So I was at a convention last week (Animefest in Dallas) and I was partying hard with my friends. It was only Friday so I had a whole con ahead of me full of fun and excitement. I decided that during the dance I was going to take a chance, chance to dance free. 

Well that was a mistake. A few steps in and I heard a sicking pop and pain in my knee. Turns out that I had retorn an ACL injury I had earned myself in 2009.

So now we are here, one week later, confirming with the doctor that I have indeed torn that tendon. Now, I'm not one for handouts, but I just got a job at Amazon and its looking like I may not be able to even perform my duties there and I will need surgery ASAP to return to a somewhat normal pace.

That means no work for about a Month.

And Medical bills up the wazoo.

So if you are a follower, or if you like my streams, you can help me out by going here https://www.paypal.com/us/cgi-bin/webscr?cmd=_flow&SESSION=RjSEOOSDEMbgkJGUyTpKY_3SdiPdOmGcxTOt-9ydGz8khba8y1twfPgszHK&dispatch=5885d80a13c0db1f8e263663d3faee8d48a116ba977951b3435308b8c4dd4ef1

This is a paypal that I use for my video game streams.

And since I will be off for a while (most likely) I may be able to have some free time to devote to more streams. So I can see what I can do. 

Lastly, if you know of any job openings that don't require a lot of standing around all day, let me know. I'm kinda low on options. 

Thanks, 

La Roo

While writing healthcare modules for providers, I began to review the new Standards of Care, SOC 7, put out by WPATH. 

Below I am going to go over the new and improved standards but before doing so, I want to list what the old standards had as a contrast/comparison of the changes. 

THE OLD STANDARDS

SOC 6 (published in 2001)

Recommended that a person seeking hormones or medical treatments follow the following standards in regard to their medical care. Again, it was recommended not REQUIRED (even though providers often assumed it was).

1. See a Mental Health Practitioner who is certified in Gender Issues for at least 3 months or 12 consecutive sessions.

2. Undergo a "Real Life Test" or "Real Life Experience" where they live as the gender they desire to transition to. 

3. Begin Hormone Therapy (recommended to be on hormones for a year before seeking surgery - typically top surgery for FTM...suggested two years on hormones for MTFs prior to breast augmentation due to the effects of estrogen).

4. If seeking chest surgery, provide 1 letter from a mental health therapist to your surgeon (what the letter needed was listed in the SOC).

5. Wait two years after being on hormones before having lower surgery. When seeking lower surgery, provide surgeon with 2 letters from mental health therapists.

The NEW Standards

The new standards are not listed in a chronological order, which shows the SOC's recognition that one's identity, choices, and medical treatment needs are very individualized! 

So instead of listing a 1, 2, 3 order, I'll list treatment options and recommendations.

If you are seeking hormones and/or surgeries the following is taken verbatim from the SOC, page 28. 

"Psychotherapy is not an absolute requirement for hormone therapy and surgery. A mental health screening and/or assessment... is needed for referral to hormonal and surgical treatments for gender dysphoria. In contrast, psychotherapy – although highly recommended – is not a requirement"

The criteria for hormone therapy are as follows:

1. Persistent, well-documented gender dysphoria;

2. Capacity to make a fully informed decision and to consent for treatment;

3. Age of majority in a given country; 

4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

In selected circumstances, it can be acceptable practice to provide hormones to patients who have not fulfilled these criteria."

The SOC stated on page 59 that one DOES NOT need to be on hormones in order to be a candidate for chest surgery for FTMs or GenderQueer female-bodied individuals. The SOC still recommends, although not an explicit criterion, that MtF patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.

"Criteria for mastectomy and creation of a male chest in FtM patients:

1. Persistent, well-documented gender dysphoria;

2. Capacity to make a fully informed decision and to consent for treatment;

3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);

4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

Criteria for breast augmentation (implants/lipofilling) in MtF patients:

1. Persistent, well-documented gender dysphoria;

2. Capacity to make a fully informed decision and to consent for treatment;

3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);

4. If significant medical or mental health concerns are present, they must be reasonably well controlled.

Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients:

1. Persistent, well documented gender dysphoria;

2. Capacity to make a fully informed decision and to consent for treatment;

3. Age of majority in a given country;

4. If significant medical or mental health concerns are present, they must be well controlled;

5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones).

6. 12 continuous months of living in a gender role that is congruent with their gender identity;"

It still appears that prior to lower surgery they recommend "two referrals." Page 56..."Consultation is readily accomplished when a surgeon practices as part of an interdisciplinary health care team. In the absence of this, a surgeon must be confident that the referring mental health professional(s), and if applicable the physician who prescribes hormones, are competent in the assessment and treatment of gender dysphoria, because the surgeon is relying heavily on their expertise."

If what I have written hasn't answered your concerns or questions, contact me and I'll go into deeper detail!