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Frequently Asked Questions? FAQs

What treatment is there for transsexuals?

The currently accepted and effective model of treatment for gender issues is based on the Standards of Care (SOC) written and enforced by the World Professional Association for Transgender Health. The tripartite treatment plan outlined in the SOC, involves an extended period (usually about 3 months) of psychotherapy prior to making a referral for hormone replacement therapy. This period is followed by an extended time (at least one year) in which the individual is required to live successfully full time in the new gender role prior to getting a referral for sex reassignment surgery. Although the SOC are minimum guidelines to be used to set eligibility criteria for patients, in actuality the course of treatment can be tailored to the individual's needs, and is usually negotiated among the patient's therapist, administrating endocrinologist and surgeon.

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What other treatments are there?

Male-to--female Transsexuals often undergo electrolysis or laser treatments to remove their beard and body hair. Transsexuals might also seek speech therapy to help attune their voices to their acquired gender.

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Are there any rules governing this treatment?

Although there are no legally binding rules, standards of care have been drawn up by the World Professional Association for Transgender Health (WPATH). The association has established standards of care for the treatment of GD, which is generally accepted by medical providers across the world these standards are revised from time to time to take into account new scientific information, and were last updated in 2014 with version 7. They provide directions for the treatment of transsexuals, which may be modified in line with a patient's particular needs and circumstances. They include minimum eligibility requirements for some procedures, such as referrals for hormones and for genital surgery.

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Do you think the standards of care as proposed by the World Professional Association for Trangender Health are reasonable?

Yes, in fact the SOC may be the most important development in the history of treating gender dysphoria. Prior to the SOC being written in the late 1970s by HBIGDA (now known as WPATH), surgeries were being performed on demand on kitchen tables by doctors who didn't have the slightest idea what they were doing. No hospital would allow the surgery. Hormone regimens were random and the surgery was about to be declared illegal. The SOC not only legitimized the surgery it provided a clear and workable path for thousands and thousands of others to follow. So are they reasonable? Sure, people handle the SOC with little or no difficulty.

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What do the guidelines state?

With regards to hormonal therapy, the WPATH guidelines set three criteria. Firstly, patients should be of legal age of medical maturity. This can range from 16 in most European counties to 18 here in the USA. Secondly, they should be aware of the effects and risks of taking the drugs. And thirdly, they should have documented proof that they were living in their desired gender role for at least three months or have undergone a period of psychotherapy sufficiently long enough for the gender specialist and the client to determine the time is right to make the referral. With regards to surgery, there are six eligibility criteria, the most important of which are that the patient should be a legal adult; have had 12 months of continuous hormone therapy; and have lived in their desired gender role for a year - a period known as the real life experience (RLE). There are also two readiness criteria. Patients should demonstrate that they are consolidating their gender identity, and enjoy better mental health as a result of dealing effectively with work, their family and relationships. Letters of Referral from two licensed mental health providers to the surgeon are required to check that patients meet these criteria.

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Nothing on this site should be viewed as providing therapeutic advice. No formation of a client/therapist
relationship with Dr. Vitale is intended or to be implied or inferred. The information provided in this site is for educational
purposes only. I attempt to keep the information current but make no representation or warranties in that regard. You should
not rely upon this information as a substitute for consul with a qualified mental health professional.