If you’re looking into a WPATH assessment, you probably have a lot of questions. What actually happens? How many sessions are there? Do you need a letter? What if you’re under 18? This post answers those questions from start to finish.
We know it can take a lot to reach the point of looking into an assessment. We’re glad you’re here.
What is a WPATH assessment?
Some doctors and services ask for a letter from a psychologist before starting puberty blockers, gender-affirming hormones or surgery. The assessment is how we get to know you so we can write that letter.
Our role is to listen to your goals, talk through the possible effects of treatment (the good parts and the harder parts), and make sure you have what you need to make an informed decision. You’re the expert on your gender. We’re not here to decide who you are or to talk you out of anything.
We follow the WPATH Standards of Care (Version 8), the international guidelines used around the world for gender-affirming care.
How many sessions are there?
The assessment usually runs across three one-hour telehealth sessions.
Session 1: Getting to know you. We talk about your gender story, the people around you, and what you’re hoping for.
Session 2: Your health and wellbeing. We cover the effects of treatment, including benefits, risks and what’s permanent. We also talk about fertility and recap what we’ve covered.
Session 3: For under 18s. This is a session with your parents or guardians. You don’t need to be there unless you’d like to be.
Some people need an extra session. That’s a normal part of the process, and it’s never a bad sign.
What happens before the first session?
Before we meet, you’ll need to:
Fill in your pre-assessment forms on Splose
Complete the questionnaires we send you, which help us understand your experience of gender and how you’re going overall
Find a private, comfortable spot for your telehealth sessions (headphones are welcome if they help)
Have a think about the topics below. There are no wrong answers.
Do I need to know all the answers before I start?
No. These are things to think about, not things you need to have sorted:
How you describe your gender, in your own words
When you first started thinking about your gender, and how it’s changed over time
What you’re hoping treatment will do for you
Anything you’re unsure or worried about
Who supports you
Whether you might want children one day (not knowing is completely fine)
Will I read my letter before it’s sent?
Yes. Once the letter is written, we’ll share it with you to read before it goes anywhere. If something doesn’t sound like you, tell us and we’ll change it.
Once we’re all happy with the letter, we’ll send it to your doctor or service. We’re also here if you’d like support while you start treatment, or at any point along the way.
What are the harder parts we’ll talk about?
Making an informed decision means thinking about everything, including the parts that are less fun to think about. We’ll talk about:
Which changes are permanent and which can reverse
Possible risks and side effects, including those that happen while your body adjusts
How treatment can affect fertility, and options if you might want children one day
How you’d cope if things didn’t go the way you hoped
What if I’m under 18?
There are a few extra steps for young people. These are part of the guidelines and Australian law, and they help make sure the decision is right for you.
You’ll have time with us on your own. This is a normal part of every assessment, so you can speak freely.
Parents or guardians are usually involved. We’ll have a session with them, usually Session 3. Young people are welcome to attend, but they don’t have to.
Everyone with parental responsibility needs to agree before treatment goes ahead. If parents or guardians disagree, the law requires extra steps before treatment can start. If this applies to you, we can talk it through.
What are my rights in the assessment?
You can:
Say “I don’t know” or “I’d rather not answer that” at any time
Take breaks, use the chat box, or turn your camera off
Bring a support person
Ask us anything, including what we’re writing down and why
Read your letter before it’s sent, and tell us if anything doesn’t sound like you
Tell us if something we say or do doesn’t feel true to your experience
Looking after yourself
Talking about gender can bring up a lot. Be gentle with yourself before and after sessions. If you need support between sessions, these services are available:
QLife (LGBTIQ+ peer support): 1800 184 527
Kids Helpline (ages 5 to 25): 1800 55 1800
Lifeline (24/7): 13 11 14
If you’re in danger or need urgent help, call 000
Questions about your assessment? Email admin@unfurlpsychology.com.au or call 0468 129 180.
Sources
Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., et al. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(Suppl 1), S1–S259. https://pmc.ncbi.nlm.nih.gov/articles/PMC9553112/
