The gatekeepers are relaxing their standards and have opened the door for exceptions, in an 8 year old guideline:
The Harry Benjamin International Gender Dysphoria Association’s Standards Of Care For Gender Identity Disorders, Sixth Version
February, 2001
of section VII:
VII. Requirements for Hormone Therapy for Adults
Reasons for Hormone Therapy. Cross-sex hormonal treatments play an important role in the anatomical and psychological gender transition process for properly selected adults with gender dentity disorders. Hormones are often medically necessary for successful living in the new gender. They improve the quality of life and limit psychiatric co-morbidity, which often accompanies lack of treatment. When physicians administer androgens to biologic females and estrogens, progesterone, and testosterone-blocking agents to biologic males, patients feel and appear more like members of their preferred gender.
Eligibility Criteria. The administration of hormones is not to be lightly undertaken because of their medical and social risks. Three criteria exist.
1. Age 18 years;
2. Demonstrable knowledge of what hormones medically can and cannot do and their social benefits and risks;
3. Either:
a. A documented real-life experience of at least three months prior to the administration
of hormones; or
b. A period of psychotherapy of a duration specified by the mental health professional after the initial evaluation (usually a minimum of three months)….
At the conclusion is this paragraph:
“……In selected circumstances, it can be acceptable to provide hormones to patients who have not fulfilled criterion 3 – for example, to facilitate the provision of monitored therapy using hormones of known quality, as an alternative to black-market or unsupervised hormone use.”
It shows admittance that the rigid standards imposed can cause harm, and that exceptions can be made in circumstances that not doing so may cause more harm than what the guidelines are purportedly meant to prevent.
Can the disposition of this particular argument be used to break down age, and other barriers?
Might it even pull the pins out from underneath what is a barrier to many transgenders, and their custodians who do not have the financial, professional, or legal resources to navigate ?
I’m not a professional but this looks like an exploitable weakness for some resourceful knowledgeable person, or persons barred by a directive that dose not trust their judgment.
If you have any questions or comments about HBS or WPATH contact:
Dr. Bean Robinson, PhD (USA)
Executive Director
Or:
Jeffrey Whitman (USA)
Executive Administrator
Email: wpath@wpath.org
1300 South Second Street, Suite 180
Minneapolis, MN 55454
found at their page:
I do need to read the whole thing in earnest, and study it more carefully, but my current feelings of frustration have me fixated on this specific portion.
I do not believe anyone would approach the subject of transgenderism for them selves, or a loved one with such disregard that a set of guidelines, be set in place of an informed individual’s judgment.
“Strength and Happiness”
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Some people get hormones on the black market on a whim, and others think about it long and hard. It can also be difficult to even obtain the services of practitioners to reach the goal of hormone replacement therapy. I knew I wanted to go on HRT, and it took me over two years before I was on. The situations vary so much from one place to another.
There have to be some kind of standards involved in our care. The rest of the medical community does not go off half cocked with treatments and doing things independently; and that is what I think would happen if the only standards on the planet were removed.
I have had my run ins with my gatekeepers about being held to what the standards say and how my team interpreted it. However I am happy to know that even after I move to Canada the HBI standards will still hold sway and I will know what I have to do to get ready for things like my surgeries.
The standards, such as they are, do allow us some continuity of treatment from one state to the next, or one country to the next. I, for one, would not want to have to fight with my next doctor and endo just to get what I have now.
track back:
http://lauras-playground.com/forums/index.php?showtopic=11541&hl=
I can understand your frustration, however, as someone that’s already been through the process I can say unequivocably that the SOC make good sense for everyone (therapists, doctors and patients). Transition is difficult under the best of circumstances and undertaking it alone and unsupervised would be foolhardy.
The SOC are not the problem. Sometimes the problem is a gate-keeper therapist. Another problem is the broken healthcare system in the US. But then again both those situations are getting better. The AMA passed Resolution 122 last year calling on the insurance industry to cover our MEDICAL condition.
The SOC have evolved over time are are quite flexible. It has also been my experience that those who complain the most about them are the ones who need them the most.