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WPATH Specific Criteria 2018-02-08T04:40:57+00:00

WPATH Specific Criteria

IMPORTANT. PLEASE NOTE : Whilst the WPATH guidelines specify ‘Mental Health Workers’ are able to provide the necessary reports required for surgery, it is the policy of Mr Ives’ that those reports must be from either a Psychiatrist OR a Clinical Psychologist only. For a single report, either of these specialists is acceptable, but when two reports are required one of them must be written by a Psychiatrist. For further information and clarification on this, please contact the rooms.

The specific criteria for different surgeries are listed below.

Criteria for breast/chest surgery (one referral):

Criteria for mastectomy and creation of a male chest FtM patients

  1. Persistent, well documented gender dysphoria;
  2. Capacity to make a fully informed decision and to consent for treatment
  3. Age of majority
  4. If significant medical or mental health concerns are present, they must be reasonably well controlled

Hormone therapy is not a pre-requisite.

Criteria for breast augmentation (implants/lipofilling) in MtF patients

  1. Persistent, well documented gender dysphoria
  2. Capacity to make a fully informed decision and to consent for treatment
  3. Age of majority
  4. If significant medical or mental health concerns are present, they must be reasonably well controlled

Although not an explicit criterion, Mr Ives recommends MtF patients undergo feminizing hormones for at least 12 months prior to surgery. He also recommends that patients should wait until their breast growth has ceased  before considering surgery.

Criteria for genital surgery (two referrals):

Criteria for orchidectomy in MtF patients

  1. Persistent, well documented gender dysphoria
  2. Capacity to make a fully informed decision and to consent for treatment
  3. Age of majority
  4. If significant medical or mental health concerns are present, they must be reasonably well controlled
  5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones)

The aim of hormone therapy prior to gonadectomy is primarily to introduce a period of reversible testosterone suppression, before the patient undergoes irreversible surgical intervention.

Criteria for vaginoplasty/labioplasty in MtF patients

  1. Persistent, well documented gender dysphoria
  2. Capacity to make a fully informed decision and to consent for treatment
  3. Age of majority
  4. If significant medical or mental health concerns are present, they must be reasonably well controlled
  5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals(unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones)
  6. 12 continuous months of living in a gender role that is congruent with their gender identity.