1479:," during which individuals seeking hormonal and other treatments are expected to begin transitioning socially to their preferred gender role sometime prior to accessing medical transition. Section Twelve, titled "Genital Surgery," deals directly with all concerns about gender-affirming surgery. It includes six "Eligibility Criteria" and two "Readiness Criteria", which are intended to be used by professionals for both diagnosis and guidance before providing patients "letters of recommendation." For this and other reasons, the WPATH SOC 6 was a controversial and often maligned document among patients seeking medical intervention (hormones, and/or surgery), who stated that their legally protected right to proper medical care and treatment was unjustly and unduly withheld or even denied based on the SOC.
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and that treatment should be focused on the alleviation of any suffering caused by gender dysphoria. They make a stance against the "deprivation of civil and human rights" on the grounds of someone's gender identity. This version, much like its predecessor requires referrals for surgical procedures based on set criteria, but notes the importance of informed consent and listening to the wishes of the patient.
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1565:"shared her view with her staff that publishing the proposed lower ages for gender transition surgeries was not supported by science or research, and could lead to an onslaught of attacks on the transgender community." In July 2024, the Biden administration reversed their earlier support and stated it opposed gender-affirming surgery for transgender minors. The
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1376:. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.
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Version 8 is the first one to include a chapter on adolescent care separate from that on the care of children. This version of the protocol gives no specific age limits for treatments, emphasizing the need to decide individually for each patient. It was criticized for suggesting that young people may
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Prior to the advent of the first SOC, there was no semblance of consensus on psychiatric, psychological, medical, and surgical requirements or procedures. Before the 1960s, few countries offered safe, legal medical options and many criminalized cross-gender behaviors or mandated unproven psychiatric
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The seventh version also includes acknowledgements of the ever-evolving language used to describe and treat transsexual, transgender, and gender non-conforming individuals. There is an emphasis placed on the idea that identifying with these labels does not inherently qualify someone as disordered,
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Continued care and careful assessment of cognitive maturity by qualified mental health professionals is recommended. In contrast to previous versions, there are no absolute requirements for duration of assessments or age to access gender-affirming treatments; rather, individual psychosocial and
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individuals are included for the first time in chapter 8. The guidelines recommend that medical treatment and social support be made available to non-binary people in individualized combinations, for example providing medical interventions without social transition or gender-affirming surgery
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The eighth version, titled "Standards of Care for the Health of
Transgender and Gender Diverse People", was published in 2022. It gives recommendations for health professionals in eighteen chapters. The guidelines were developed by a multidisciplinary committee of experts, building on previous
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1561:(HHS), this provision was removed in the final release. Despite the criticism, transgender youths wishing to be treated are still required to undergo a "comprehensive diagnostic assessment". In a statement by a spokesperson for the HHS, they explained that Assistant Secretary
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without hormone therapy. The chapter additionally notes unique experiences of discrimination, minority stress, and difficulty accessing gender-affirming medical treatment among non-binary people, which healthcare providers should take into consideration.
1464:. It recommends that mental health professionals document a patient's relevant history in a letter, which should be required by medical professionals prior to physical intervention. One letter is required for hormone replacement therapy or either
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1395:
The WPATH SOC are periodically updated and revised. The eighth and latest version was released on
September 15, 2022. Previous versions were released in 1979 (1st), 1980 (2nd), 1981 (3rd), 1990 (4th), 1998 (5th), 2001 (6th), and 2012 (7th).
2267:
Meyer, W.; Bockting, W. O.; Cohen-Kettenis, P.; Coleman, E.; DiCeglie, D.; Devor, H.; Gooren, L.; Joris Hage, J.; Kirk, S.; Kuiper, B.; Laub, D.; Lawrence, A.; Menard, Y.; Patton, J.; Schaefer, L.; Webb, A.; Wheeler, C. C. (February 2001).
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to create guidelines for transgender people in
England. A systematic review into international guidelines published as part of the review was published in 2024 and stated that WPATH SOC 8 lacked "developmental rigour and transparency".
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Meyer, W.; Bockting, W. O.; Cohen-Kettenis, P.; Coleman, E.; DiCeglie, D.; Devor, H.; Gooren, L.; Joris Hage, J.; Kirk, S.; Kuiper, B.; Laub, D.; Lawrence, A.; Menard, Y.; Patton, J.; Schaefer, L.; Webb, A.; Wheeler, C. C. (2001).
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1392:) authored one of the earliest sets of clinical guidelines for the express purpose of ensuring "lasting personal comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment."
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and as a standalone document. Included in the guidelines are sections on purpose and use of the WPATH SOC, the global applicability of the WPATH SOC, the difference between gender nonconformity and gender dysphoria,
1412:. The first version was released in 1979 and revisions were made in 1980, 1981, and 1990. These revisions were relatively minor, with the text staying mostly the same between versions. The first four versions of the
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Consultants: Dallas Denny MA, Domineco DiCeglie MD, Wolf Eicher MD, Jamison Green, Richard Green MD, Louis Gooren MD, Donald Laub MD, Anne
Lawrence MD, Walter Meyer III MD, C. Christine Wheeler Ph.D
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Walker, P. A.; Berger, J. C.; Green, R.; Laub, D. R.; Reynolds, C. L.; Wollman, L. (February 1985). "Standards of Care: The
Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons ".
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The
Eligibility Criteria and Readiness Criteria in version 6 give certain very specific minimum requirements as prerequisites to HRT or gender-affirming surgery (GAS). Section Nine covers "The
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An earlier draft would have required several years of transgender identity before an adolescent could begin treatment. After criticism from transgender advocates, as well as from staff of
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The seventh version includes a section distinguishing between cases of gender dysphoria and non-conformity for children and adolescents, as well as recommended treatment paths for each.
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were published as standalone documents by the Harry
Benjamin International Gender Dysphoria Association. However, the third version was also published as a 1985 reprint in the journal
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children only, chapter 7 makes recommendations regarding the support of children and their families throughout gender exploration and potential social transitions.
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A systematic review into international guidelines for management of gender dysphoria and gender incongruence in children and adolescents published as part of the
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1990:"World Professional Association for Transgender Health (WPATH) Releases the Standards of Care for the Health of Transgender and Gender Diverse People, Version 8"
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The seventh version, titled "Standards of Care for the Health of
Transsexual, Transgender, and Gender Nonconforming People", was published in 2012 both in the
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2179:(4 ed.), San Francisco, California: The Harry Benjamin International Gender Dysphoria Association, archived from the original on February 27, 2004
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Levine, S. B.; Brown, G.; Coleman, E.; Cohen-Kettenis, P.; Joris Hage, J.; Van
Maasdam, J.; Petersen, M.; Pfaefflin, F.; Schaefer, L. C. (June 1998).
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2391:"Clinical guidelines for children and adolescents experiencing gender dysphoria or incongruence: a systematic review of guideline quality (part 1)"
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Additionally, Chapter 12 and 13 and
Appendix D contain further recommendations regarding hormone therapy and surgical treatments in adolescents.
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In a departure from previous versions, Version 8 draws a conceptual distinction between Adolescents and Children with separate chapters.
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announced that it started an investigation and requested documents and information from the HHS related to its interactions with WPATH.
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Issues specific to certain demographics, including adults, children, and adolescents, are described in chapters 5–11 of version 8.
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treatments. In response to this problem, the Harry Benjamin International Gender Dysphoria Association (now known as the
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Taylor, Jo; Hall, Ruth; Heathcote, Claire; Hewitt, Catherine Elizabeth; Langton, Trilby; Fraser, Lorna (April 9, 2024).
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2691:"Puberty Suppressing Hormones (PSH) for children and adolescents who have gender incongruence/dysphoria [URN 1927"
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in March 2024 updated their guidelines and stated that for children and adolescents they do not follow WPATH 8.
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2635:"McClain Probes Biden Administration's Influence on Removal of Age Minimums for Gender Transition Procedures"
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The World Professional Association for Transgender Health's Standards Of Care For Gender Identity Disorders.
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1893:"Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7"
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2062:(2 ed.), Stanford, California: The Harry Benjamin International Gender Dysphoria Association, Inc.,
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2036:(1 ed.), Palo Alto, California: The Harry Benjamin International Gender Dysphoria Association, Inc.
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Walker, P. A.; Berger, J. C.; Green, R.; Laub, D. R.; Reynolds, C. L.; Wollman, L. (February 13, 1979),
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Walker, P. A.; Berger, J. C.; Green, R.; Laub, D. R.; Reynolds, C. L.; Wollman, L. (January 25, 1990),
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Walker, P. A.; Berger, J. C.; Green, R.; Laub, D. R.; Reynolds, C. L.; Wollman, L. (January 20, 1980),
2099:(3 ed.), San Francisco, California: The Harry Benjamin International Gender Dysphoria Association
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Walker, P. A.; Berger, J. C.; Green, R.; Laub, D. R.; Reynolds, C. L.; Wollman, L. (March 9, 1981),
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The assessment and treatment of children and adolescents was covered in section V of version 6.
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The sixth version, titled The Harry Benjamin International Gender Dysphoria Association's
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Version 8 of the WPATH SOC, the latest version, was released online on September 15, 2022.
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Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons
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Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons
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Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons
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Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons
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Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons
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2449:"Trans kids and advocates blame culture war for debate over adolescent health care"
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Britt Colebunders; et al. (2015). "New Criteria for Sex Reassignment Surgery:
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World Professional Association for Transgender Health (September 15, 2022).
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in 2024 stated WPATH SOC 7 lacked "developmental rigour and transparency".
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2576:"White House says gender-affirming surgeries should be limited to adults"
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1954:"What is medically necessary treatment for gender-affirming health care?"
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Standards of Care for the Health of Transgender and Gender Diverse People
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Recommendations for treatments, including medical and social aspects of
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The guidelines became a focus of controversy during the debate over the
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2605:"White House comes out against gender-affirming surgeries for minors"
2270:"The Standards of Care for Gender Identity Disorders – Sixth Version"
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2319:"The Standards of Care for Gender Identity Disorders, Sixth Version"
17:
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2482:"WPATH Removes Age Limits From Transgender Treatment Guidelines"
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U.S. Congress Subcommittee on Health Care and Financial Services
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come to believe they are transgender through social influence.
1438:, was published in 1998. It was the first major rewrite of the
1353:(WPATH) outlining the recommended assessment and treatment for
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1511:; HRT), reproductive health, voice and communication therapy,
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United States House Committee on Oversight and Accountability
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1472:. Two additional letters are needed for genital surgeries.
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as well as mental health, as are given in Chapters 12–18.
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in 2022. Opponents of the bill highlighted the chapter on
2661:"NHS apologises for claiming eunuch is a gender identity"
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NHS England- Children and young people’s gender services
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World Professional Association for Transgender Health
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World Professional Association for Transgender Health
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World Professional Association for Transgender Health
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The Standards of Care for Gender Identity Disorders
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The Standards of Care for Gender Identity Disorders
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2280:(1). Archived from the original on July 9, 2001
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8:
1782:Coleman, E.; et al. (August 19, 2022).
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1789:International Journal of Transgender Health
1559:US Department of Health and Human Services
1361:individuals across the lifespan including
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31:
1819:
1801:
2494:from the original on September 23, 2022
2480:Nainggolan, Lisa (September 16, 2022).
2274:International Journal of Transgenderism
2222:International Journal of Transgenderism
2002:from the original on September 20, 2022
1900:International Journal of Transgenderism
1850:International Journal of Transgenderism
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1492:International Journal of Transgenderism
1462:International Journal of Transgenderism
1445:International Journal of Transgenderism
43:
2671:from the original on September 9, 2024
2615:from the original on September 1, 2024
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2425:from the original on September 9, 2024
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2066:from the original on September 9, 2024
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1952:Grinberg, Emanuella (June 20, 2018).
7:
360:Puberty-suppressing hormone therapy
2707:from the original on April 7, 2024
2544:Ghorayshi, Azeen (June 25, 2024).
2530:from the original on July 1, 2022.
2372:"The Mental Health Professional."
1966:from the original on June 27, 2023
1891:Coleman, Eli; et al. (2012).
1845:WPATH Standards of Care, Version 7
1724:List of transgender-related topics
25:
2757:Gender transitioning and medicine
2518:"The Battle Over Gender Therapy"
2403:10.1136/archdischild-2023-326499
2395:Archives of Disease in Childhood
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421:Assisted reproductive technology
2603:Migdon, Brooke (July 3, 2024).
1503:, hormone replacement therapy (
1460:, was published in 2001 in the
1404:The first four versions of the
1586:Gender Recognition Reform Bill
1555:Assistant Secretary for Health
779:Cisgender / cissexual
774:Childhood gender nonconformity
400:Facial masculinization surgery
1:
2447:Yurcaba, Jo (June 17, 2022).
1863:10.1080/15532739.2015.1081086
1803:10.1080/26895269.2022.2100644
1256:Social construction of gender
1916:10.1080/15532739.2011.700873
1517:disorders of sex development
828:Gender-sexuality questioning
2523:The New York Times Magazine
2123:Archives of Sexual Behavior
1596:'s association with WPATH.
1442:, and was published in the
1419:Archives of Sexual Behavior
393:Facial feminization surgery
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763:Androphilia and gynephilia
463:Gender self-identification
1470:male chest reconstruction
1430:The fifth version of the
137:Non-binary or genderqueer
2735:August 14, 2015, at the
1513:gender-affirming surgery
1466:augmentation mammoplasty
582:Parental rights movement
491:Political office-holders
370:Gender-affirming surgery
2730:WPATH Standards of Care
1719:Transgender health care
1542:versions and using the
1383:History and development
176:
109:Bissu, Calabai, Calalai
1639:This section is empty.
1345:) is an international
1277:Transgender portal
1246:Sex–gender distinction
805:Gender detransitioning
692:Anatomical terminology
2338:10.1300/J056v13n01_01
1231:Queer heterosexuality
843:Rapid-onset dysphoria
626:Yogyakarta Principles
1796:(Suppl 1): S1–S259.
1477:Real-life Experience
817:Gender transitioning
769:Blanchard's typology
697:Fictional characters
643:Events and awareness
549:Anti-gender movement
2767:Transgender studies
1211:Anti-LGBTQ rhetoric
756:Theory and concepts
638:Society and culture
619:Trans panic defense
27:Healthcare protocol
2700:. March 14, 2024.
2550:The New York Times
2135:10.1007/BF01541354
1251:Sexual orientation
1090:Disenfranchisement
659:Day of Remembrance
560:trans-exclusionary
45:Transgender topics
2641:. August 27, 2024
2516:(June 15, 2022).
1995:(Press release).
1933:on March 27, 2018
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811:Gender expression
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865:Transmedicalism
833:Gender variance
823:Gender identity
815:
803:
761:
757:
749:
748:
688:
683:
654:Beauty pageants
645:
639:
631:
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587:Transgender men
562:
559:
556:Gender-critical
555:
554:
545:
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481:Rights movement
477:
458:
447:
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408:
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341:Hormone therapy
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142:Gender fluidity
98:
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2724:External links
2722:
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2595:
2584:. July 3, 2024
2567:
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2514:Bazelon, Emily
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2203:
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2076:
2039:
2013:
1977:
1944:
1876:
1857:(4): 222–233.
1847:, Revisited".
1835:
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789:Cross-dressing
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784:Cisnormativity
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572:Discrimination
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384:male-to-female
380:
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2588:September 13,
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2376:6th ed. 2001.
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2006:September 18,
1998:
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1544:Delphi method
1536:
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1505:masculinizing
1502:
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870:Transmisogyny
868:
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855:
854:
853:Transfeminism
851:
849:
846:
844:
841:
839:
838:Postgenderism
836:
834:
831:
829:
826:
824:
821:
818:
814:
812:
809:
806:
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799:Gender binary
797:
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592:Transmisogyny
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519:United States
517:
515:
512:
511:
510:
507:
505:
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500:
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489:
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486:Organizations
484:
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471:
469:
466:
464:
461:
460:
457:
451:
450:
440:
436:
435:
434:
431:
428:
427:Voice therapy
424:
422:
419:
417:
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411:
407:
406:
401:
397:
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385:
381:
378:
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367:
366:
361:
357:
353:
352:masculinizing
350:
348:
345:
344:
342:
338:
337:
332:
328:
323:
319:
318:
316:
312:
309:
308:Gender clinic
305:
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295:
294:
287:
284:
280:
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159:
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147:
143:
140:
139:
138:
135:
133:
130:
128:
127:Gender bender
125:
123:
120:
118:
117:
113:
111:
110:
106:
104:
101:
100:
97:
92:
91:
85:
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71:
69:
68:
50:
49:
46:
42:
38:
34:
33:
30:
19:
2709:. Retrieved
2697:
2685:
2673:. Retrieved
2664:
2655:
2645:September 7,
2643:. Retrieved
2638:
2629:
2619:September 7,
2617:. Retrieved
2608:
2598:
2586:. Retrieved
2579:
2570:
2558:. Retrieved
2549:
2521:
2508:
2496:. Retrieved
2485:
2475:
2463:. Retrieved
2452:
2427:. Retrieved
2394:
2373:
2368:
2354:cite journal
2342:. Retrieved
2329:
2325:
2294:cite journal
2282:. Retrieved
2277:
2273:
2245:cite journal
2237:
2230:. Retrieved
2225:
2221:
2181:, retrieved
2175:
2129:(1): 79–90.
2126:
2122:
2095:
2068:, retrieved
2058:
2032:
2004:. Retrieved
1968:. Retrieved
1957:
1947:
1935:. Retrieved
1928:the original
1903:
1899:
1854:
1848:
1844:
1838:
1793:
1787:
1704:
1692:
1683:prepubescent
1680:
1672:
1668:
1665:
1647:
1643:adding to it
1638:
1618:
1598:
1594:NHS Scotland
1579:
1571:Lisa McClain
1552:
1548:
1540:
1528:
1525:
1521:
1497:epidemiology
1491:
1489:
1481:
1474:
1461:
1457:
1455:
1443:
1439:
1435:
1431:
1429:
1417:
1413:
1409:
1408:were titled
1405:
1403:
1394:
1386:
1378:
1342:
1338:
1336:
1156:Nazi Germany
1108:
888:
729:Publications
685:
642:
468:Legal gender
456:legal status
438:
410:Hair removal
276:
257:
250:
221:
189:
161:Third gender
148:
114:
107:
29:
2675:November 1,
2332:(1): 1–30.
1910:: 165–232.
1757:Transgender
1662:Adolescents
1615:Populations
1609:NHS England
1604:Cass Review
1600:NHS England
1569:chairwoman
1531:Cass Review
1355:transgender
1120: [
1100:Transphobia
1053:South Korea
1023:New Zealand
947: [
514:South Korea
454:Rights and
322:in children
299:Health care
286:Transsexual
267:Transgender
241:Trans woman
197:Mudoko dako
178:Femminiello
2751:Categories
1764:References
1701:Treatments
1694:Non-binary
1689:Non-binary
1567:Republican
1509:feminizing
1374:transition
991:Tamil Nadu
883:By country
794:Deadnaming
744:Television
722:non-binary
707:Literature
604:Inequality
577:Non-binary
504:Healthcare
347:feminizing
217:Two-spirit
202:Mukhannath
171:Faʻafafine
2711:March 25,
2560:August 8,
2429:April 26,
2411:0003-9888
2143:0004-0002
1924:1553-2739
1812:2689-5269
1537:Version 8
1486:Version 7
1452:Version 6
1434:, titled
1426:Version 5
1191:Stonewall
1161:Singapore
1129:Australia
1117:Argentina
1078:2022 bill
1038:Singapore
1011:2017 bill
1007:Pakistan
981:2014 bill
927:2016 bill
912:Australia
895:Argentina
416:Pregnancy
301:practices
278:Akava'ine
246:Fakaleitī
236:Trans man
156:Koekchuch
122:Cisgender
116:Burrnesha
103:Androgyne
2733:Archived
2702:Archived
2669:Archived
2613:Archived
2609:The Hill
2581:The Hill
2554:Archived
2528:Archived
2492:Archived
2487:Medscape
2459:Archived
2454:NBC News
2423:Archived
2419:38594049
2192:citation
2064:archived
1997:Archived
1964:Archived
1871:74097076
1830:36238954
1745:Medicine
1713:See also
1677:Children
1582:Scottish
1371:surgical
1367:hormonal
1301:Category
1226:Intersex
1205:See also
1176:Legality
1134:Re Kevin
1095:Title IX
1073:2004 act
1061:2022 law
1046:2003 act
1031:2016 act
1016:2018 act
986:2019 act
971:2024 law
966:2018 law
961:1980 law
905:2021 law
900:2012 law
734:Religion
609:Violence
599:Genocide
530:Toilets
252:Mak nyah
229:X-gender
212:Travesti
84:Timeline
37:a series
35:Part of
2344:May 15,
2284:May 15,
2232:May 15,
2183:May 15,
2151:3977585
2070:May 15,
1970:July 6,
1821:9553112
1731:Portals
1590:eunuchs
1573:of the
1557:of the
1349:by the
1151:Finland
1110:History
1027:Norway
1003:Ireland
956:Germany
939:Finland
848:Studies
686:Culture
614:Murders
526:Prisons
259:Rae-rae
185:Khanith
150:Kathoey
79:History
74:Outline
2417:
2409:
2149:
2141:
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