsexualism. They loathe their manhood, but do not identify as, nor wish to be, female. Instead, they seek castration to become something outside the binary sexes. The formal term for such an individual is “eunuch,” which we here refer to as an MtE transgendered individual."

Abstract of paper from 2010:

I saw that and a 2009 presentation that was presenting eunuch as non-binary. It's remarkable to think just how much the non-binary category has increased since then and not in a sense where 'eunuch' would be a significant subgroup (this might vary with age).

Bookmarking!

Look forward to the eunuch flag and tee shirt.