Roadblocks all Transgender patients run in to come from false information given by providers in that before a Transgender patient can begin Hormone Replacement Therapy, one must live full time in their preferred gender for a stated amount of time. What isn't told to patients, is that standards of Transgender Treatment DO exist and the information given patients is not always true or in the best interest of the patient. Benjamin Standards of Transgender Treatment Version 7 dated 2011 detail at great length the Standards of Care (SoC) for us.
In this Version 7 SoC, you'll not find a requirement for "Real Life Experience", but will find that a thorough evaluation and a letter from a Psychotherapist is required prior to Hormone Replacement Therapy to be recommended.
The following is a summary of criteria for hormone therapy and surgeries from page 227 of Version 7 of Benjamin's Standards.....
APPENDIX C: SUMMARY OF
CRITERIA FOR HORMONE THERAPY
AND SURGERIES
As for all previous versions of the SOC, the
criteria put forth in the SOC for hormone therapy
and surgical treatments for gender dysphoria are
clinical guidelines; individual health professionals
and programs may modify them. Clinical
departures from the SOC may come about
because of a patient’s unique anatomic, social, or
psychological situation; an experienced health
professional’s evolving method of handling a
common situation; a research protocol; lack
of resources in various parts of the world;
or the need for specific harm-reduction strategies.
These departures should be recognized as
such, explained to the patient, and documented
through informed consent for quality patient care
and legal protection. This documentation is also
valuable to accumulate new data, which can
be retrospectively examined to allow for health
care—and the SOC—to evolve.
Criteria for Feminizing/Masculinizing
Hormone Therapy (One Referral or Chart
Documentation of Psychosocial
Assessment)
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision
and to give consent for treatment;
3. Age of majority in a given country (if
younger, follow the SOC for children and
adolescents);
4. If significant medical or mental concerns
are present, they must be reasonably well
controlled.
Criteria for Breast/Chest Surgery (One
Referral)
Mastectomy and Creation of a Male Chest
in FtM Patients
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision
and to give consent for treatment;
3. Age of majority in a given country (if
younger, follow the SOC for children and
adolescents);
4. If significantmedical or mental health concerns
are present, they must be reasonably
well controlled.
Hormone therapy is not a prerequisite.
Breast Augmentation (Implants/Lipofilling)
in MtF Patients
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision
and to give consent for treatment;
3. Age of majority in a given country (if
younger, follow the SOC for children and
adolescents);
4. If significantmedical or mental health concerns
are present, they must be reasonably
well controlled.
Although not an explicit criterion, it is recommended
that MtF patients undergo feminizing
hormone therapy (minimum 12 months) prior to
breast augmentation surgery. The purpose is to
maximize breast growth in order to obtain better
surgical (aesthetic) results.
Criteria for Genital Surgery (Two
Referrals)
Hysterectomy and Salpingo-oophorectomy
in FtM Patients and Orchiectomy in MtF
Patients
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision
and to give consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health
concerns are present, they must be well
controlled;
5. 12 continuous months of hormone therapy
as appropriate to the patient’s gender
goals (unless hormones are not clinically
indicated for the individual).
