A very simple Standards of Care that protects patients right, requiring only informed consent and the treatment will not impact the health of the patient.
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Health Law Standards of Care for Transsexualism
Health Law Standards of Care for Transsexualism first adopted at the 2nd International Conference on Transgender Law and Employment Policy, August 1993 in Houston, Texas, U.S.A.
Principle 1. Transsexualism is an ancient and persistent part of human experience and is not in itself a medical illness or mental disorder. Transsexualism is a desire to change the expression of one's gender identity.
Principle 3. Persons denied the ability to exercise control over their own bodies in terms of gender expression, through informed access to medical services, may experience significant distress and suffer a diminished capacity to function socially, economically and sexually.
Principle 4. Providers of health care (including surgical) services to transsexuals have a right to charge reasonable fees for their services, to be paid in advance, and to require a waiver of all tort liability except negligence.
Principle 5. It is unethical to discriminate in the provision of sex reassignment services based on the sexual orientation , marital status, or physical appearance of a patient.
Standard 1. Physicians participating in transsexual health care shall provide hormonal sex reassignment therapy to patients requesting a change in their sexual appearance subject only to (1) the physician's reasonable belief that the therapy will not aggravate a patient's health conditions, (2) the patient's compliance with periodic blood chemistry checks to ensure a continued healthy condition, and (3) patient's signature of an informed consent and waiver of liability form. If the patient is married, the physician may not require divorce but may also require the spouse to sign a waiver of liability form.
Standard 2. Physicians providing hormonal sex reassignment therapy shall collect and publish on an annual basis the number of hormone prescriptions they have issued and the number and general nature of any complications and complaints involved. The publication requirement of this Standard shall be satisfied by providing the collected statistics in writing, together with other current information on the potential risks and complications of sex hormone therapy, to all prospective patients inquiring into the physician's hormone therapy services.
Standard 3. Surgeons participating in transsexual health care shall provide sex reassignment surgery to patients requesting a change in their sexual appearance subject only to (1) the surgeon's reasonable belief that the surgery will not aggravate pre-existing health conditions. (2) the surgeon's reasonable determination that the patient has been under hormonal sex reassignment therapy for at least one year, and (3) the patient's signature of an informed consent and waiver of liability form. If the patient is married, the surgeon may not require divorce but may also require the spouse to sign a waiver of liability form.
Standard 4. Surgeons providing sex reassignment surgery shall collect and publish on an annual basis the number of sex reassignment surgeries they performed and the number and general nature of any complications and complaints involved. The publication requirement of this Standard shall be satisfied by providing the collected statistics in writing, together with other current information on the potential risks and complications of sex reassignment surgery, to all prospective patients inquiring into the sex surgeon's sex reassignment services.
Standard 5. Physicians and surgeons shall not divulge the nature or identity of any patient requesting or receiving sex reassignment services except as explicitly directed in a notarized written request by the patient.
Proposed Legal Definitions
Faced with the wide array of definitions of sex, gender and transsexualism, ICTLEP offer some standard definitions from the standpoint of utility under health law.
Sex: A person's identity along a continuum of role types with "male" and "female" at the polar extremes.
Role Type: A set of beliefs, behaviors and appearances.
Male: A role type which a particular culture associates with individuals anatomically structured for contributing reproductive cells to another person.
Female: A role type which a particular culture associates with individuals anatomically structured for receiving reproductive cells from another person.
Gender: The characteristics of a continuum of role types ranging from male to female, with such characteristics including behaviors and sexual anatomy, and being labeled as "masculine" and "feminine" at the polar extremes.
Transsexualism = Transgenderism: The condition of wanting to change one's gender to better match one's sex.
These revised legal definitions recognize the emerging scientific reality that sex is in the brain, and not the body. Transsexuals do not really change their sex - they are born with that. Instead, transsexuals aim to change the erroneous sex labels that were assigned to them at birth. The only way to change those labels is to change the basis upon which those labels were applied, namely, the outward expressions of sex. This means that to change a sexual label, one must change their gender - from behavior to anatomy - since gender is the outward expression of one's sexual identify. Hence, transsexualism is really a misnomer and transgenderism is a more scientifically accurate term.