News From the USPATH Convention

I am in D.C. at the USPATH convention. (USPATH is a subsidiary organization of the World Professional Association for Transgender Health). And I have some good news. On Friday we presented the case for real inclusion of non-transitioning transgender people under the WPATH umbrella. When I say we, I mean myself and representatives from Tri-Ess, both nationally and from the Atlanta chapter. In future, I hope to get other support groups that include non-transitioning transgender people onboard, but it was great to have their support as a national organization. (If you know that certain groups are interested, please let me know).

A table similar to that owned by Louise Lawrence.

The Tri-Ess and WPATH wings of transgender advocacy have been apart for many years, almost from their beginnings. Ironically they both started in the kitchen of Louise Lawrence in San Francisco in 1972. Louise seemed to know everyone in the U.S. and the world who were concerned with transgender advocacy at a time when email did not exist—she wrote a lot of letters. WPATH got started when she was introduced to Harry Benjamin by none other than Alfred Kinsey, the most prominent sexologist in the U.S. at the time. Louise found Harry many of his patients and helped introduce him to San Francisco transgender providers and allies. This included a group of physicians at UCSF who were interested in gender. Harry would come to spend his summers there, away from his New York endocrinology consulting practice, tending to transgender patients. He spent a lot of energy advocating for his patients and arranged for them to get transgender genital plastic surgeries which were illegal in California at the time. He formed an organization which became known as the Harry Benjamin International Gender Dysphoria Association which later renamed itself as WPATH (World Professional Association for Transgender Health).

Likewise, a pharmacologist at UCSF developed the first national transgender support group network. Because she was transgender and because she lived on Prince Street in SFO, she took on the name of Virginia Prince. Louise helped Virginia with her writing and newsletters, some of which were considered obscene by the U.S. Postal Service. Virginia was convicted and put on probation which was quickly lifted as times were changing rapidly. Virginia formed Tri-Ess by merging existing organizations led by Carol Beecroft and her own chapters. Many independent peer-led support groups developed thereafter which were modeled after Tri-Ess but differed in terms of membership requirements. The peer-led support group movement took off.

Louise Lawrence

The two advocacy movements, WPATH and support groups had different constituencies and both were engulfed in secrecy, so they went their own separate ways. There were occasional slurs addressed between the constituencies. And there was some transition chauvinism with some post-ops considering themselves to be the “real” transgender people with higher status. Since the increased tolerance of transgender people in this decade and consequent reduction in secrecy, many of their constituent differences have dissipated. I am invited to attend monthly informal dinner meetings of Tri-Ess because many of my friends are or used to be in Tri-Ess. Generally, both transitioning and non-transitioning people have become friendly and tolerant of each other. They mingle in support groups like PFLAG and my own local support group.

So, it is time for these two advocacy movements to move forward and work with one another to achieve the cultural acceptance that they both want. Support group constituencies have real psychological and medical needs which must be understood by providers. And Tri-Ess representatives are concern with over-treatment. WPATH is scrambling to teach providers about transitioning transgender people but must extend that training to non-transitioning transgender people. Non-transitioning people need training coverage for marital, family and individual counselors who address the psychological depression and other problems resulting from cultural rejection and secrecy. There are medical privacy issues that providers must address. WPATH needs to include non-transitioning transgender people in its concerns because they comprise at least 80% of transgender people. To do otherwise would mean that they no longer can claim all transgender people as their constituents.

So, what is required for this cooperation to occur? First, there is a terminology issue. Are those who consider themselves “crossdressers” included in the definitions used by WPATH in their current and future Standards of Care documents? Well, the person who wrote the current SOC definition attended our meeting on Friday and they said that they had intended the definition to include all transgender people including non-transitioning folks. But the support group folks want more clarification in the next Standards of Care (SOC 8). We buttonholed the person responsible for the next SOC and they said that they would coordinate with our little group. So, with some persistent follow-through, that issue can be addressed.

Second, we plan to go after the WPATH training folks to insert curricula that covers non-transitioning transgender patients. The curricula is subject to current revision, so that should be feasible. And third, we need to challenge WPATH and other providers/scientists to focus on research involving non-transitioning transgender people.

So, our initiative to get these strong advocacy groups working together appears to be on its way.

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