Updated Recommendations from the World Professional Association for Transgender Health Standards of Care

Preventive care approaches are similar to those of nontransgender persons, with adjustments based on hormonal and anatomical differences, such as the need for cervical screening in transmen and breast cancer screening in transwomen.3 The World Professional Association for Transgender Health (WPATH) is an international multidisciplinary professional association that publishes recognized standards for the care of transgender and gender-variant persons. The SOC7 states that primary care is an ideal setting for transgender health care, given that primary care physicians are knowledgeable of and often experienced with the administration of estrogens (for menopausal care and contraception), testosterone (for androgen deficient states such as with human immunodeficiency virus), and testosterone-blocking medications (for hirsutism and prostatic disease), and are aware of important mental and social health issues.10 This recommendation is also in line with the position statement recently released by the American College of Obstetricians and Gynecologists directing physicians to prepare themselves for the care of transgender persons.11 Table 1. Statements of Medical Necessity and Individuality In a 2008 statement, the WPATH Board of Directors defined all medical, surgical, and mental health care services related to gender dysphoria as medically necessary.14 The SOC7 reiterates this statement, and calls for universal insurance coverage of such services.