The World Professional Association for Transgender Health (WPATH) publishes the Standards of Care — the primary clinical guidance most gender-affirming providers around the world use to structure care. Version 8 (SOC8) was published in September 2022 in the International Journal of Transgender Health, replacing the previous version from 2012. It's a large, multi-author, peer-reviewed document (258 pages), organized into 18 chapters covering everything from terminology to surgery to primary care.

What's actually new in this version, relevant to the hormone therapy conversation:

• A dedicated nonbinary chapter (Chapter 8) — the first time SOC has given nonbinary and gender-diverse experience its own standalone treatment, rather than folding it into binary trans care as an afterthought. This lines up directly with what we covered in the combined HRT pieces: nonbinary and gender-expansive goals are treated as legitimate destinations in their own right, not partial or preliminary versions of a binary transition.
• A dedicated hormone therapy chapter (Chapter 12), separate from surgery and primary care, reflecting how central and individualized this part of care has become.
• New chapters not present in earlier versions, including ones specifically addressing adolescents (Chapter 6), children (Chapter 7), eunuchs (Chapter 9), and intersex people (Chapter 10) — a broadening of who the standards explicitly speak to.
• An overall shift toward individualized, patient-centered care. The document's stated goal is to give clinicians guidance that helps real people achieve "lasting personal comfort" with their gendered self, rather than prescribing one uniform path everyone is expected to follow.

What this quick read is not: a substitute for reading the actual hormone therapy chapter if you want its specific clinical recommendations. This overview is built from the document's structure, stated goals, and publicly available abstract — accurate as far as it goes, but the full chapter content (specific hormone protocols, monitoring recommendations, etc.) should be read directly rather than taken secondhand from any summary, including this one.

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., … Arcelus, J. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(S1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Read the full document:

• Publisher page (Taylor & Francis, open access): https://www.tandfonline.com/doi/full/10.1080/26895269.2022.2100644
• WPATH's own site: https://www.wpath.org/soc8

Related reading:

• What to Actually Expect on Testosterone — the transmasculine HRT guide
• What to Actually Expect on Estrogen — the transfeminine HRT guide
• Hormone Therapy & WPATH SOC8 — the full clinical overview

This article is for educational purposes only and is not medical advice. This is a licensed, open-access clinical document (Creative Commons Attribution-NonCommercial-NoDerivatives), and readers are encouraged to read the primary source directly rather than rely solely on any summary, including this one.

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Mx. Love C. Dialogos, LMFT Licensed Marriage and Family Therapist | Buddhist Chaplain Pronouns: They/Them