This webpage deals with two topics: assessment (criteria of DSM-5) and treatment (WPATH Standards of Care).


1. Assessment

Assessment is based on DSM-5. The assessment of adolescents and adults is done on the following criteria (at least 6 months' duration, at least two of these):

1. Marked incongruence between one's experienced/expressed gender and primary and/or secundary sex characteristics (...) 
2. Strong desire to be rid of one's primary and/or secundary sex characteristics because of a marked incongruence with one's experienced/expressed gender (...)
3. Strong desire for the primary and/or secundary sex characteristics of the other gender (...)
4. Strong desire to be of the other gender (...)
5. Strong desire to be treated as the other gender (...)
6. Strong conviction that one has the typical feelings and reactions of the other gender (...)

 (*) Criteria 1 and 2 assume that Gender Identity should match body parts. Criteria 4-6 are not incorrect by themselve, but are incorrect because one needs to match at least two of six criteria before one is assessed with "gender dysphoria". This means that it is impossible to get hormones or surgery just by having the feeling that the body parts that one has do not match the body parts that one should have. Criterium 3 is strange: shouldn't there not also be a criterium about getting rid of ones own body parts? These criteria all asume a very big difference between male and female. We believe that there is more graduality (see also part 1 about the gender cloud).  

The B-section is about the need to suffer. More to this in part 6 ("Gender Dysphoria vs Being Transgender").

The definition of being transgender of WPATH Standards of Care 7 (page 11) is also very strange:

Gender nonconformity refers to the extent to which a person’s gender identity, role, or expression differs from the cultural norms prescribed for people of a particular sex (Institute of Medicine, 2011). Gender dysphoria refers to discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics) (Fisk, 1974; Knudson, De Cuypere, & Bockting, 2010b). Only some gender-nonconforming people experience gender dysphoria at some point in their lives.

There are transgender people who believe in binary males and females. There are transgender people who would be very scared at the thought of ever being gender-nonconforming. They are strictly gender-conforming, but just not to the assigned gender at birth...


2. Treatment:

Treatment is done based on Standards of Care version 7. MHP's gave themselve a huge role in our process compared to version 6. See about the role of the MHP also part 3 ("Health model"). The biggest flaw however is that SoC-7 forces people to live at least 12 month in a "identity-congruent gender role" (p. 60). Look again at the gender cloud: health care professionals are not able to determine if it is good or bad for individial people to enforce hormones or RLE before surgery. 

More remarks about the treatment can be found in the document of STP-2012 (see below).


See also:

DSM-5 is for sale in book shops, it is not on-line. The official DSM-5 website is:

WPATH Standards of Care: on-line via

Opinion of Stop Trans Pathologization 2012 about the Standards of Care: