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THE HARRY BENJAMIN STANDARDS OF CARE.
A SAFEGUARD FOR CONSUMERS AND
CAREGIVERS.

In November 1993 Sophia Pastel, a transgendered woman from Norfolk, Virginia, came to Atlanta for treatment. The treatment she sought was one which fell squarely in the medical realm: Induction of a foreign substance under the skin. In fact, the Food and Drug Administration considers the procedure she was seeking so dangerous that it has outlawed  its use even by physicians.
In some cookie-cutter Atlanta motel room, Sophia Pastel died moments after receiving a subcutaneous injection of liquid silicone from a practitioner whose only qualification was that he had a syringe and enough money to buy a tube of industrial-grade silicone in a hardware or auto parts store.
Sophia isn't around to tell us if she has any regrets, or if she had enough facts to make an informed choice about the treatment she had elected to receive. But there are a considerable number of individuals, both male and female, who are around to tell the world loudly and abrasively that they have great regrets about having had genital reassignment surgery. One of their primary gripes is that they did not realise what they were getting into.
There are other sources of dissatisfaction with the surgical treatment of transsexualism.       
Sometimes physicians become disenchanted and proclaim their disgust with the treatment process. Jon Meyer, who was the head of the Gender Identity Clinic at Johns Hopkins University did just that. His feelings on the subject were so strong that they affected his  objectivity.
His 1979 paper with Donna Reter was a model for bad science, incorporating faulty assumptions, poor sampling techniques, invalid messages, and contrived criteria for the success of surgical intervention in transsexualism. And yet its impact was dramatic, as it led to a domino-like closing of dozens of gender clinics.
Also in 1979, the Harry Benjamin International Gender Dysphoria Association, Inc; an organisation composed entirely of psychologists, psychiatrists, surgeons, endocrinologists, and other caregivers, proposed minimal standards of care for hormonal and surgical treatment of persons of gender dysphoria. These Standards of Care were introduced because HBIGDA members were concerned by the human misery which was being caused by the unregulated treatment of transsexual persons.
The standards of care have been periodically revised, most recently in 1990, and remain the commonly accepted professional standards for treatment. They are a

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