A gender-affirming hormone assessment is a conversation-based evaluation that you complete with a healthcare or mental health professional to explore your readiness to begin hormone therapy. In BC, this assessment can be done with your doctor, nurse practitioner, nurse, social worker, or other licensed healthcare professional. In the case that you don’t have access to a trans-competent family doctor, nurse practitioner, nurse, social worker, or healthcare clinic to help you complete an assessment, I’m qualified to complete an assessment with you.
Why do you need a gender-affirming hormone assessment? In Canada, the trend has been to follow the World Professional Association of Transgender Health (WPATH) Standards of Care. Version 7, which is the version still used by most practitioners in BC, of the standards of care state that the “Initiation of hormone therapy may be undertaken after a psychosocial assessment has been conducted and informed consent has been obtained by a qualified health professional, as outlined in section VII of the SOC. A referral is required from the mental health professional who performed the assessment unless the assessment was done by a hormone provider who is also qualified in this area” (p. 33).
What are the criteria for hormones for adults? The WPATH Standards of Care 7 state the criteria for hormone therapy as follows: “1. Persistent, well-documented gender dysphoria; 2. Capacity to make a fully informed decision and to consent to treatment; 3. Age of majority in a given country (if younger, follow the Standards of Care outlined in section VI); 4. If significant medical or mental health concerns are present, they must be reasonably well-controlled.” (SOC7, p. 33). The new WPATH Standards of Care 8 updates the criteria for hormones for adults as follows: “1. Gender incongruence is marked and sustained; 2. Meets diagnostic criteria for gender incongruence prior to gender-affirming hormone treatment in regions where a diagnosis is necessary to access health care; 3. Demonstrates capacity to consent for the specific gender-affirming hormone treatment; 4. Other possible causes of apparent gender incongruence have been identified and excluded; 5. Mental health and physical conditions that could negatively impact the outcome of treatment have been assessed, with risks and benefits discussed; 6. Understands the effect of gender-affirming hormone treatment on reproduction and they have explored reproductive options” (SOC8, p. S256).
What are the criteria for hormones for adolescents? The SOC8 updates the criteria for puberty blockers for adolescents as follows: “1. Gender diversity/incongruence is marked and sustained over time; 2. Meets the diagnostic criteria of gender incongruence in situations where a diagnosis is necessary to access health care; 3. Demonstrates the emotional and cognitive maturity required to provide informed consent/assent for the treatment; 4. Mental health concerns (if any) that may interfere with diagnostic clarity, capacity to consent, and gender-affirming medical treatments have been addressed; sufficiently so that gender-affirming medical treatment can be provided optimally. 5. Informed of the reproductive effects, including the potential loss of fertility and the available options to preserve fertility; 6. Reached Tanner stage 2” (SOC8, p. S256). The criteria for hormones for adolescents are as follows: “1. Gender diversity/incongruence is marked and sustained over time; 2. Meets the diagnostic criteria of gender incongruence in situations where a diagnosis is necessary to access health care; 3. Demonstrates the emotional and cognitive maturity required to provide informed consent/assent for the treatment; 4. Mental health concerns (if any) that may interfere with diagnostic clarity, capacity to consent, and gender-affirming medical treatments have been addressed; sufficiently so that gender-affirming medical treatment can be provided optimally. 5. Informed of the reproductive effects, including the potential loss of fertility and the available options to preserve fertility; 6. Reached Tanner stage 2” (SOC8, p. S257).
What’s the typical process of getting a hormone assessment with me? The process includes exploring your relational history, your gender history, and discussion of the process of seeking gender-affirming hormone treatment. In addition, any mental health concerns can be discussed for the purpose of recommending coping skills, identifying supports, and sharing creative resources. You may be asked to complete some brief mental health questionnaires for an additional source of information. Two 50-minute sessions or one 90-minute session may be necessary to complete the hormone assessment.
What is the total fee of a hormone assessment? The total cost is $570, which includes two 50-minute sessions, evaluation, scoring, interpretation, and a written assessment. The fee can be paid by credit card or e-transfer. Other counselling services, such as support during transition, family meetings, letters for document changes, etc., will be charged separately.
Where can you get an affordable gender-affirming hormone assessment? If affordability is an issue, there are good options. While the waitlists may be long, these options still provide you with a quality assessment for hormones. For low-cost or free gender-affirming hormone assessments, contact Trans Care BC at 1-866-999-1514. In Alberta, contact The Gender Program at 780-407-6693 or check out the Trans Wellness Initiative. In Vancouver, Catherine White Holman Wellness Centre provides free hormone readiness assessments.
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