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New clinical guidelines that will influence the care of transgender people in the US and internationally have removed recommendations on the minimum age for treatment, including hormones and surgery, and left decisions in the hands of clinicians.

The World Professional Association for Transgender Health (WPATH) released its “Standards of Care for the Health of Transgender and Gender Diverse People, Version 8” (SOC8) on 15 September. The omission of minimum age recommendations for treatment was unexpected because they had been included in a draft version last spring.

The final SOC8 was expected to lower the minimum age for prescribing testosterone or oestrogen from 16 (in version 7) to 14 and to set minimum recommended ages of 15 for breast removal, 16 for breast augmentation and facial surgeries, 17 for hysterectomy, vaginoplasty, or removal of testicles, and 18 for phalloplasty.

The deletion of the age recommendations seemed to have happened at a late stage and after increased attention in social media on gender related surgery among adolescents.

The guidelines were due to be published on 6 September in the International Journal of Transgender Health, but WPATH’s executive board and SOC8 co-chairs sent notice that day to the association’s membership …