WPATH

WPATH, the World Professional Association for Transgender Health, is an international professional body that publishes the Standards of Care, the most widely cited guidelines for gender-affirming health care. The current edition is version 8, SOC-8, published in 2022.

Where you'll meet it

In clinic policies, insurance documents and surgeon requirements, often as "per WPATH SOC-8". Hormone prescribers also draw on the Endocrine Society's guideline for gender-affirming hormone therapy, and in the UK, on national service specifications.

What it says about hormones

For adults, SOC-8 supports starting hormones after an assessment that confirms marked and sustained gender incongruence, capacity to consent, and that other health conditions are reasonably managed. It explicitly allows for that assessment to be done by the prescriber themselves, which is part of what makes informed-consent models possible. It also covers monitoring, the effects to expect and the risks to discuss.

What it is not

The Standards are guidelines, not law. Clinics, insurers and health systems adopt them fully, partly or not at all, and many policies still carry wording from the previous edition. If a clinic tells you WPATH requires something, it is fair to ask which part of the Standards they mean, and whether it is their policy or the guideline's. Gender clinics covers how requirements differ between services.

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