WPATH Guidelines

The World Professional Association for Transgender Health promotes the highest standards of health care for individuals through the Standard of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People. The SOC are based on the best available science and expert professional consensus.

The overall goal of the SOC is to provide clinical guidance for health professionals to assist patients with safe and effective pathways to achieving lasting personal comfort with their gendered selves in order to maximize their overall health, psychological well-being, and self-fulfillment.

Stanford Healthcare requires that all patients seeking genital gender-affirming surgeries must obtain letters from two different licensed mental health professionals (counselor, social worker, psychiatrist, etc.) that meets WPATH Guidelines.

WPATH Guidelines for Genital Gender-Affirming Surgeries

  • Age of majority (<18)*
  • Hormone therapy for 12 consecutive months unless medically contraindicated or if there is documentation in the medical record explaining why hormone therapy is not part of the transition journey
  • Living in gender role full time for minimum of 12 consecutive months
  • Demonstrated the capacity to make a fully informed decision and consent for treatment and the ability to comply with medical instruction
  • Demonstrated understanding of surgery and the implications of this irreversible step
  • Stable mental health, sufficiently self-aware, and successfully managing identified issues with depression
  • Two letters of referral from a qualified mental health professional

*Exceptions made on a case-by-case basis