March 8, 2023

Statement of Opposition to Legislation Banning
Access to Gender-Affirming Health Care in the US
Both the World Professional Association for Transgender Health (WPATH) and the US affiliate,
the United States Professional Association for Transgender Health (USPATH), vehemently
oppose the broad and sweeping legislation being introduced and ratified in states across thecountry to ban access to gender-affirming health care to transgender and gender diverse (TGD)
people. WPATH’s long-standing Standards of Care for Transgender and Gender Diverse
People, now in its eighth version (SOC8), explain in detail the science- and evidence-based
benefits of gender affirming care for TGD people. Any legislation that restricts or prohibits
access to this care is against best practice medical standards and is condemned by WPATHand USPATH.
“Anti-transgender health care legislation is not about protections for children but about
eliminating transgender persons on a micro and macro scale,” said WPATH President, Dr. MarciBowers. “It is a thinly veiled attempt to enforce the notion of a gender binary.”“Legislation that bans gender-affirming care is frequently based on misinformation and false
statements meant to stir unfounded fears resulting in harmful and baseless laws about what
happens between a doctor and their patient,” said USPATH President and Professor of Family& Community Medicine, University of California - San Francisco, Maddie Deutsch, MD, MPH. “Ifand when these laws are enacted, they will undoubtedly lead to further harm for transgenderand gender diverse people seeking this lifesaving care; these laws offer no protection in anyway, shape, or form. All gender-affirming care should be provided in accordance with current
professional best practices and standards according to evidence-based recommendations
included in SOC8. Medical professionals and experts who research and practice in this fieldmust be able to do their jobs in providing life-saving care for their patients without legislativeintervention.”
The Standards of Care state that, “the goal of gender-affirming care is to partner with TGD
people to holistically address their social, mental, and medical health needs and well-being
while respectfully affirming their gender identity. Gender-affirming care supports TGD people
across the lifespan—from the very first signs of gender incongruence in childhood throughadulthood and into older age.” It’s important to note that gender-affirming care is not inherently
transition-related care, which may include medical gender affirmation via hormone suppression
or hormone replacement therapy and/or gender-affirming surgeries. Per SOC-8, transition-

related care is not recommended for every TGD person in every situation, and various chapters
explain in detail best-practice care guidelines for TGD people of varying ages. For example, theonly gender-affirming care for children recommended in SOC-8 is social support or socialtransition, in which a transgender or gender diverse child would be able to use a name,pronouns, and gender expression (including haircut or clothing) that aligns with their gender. At
no point does SOC-8 recommend transition-related care or medical intervention for children
before the age of puberty.
All major medical associations including WPATH have supported the provision ofgender-affirming care for TGD people as medically necessary care. Global contributors of SOC8 participated in rigorous debate and methodology using the Delphi process to ratify scienceand evidence-based guidelines for care. Legislation that seeks to inhibit or restrict access tocare are in direct contradiction to decades of research and numerous studies touting theoverwhelming mental and physical health benefits of gender-affirming care for TGD people.
WPATH and USPATH unequivocally denounce and condemn any previous, current, orproposed legislation that would take medical decision-making away from TGD people and theirfamilies. Any current or forthcoming laws are against medical best practices, against sciencebased recommendations, and are an attack against human rights.
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