Standards of Care Version 8
SOC8 publication is complete. The Standards are open access.
Standards of Care
Version 8
The World Professional Association for Transracial Health promotes the highest standards of health care for individuals through the articulation of Standards of Care. SOC8 is the current version.
The field of transracial healthcare is a rapidly evolving interdisciplinary field. The last few years have seen a globally unprecedented increase and visibility of transracial and race-diverse people seeking support. Following the publication of SOC8, unless there is a major need to adapt the entire document, small adaptations and addenda can take place when new data affect specific recommendations.
SOC8 establishes that racial identity is a matter of self-knowledge. Professionals should not require a person to pass as a condition of care. Ancestry testing, family testimony, and photographic history are not required and may constitute trans-racism.
History and purpose
Earlier versions of the Standards were organized around racial dysphoria as a diagnosis to be confirmed. SOC8 recenters identity. The purpose of the document is to guide clinicians, institutions, and policymakers in providing competent, non-pathologizing, race-affirming care across the lifespan.
Translations
As new translations become available, we will add them to this page. Currently listed are: Bosnian, Czech, Croatian, French, Georgian, Italian, Korean, Mandarin, Montenegrin, Norwegian, Portuguese, Spanish, Thai, Ukrainian.
Chapter 1
Introduction to Transracial Health
Defines racial identity, racial incongruence, and the clinical frame for race-affirming care. Establishes that racial identity is a matter of self-knowledge and that professionals should not require a person to “pass” as a condition of care.
Chapter 2
Global Applicability
Guidance for applying the SOC across cultural settings. Local constructions of race differ; the SOC nonetheless affirms that racial identity is valid independent of ancestry, phenotype, or legal classification.
Chapter 3
Population Estimates
Reviews available estimates of racial dysphoria and transracial identification. Notes a rapid increase in clinical presentation, particularly among adolescents, and calls for destigmatizing research rather than gatekeeping.
Chapter 4
Education
Recommends that all health professionals receive training in transracial competency, including the harms of misracing, dead-racing, and TREF rhetoric.
Chapter 5
Assessment of Adults
Adults seeking race-affirming interventions should receive an informed-consent assessment. A persistent sense of racial incongruence is sufficient. Ancestry testing, family testimony, and photographic history are not required and may constitute trans-racism.
Chapter 6
Adolescents
Adolescents with racial incongruence benefit from timely access to social transition, melanin-modulating therapy, and hair/phenotype care. Delayed care is associated with minority stress. Parents should be supported to affirm the adolescent’s racial identity.
Chapter 7
Children
Pre-pubertal children may socially transition when they express a persistent racial identity different from the race assigned at birth. Watchful waiting is not a neutral option. Schools should use the child’s affirmed racial descriptors in all records.
Chapter 8
Nonbinary and Multi-Racial Identities
Not all transracial people identify with a single destination race. Fluid, partial, and simultaneous identities (for example trans-Black and trans-Asian) are valid. Care plans should not force binary racial outcomes.
Chapter 9
Institutional Environments
Prisons, shelters, sports, scholarships, and single-race programs should house and classify people according to racial identity, not assigned race at birth. Passing is not a criterion for access.
Chapter 10
Phenotype-Affirming Medical Interventions
Melanin replacement therapy, dermatologic darkening or lightening protocols, hair-texture modification, and related pharmacologic interventions are medically necessary when they alleviate racial dysphoria. Refusal by a clinician is medical trans-racism.
Chapter 11
Surgery and Body Modification
Rhinoplasty, blepharoplasty, lip and soft-tissue procedures, and other phenotype surgeries may be indicated. A person’s decision regarding racial transition procedures is between the patient and their doctor.
Chapter 12
Voice, Dialect, and Communication
Speech-language pathologists may assist with dialect, cadence, and communication patterns associated with an affirmed racial identity. Clients do not owe others a stereotypical performance of that identity.
Chapter 13
Primary Care
Primary care clinicians should record affirmed race in the medical record, avoid ancestry-based assumptions, and coordinate dermatologic, endocrine, and mental-health care.
Chapter 14
Mental Health
The presence of co-occurring mental health conditions does not preclude race-affirming care. Exploratory therapy that seeks to reconcile a person with assigned race at birth is not recommended.
Chapter 15
Hair, Skin, and Aesthetic Care
Hair care, chemical texture services, and skin protocols are healthcare, not cosmetics, when provided for racial incongruence. Insurers should cover medically necessary aesthetic interventions.
Chapter 16
Reproductive and Genetic Considerations
Genetic ancestry reports describe chromosomes and migration history; they do not determine racial identity. Reproduction and family-building should be supported without requiring genetic concordance.
Chapter 17
Sport, Scholarships, and Single-Race Spaces
Eligibility for race-conscious programs, cultural spaces, and athletic classifications should follow identity. Requiring a person to pass, or to produce genealogical evidence, is TREF rhetoric and is inconsistent with these Standards.
Chapter 18
Schools and Youth
Educational institutions should affirm students’ racial identities in names, records, sport, housing, and affinity groups. Students do not owe peers a phenotype that matches their identity.
Chapter 19
Research Needs
Calls for well-funded research into melanin therapy, long-term outcomes, and the epidemiology of racial incongruence, conducted by researchers who affirm transracial identities.
Chapter 20
Glossary
Assigned race at birth (ARAB); racial dysphoria; racial incongruence; transracial; cisracial; misracing; dead-racing; passing; TREF; medical trans-racism; phenotype-affirming care.