WPATH urges the U.S. Department of Health and Human Services NOT to reopen the final rule regarding section 1557 of the Affordable Care Act (ACA).

August 15, 2017

Roger Severino, JD, MPP
Director, Office of Civil Rights
U.S. Department of Health and Human Services (HHS)
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

Dear Director Severino:

Thank you for your consideration in reading this letter. The World Professional Association for Transgender Health (WPATH) is the only medical association dedicated to the study, care, and treatment of transgender and gender-nonconforming people. Founded in 1979, ours is a
non-profit, interdisciplinary association of over 1400 physicians, mental health professionals, legal professionals, and academic and clinical researchers whose work directly impacts the health of transgender people. We are based near Chicago, and while we are an international association, the majority of our members practice in the U.S. As such, we have a firm stake in the provisions of § 1557 of the Affordable Care Act, and we were grateful for the opportunity to submit our comments during the prior review of § 1557 last year. We are the source of the internationally accepted Standards of Care for the Health of Transsexual, Transgender, and
Gender-nonconforming People which is referenced extensively in medical education, research, and policy statements.

We are concerned that the Trump administration has adopted an antagonistic position with regard to transgender people. It may be helpful to HHS to know that transgender people are not a modern invention, but they have been part of the human family in every race, class, and culture since the start of recorded history. The term “transgender,” though, is relatively new, as both science and culture have struggled for centuries to define people whose gender and sex do not correspond, or may be seen as untypical. Regardless of terminology, our research and clinical experience has shown that being a transgender person does not in itself constitute
mental illness (this is confirmed by the American Psychiatric Association). However, being transgender can lead to experiences of ridicule, intolerance, adverse discrimination in workplaces and even when accessing basic medical and emergency care, and various forms of abuse, both psychological and physical. No one should have to experience adverse discrimination when they are in need of health care. Such discrimination is known to lead to worse health outcomes for anyone, not just transgender people. We unequivocally support nondiscrimination protections for transgender people, and also for others with marginalizing characteristics such as race, age, disability, national origin, etc.

We also attest to the fact that medical and mental health treatments related to gender transition have been demonstrated to be beneficial and medically necessary for many transgender patients. Treatments are cost-effective and, when averaged into a large pool of covered individuals, are typically less expensive than many common, routine procedures, such as appendectomy or childbirth. We oppose health insurance exclusions targeting transition-related care. Accordingly, we support the gender identity nondiscrimination provisions of the § 1557 final rule and oppose reopening the rule. To the extent that HHS seeks to clarify the application of § 1557 and the final rule in certain respects and to address issues raised inlitigation, we urge HHS to do so through issuing interpretive guidance. However, if HHS chooses to reopen the rule, we ask HHS to first seek input from stakeholders through a Request for Information and public comment period prior to issuing a proposed rule. This is appropriate given the importance and scope of the rule, and the fact that the rule was originally developed using this process.

Please do not hesitate to contact us should you require further information.

Gail Knudson, M.D.
President, WPATH


WPATH Global Education Initiative Announces
Three Outstanding Events 

Register Now!

October 20-22, 2017/ Columbus Ohio / Best Practices in Medical and Mental Health Care

Save the date

April 26-28, 2018 / Mount Sinai, New York / Inaugural WPATH Live Surgery Course

November 2-6, 2018 / Buenos Aires, Argentina/ 25th WPATH Symposium featuring GEI Training Courses

See Details On All Three Below

Transgender Health: Best Practices
in Medical and Mental Health Care

October 20th -22nd

The Ohio State University
Fawcett Center
2400 Olentangy River Rd
Columbus, OH

Click Here to Register


We are proud to announce the upcoming training courses in our Best Practices in Medical and Mental Health Care Series. Sponsored by the WPATH Global Education Initiative, these are certified WPATH training courses and will count as the first components for members who choose to pursue certification as a WPATH Transgender Health Care Provider.

Friday Oct. 20th and 21st
Best Practices in Medical and Mental Health Care- Foundations Course

Advanced session below are separate courses that run concurrently not breakout tracks

This 2-day multidisciplinary conference provides foundational evidence based sessions, case discussions and group work. The program based on the WPATH Standards of Care will cover a wide variety of topics. Discussions are designed to enhance your skill sets necessary to effectively work with clients and patients in your practice or gender center.

Best Practices Advanced Course curriculum

These sessions run concurrently so please choose only one

Pre-Requisite: Registrant must have previously completed our Foundations Course or have been a WPATH member for more than 5 years.

Saturday October 21st.

  • Best Practices in Mental Health Care: 1-day advanced course for mental health providers
  • Best Practices in Medical Treatment: 1-day course for medical providers 

Sunday Oct. 22nd.

Half-Day Post Course Workshops - These sessions run concurrently so please choose only one

  • Caring for Children and Adolescents
  • Planning and Documenting for Medical Transition


GEI Training will be held in partnership with the 
Transforming Care: LGBTQ & HIV/AIDS Health Equity Conference

http://transformingcareconference.com  (separate registration required)

The Equitas Health Institute for LGBTQ Health Equity is hosting the 2017 Transforming Care: LGBTQ & HIV/AIDS Health Equity Conference on October 19-20 at The Ohio State University Fawcett Center. Activists, academics, community members, and health & social service professionals are encouraged to attend this two-day conference that addresses health disparities affecting the LGBTQ and HIV/AIDS community.


Download Surgical Save the Date (PDF Brochure)




Download 25th WPATH Symposia Save the Date (PDF Brochure)


For Immediate Release CONTACT: Jamison Green, PhD
Communications Director
510-393-4785 | pr@wpath.org

WPATH Opposes Transgender Military Ban

July 26, 2017: Elgin, IL. -

The Executive Board of the World Professional Association for Transgender Health (WPATH) deplores President Trump’s tweet this morning, in which he declared that transgender people will not be allowed to serve in the U.S. military “in any capacity.” Citing “tremendous” costs of care and “disruption,” the President said he had consulted with “my Generals and military experts” in reaching his decision, but this reversal of policy is itself disruptive and wasteful.

“Many thousands of dollars have already been spent studying the matter,” said Gail Knudson, M.D., WPATH President, “and creating detailed analyses reaching the conclusion that transgender people are already serving, and have been serving in secret for decades. There’s no appreciable increase in cost associated with allowing transgender people to serve openly, which is what the current policy, as stated in Directive-Type Memorandum (DTM) 16-005, ‘Military Service of Transgender Service Members’ (issued June 30, 2016) is designed to achieve. Instead, this reversal will waste all of the previous studies and the investment in training the Armed Forces have made in the estimated up to 250 currently-serving transgender-identified soldiers and sailors who have already come forward under the assumption it was safe to do so. Thousands more who haven’t come forward will have to go back into hiding to continue serving their country.”

George Brown, M.D., a former WPATH board member and author of numerous scholarly papers focused on transgender military veterans and active duty personnel, wrote in an email to the WPATH Directors, “the policies (issued last year) are currently in effect unless and until officially rescinded by the Secretary of Defense, General Jim Mattis.  The 6-month hold on new accessions ("enlistments"), effective June 30, 2017, is the last official statement in the form of a memorandum from SecDef Mattis.”

WPATH members in the US region (and globally) are professionals who work with transgender people every day. Transgender people are not a mystery to WPATH, nor is the science concerning transgender care. As a professional and educational association, WPATH is committed to promoting health, research, education, respect, dignity, and equality for transgender people in all settings, including the U.S. Armed Services.

              Transgender troops have proven themselves to be capable and dependable soldiers. They should be judged on their performance of their duties, like any other service member, and not denied medically necessary care or otherwise discriminated against or because of their gender identity. The President’s tweet is a shameful attack on a group of our fellow citizens who are right now risking their lives to protect our society and way of life. The damage done by this morning’s tweet is an outright threat to unit cohesion and military readiness as it reinforces stigma and contributes to uncertainty, leading to depression and anxiety, undermining troop morale. Along with the American Medical Association, the American Psychological Association, the HIV Medicine Association, GLMA—Health Professionals Advancing LGBT Equality, and many other healthcare, legal advocacy, and civil rights organizations, WPATH stands in staunch opposition to this proposed policy reversal. 


In an unprecedented move, the World Professional Association for Transgender Health (WPATH) has joined the World Association for Sexual Health (WAS) in delivering three joint statements to the World Health Organization (WHO) as the latter group is engaged in the ongoing revision of its International Classification of Diseases (ICD). Both Associations consider proposals for a new chapter on sexual health, and the relocation of relevant trans-related diagnoses to that chapter, as being of the utmost importance. Both Associations are aware that there has been debate around these proposals, and they have therefore issued the following three joint statements, all dated 30/6/2017:

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to inclusion of a chapter on Conditions Related to Sexual Health in ICD-11 in the version to be presented for approval at the World Health Assembly. We also urge WHO member states to support the proposed chapter.

The World Association for Sexual Health and the World Professional Association for Transgender Health urge the World Health Organisation to remain fully committed to locating the proposed diagnosis of Gender Incongruence of Adolescence and Adulthood within the chapter on Conditions Related to Sexual Health. We also urge member states to support the proposed placement.

The World Association for Sexual Health and the World Professional Association for Transgender Health call on WHO to consider further the proposed Gender Incongruence of Childhood diagnosis, including through comprehensive consultation with the transgender community.


Dear Members of WPATH,

For the past four years I have served as the founding Co-Chair of the WPATH Student Initiative (WSI) and have had the pleasure of working on the WSI under three supportive WPATH presidents (Dr. Lin Fraser, Dr. Jamison Green, and Dr. Gail Knudson), three boards of directors, and two sensational Co-Chairs. I want to acknowledge the important work of Dr. Colton Keo-Meier who served with me as founding student co-chair to get the Student Initiative off the ground and on its feet for the first few years.  More recently, it has been my great pleasure to work with Luke Roy Allen, the real force behind the current WSI. Luke has brought great energy and professional skills to his work as the student Co-Chair. He continues to devote hours every day to advocate on behalf of our student members and to produce events such as the upcoming WPATH Graduate Student Research Symposia at the Philadelphia Trans Health Conference on September 8, 2017. (Please attend if you are in Philadelphia!)

While I will continue to remain involved in the Student Initiative, I am stepping down to pursue other projects and am now very glad to turn over my position in the WSI to Dr. Alex Laungani. Dr. Laungani is a board certified plastic surgeon from Belgium, currently in the process of completing a second plastic surgery residency at the Mayo Clinic in the USA. He has been an advocate for the LGBTQ community at large for many years and has been a member of WPATH since 2014. He is active in national and international meetings on transgender surgical care and is leading multiple research projects on outcomes after gender confirmation surgery. I am very pleased that he has agreed to take on the co-leadership of the student initiative and I am sure that he will do an amazing job.

Thank you all for your support of the student initiative. It has been a pleasure to serve our student members and I know that the WSI is in good hands.

Warm regards to you all,

Kit Rachlin

WPATH Supports Students Health and Safety

Please see official statement here

Save the Date!
WPATH 2018 Symposium – Buenos Aires
November 2-6, 2018
Hilton Buenos Aires, Argentina

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