The WPATH (World Professional Association for Transgender Health) Standards of Care, currently version 8 (SOC-8), are the consensus clinical guidelines for gender affirming care.
What WPATH actually is
WPATH is an international, multidisciplinary professional association. The Standards of Care are a consensus document drafted by clinicians, researchers, and community members. They are guidelines, not law. Most insurance carriers and many medical providers reference them when deciding what care to authorize.
What SOC-8 says about mental health letters
SOC-8 supports an informed-consent model for hormone therapy. For some surgical procedures and for some payers, a mental health letter is still required. The letter affirms capacity to give informed consent, names any co-occurring concerns that have been considered, and supports the requested care.
What WPATH does not require
WPATH does not require a person to have lived in a gender role for a specific time before care. WPATH does not require a person to disclose a particular childhood narrative. WPATH explicitly removes earlier gatekeeping requirements that reflected assumptions rather than evidence.
What the work looks like in practice
Most clients seeking a letter complete one intake session. A draft of the letter is sent to you for review before it is finalized. The letter goes to your provider with a copy to you.