WPATH is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, advocacy, public policy, and respect for transgender health. The vision of WPATH is to bring together diverse professionals dedicated to developing best practices and supportive policies worldwide that promote health, research, education, respect, dignity, and equality for transsexual, transgender, and gender nonconforming people in all cultural settings.

The new SOC builds upon the important declaration by the WPATH Board of Directors in spring 2010 that “the expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon [that] should not be judged as inherently pathological or negative.” In explicitly declaring that gender diversity is a natural aspect of human development, WPATH has created a context in which such diversity in children can be considered by families and professionals alike in a more balanced and healthy way.

A second critical difference is a clear statement about the danger of “treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth.” SOC7 goes on to recognize the negative long term consequences of such approaches, concluding, “Such treatment is no longer considered ethical.”

What else is different about these new standards? There is a greater focus specifically on the needs of children and adolescents. With a more thorough consideration of the issues faced by gender diverse children and adolescents, SOC7 emphasizes the importance of supporting families “in managing uncertainty and anxiety about their child’s or adolescent’s psychosexual outcomes and in helping youth to develop a positive self-concept.”

However, there remain some aspects of the new SOC that are troubling.  One is the overall emphasis on gender dysphoria being a prerequisite for treatment of gender diverse youth. Defining gender dysphoria as “discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth,” many of the recommendations for professionals begin with an assumption that such discomfort or distress need be present in order to provide support. Yet, as families all over the world are discovering, when children are in fact allowed to authentically explore their own gender in a safe and supportive setting, little or no distress is demonstrated. Quite the contrary, many young people see such distress reduce or disappear once their own sense of self is recognized and affirmed by those around them.

A second area of concern is the language regarding social transitions in young people.  While not discouraging parents entirely, the document reflects on data showing “relatively low persistence rates of childhood gender dysphoria,” before chillingly suggesting that, “a change back to the original gender role can be highly distressing and even result in postponement of this second social transition on the child’s part.”  The conclusion:  “Mental health professionals can assist parents in identifying potential in-between solutions or compromises (e.g., only when on vacation).”

What this line of reasoning fails to recognize is that much of the data regarding “persistence of gender dysphoria” comes from studies that failed to effectively assess the roots or depth of the child’s gender nonconformity, therefore failing to distinguish children presenting a true sense of a transgender identity from those who were simply expressing gender in atypical ways. Further, referencing the “distress” of “a change back,” without at the same time naming the alleviation of stress that may also result seems disingenuous at best and potentially manipulative. While of course families considering social transitions must weigh many factors, not the least of which is a child’s safety, the message in SOC7 seems to caution against such transitions without weighing the possible trade-offs of such a course.

What do these new guidelines mean for families? Overall, they offer a more affirmative view of gender diversity in children. The document calls for supportive stances and interventions by professionals and greater acceptance of a child’s professed sense of their own gender. Yet unfortunately, they also continue to imply that a child’s gender should be gauged against a supposed norm, with the implication that typical experiences of gender are inherently healthier. As the world’s leading body focused on the health and well being of transgender and gender diverse people, it is unfortunate that these troubling aspects remain, despite an overall positive message. Find out more about SOC 7 at: http://www.wpath.org/