
WPATH Requirements for Metoidioplasty and Phalloplasty*
WPATH: World Professional Association for Transgender Health
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Persistent, well documented gender dysphoria.
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Capacity to make a fully informed decision and to consent for treatment.
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Age of majority in a given country.
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If significant medical or mental health concerns are present, they must be well controlled.
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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).
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12 continuous months of living in a gender role that is congruent with their gender identity.
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TWO Referral letters: (1) mental health professional such as psychiatrist or psychologist; (2) hormone provider. NOTE: most insurance companies want THREE referral letters: (2) mental health professional AND (1) hormone provider.
Although not an explicit criterion, it is recommended that patients also have regular visits with a mental health or other medical professional. The criteria noted above for some types of genital surgeries – i.e., that patients engage in 12 continuous months of living in a gender role that is congruent with their gender identity – is based on expert clinical consensus that this experience provides ample opportunity for patients to experience and socially adjust in their desired gender role before undergoing irreversible surgery.
*Above requirements are from the WPATH Standards of Care version 7*
Optional Prerequisites for Gender Affirmation Surgery
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Adult age (at least 18 years old)
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Support of spouse, family, significant other, friends
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Economic stability