Guidance Appraisals · GA-003 · In progress
Appraising WPATH Standards of Care 8
Our appraisal of the World Professional Association for Transgender Health’s Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (2022), under the series’ registered method. No findings have been published. None will be until the appraisal is complete, independently verified and released.
Where it stands
- Confirm and freezeThe exact version fixed and fingerprinted.Registered 7 October 2026
- Read in fullEvery statement recorded and given a verdict.Re-coded under the registered rules
- Decide the depthWhich claims need their sources checked.Fixed and registered 10 October 2026
- Check the sourcesEvery source on that list read in full, or marked as unobtainable.We are here
- The wider recordHow others have appraised SOC-8.
- VerifyAn AI check, then a human verifier who is not shown our findings.
- PublishThe appraisal, deposited with a DOI.
On 10 October 2026 we fixed which of SOC-8’s statements and claims will have their sources read in full, which sources those are, and which systematic reviews a search found on the same questions. We registered that list on the Open Science Framework before opening any source we had not already read. The sources are now being retrieved.
The registration is embargoed until the appraisal is released. That keeps work-in-progress verdicts out of public view before the sources are checked and the verifier has worked. It does not weaken the record: the registration date and the fingerprint of every file are fixed now, and both are published at release, so anyone can check that nothing changed after the list was fixed.
The scope, in numbers
These are the numbers of what was fixed on 10 October. They describe how much will be checked, not what the checking will find.
- Which statements. 205 of the 216 meet the rules for having their sources checked; the other 11 do not, and are listed with the reason. A further 34 sub-items are recorded under the statements they belong to.
- Which claims. Readers who had not seen any verdict found 2,341 claims that the statements rest on. The 2,097 that meet the rules form the set that is graded; every claim and its sources is listed either way.
- What has to be retrieved. Of the 1,193 cited works, 25 were already in our archive and one is held back under the rule described below, leaving 1,167 to obtain. Of the 926 items the search found, 310 are works SOC-8 already cites or that are already held, leaving 616 more. In all, 1,783 distinct works are being retrieved and read in full.
A development object, and how it entered the method. SOC-8 is the series’ development object. We first read and appraised it on 4 and 5 October 2026, before the method was fixed, and the method was shaped by that reading. Its appraisal continues under a transition provision in the registered method (Verdict Series Standard v0.6, §3.2):
- We do not claim that its first two stages were carried out prospectively. Our earlier reading is declared as the starting record, and the first reading’s verdicts are kept beside the re-coded ones.
- Its work under the registered method begins at the third stage, deciding the depth, which is now fixed and registered.
- Its findings are development material, not a validation of the method. The first appraisal to run the whole method prospectively is the next in the series, the American Academy of Pediatrics 2018 policy statement (GA-004).
The appraisal plan
SOC-8 is appraised under the EO Guideline Appraisal Protocol (GAP), version 0.6, registered with the Verdict Series Standard on 7 October 2026. The protocol sets out every stage, form and test. What follows is a plain summary; where it and the registered texts differ, the registered texts govern.
1Confirm and freeze
Done · registered late, 7 October 2026
The document appraised is the version of record of SOC-8 (Coleman et al., International Journal of Transgender Health, 2022; 10.1080/26895269.2022.2100644), which replaced a version published in error in September 2022. We checked for errata and later versions and found none beyond the publisher’s statement about that replacement. Because SOC-8 was read before the method existed, this record was completed afterwards from our records of that reading, labelled as such, and registered late, as the method requires.
2Read in full
Done · re-coded under the registered rules
Every recommendation and statement in SOC-8 is recorded with its page and given a verdict, GOOD, BAD or INDIFFERENT, with the reason and the grounds for it. The verdicts from our first reading were re-coded under the registered rules by separate roles: one coded the grounds, one assessed what evidence SOC-8 itself reports for each strong recommendation, and one applied the tests for strong recommendations made on weak evidence. Every change is recorded with the direction it moved.
3Decide the depth
Done · fixed and registered 10 October 2026
Fixed rules, not judgement, pick which statements need their sources checked; every statement about a clinical intervention is among them. Readers who had not seen any verdict listed the claims each statement rests on, and a seeded check of their work found the claims they had missed, which were added. A search for systematic reviews on the same questions found the reviews the appraisal must also read. Independent checkers then re-examined the whole set before it was fixed and registered.
4Check the sources
Now under way
Every source on the fixed list, and every review the search found, is obtained and read in full. A source that cannot be obtained after a set minimum of attempts is declared unobtainable, and any claim that rests only on such sources is published as ungraded: source unobtainable, never graded on a weaker basis. Verdicts are re-tested against what the sources actually show, and they can move in either direction.
5The wider record
To come
How others have appraised SOC-8, with criticism and defence given the same weight.
6Verify
To come
An AI verification pass, then a human verifier who has been kept away from our SOC-8 work and is not shown our findings. Working from SOC-8 and the sources, the verifier checks every claim in the fixed set, every BAD verdict and a seeded sample of at least one in ten of the rest. Every finding is resolved and logged.
7Publish
To come
The appraisal is released once, as a deposited Guidance Appraisal with a DOI, with no interim verdict page. It contains every statement and its verdict, a section on what SOC-8 gets right at full weight, the direction our findings run, our own correction record, and every registration with its identifier and fingerprint.
A linked guideline, held
SOC-8 draws on the Endocrine Society’s 2017 guideline, which this series appraises separately (GA-005). So that one appraisal cannot shape another, a rule fixed in advance stops us opening that guideline for SOC-8’s appraisal until GA-005’s own list of sources to check has been fixed. Our first reading of SOC-8 included that guideline, before the rule was made, and that reading is declared. SOC-8’s appraisal cannot be released until the hold ends.
Our position
We are not neutral, and we say so. Eden is a transgender woman with a declared view in favour of access to gender-affirming care, filed as a competing interest. She also founded a non-profit organisation that teaches its own standards of care, which address many of the same questions as SOC-8; that interest can pull the other way, and it is declared too. Every interest is listed, with its date, in our register of declared interests. The controls the method applies to our own bias are set out on Appraising the guidelines.
→ The Guideline Appraisal Protocol, v0.6 (PDF) · Method registration 10.17605/OSF.IO/SY4GP · The programme and the full list · Guidance Appraisals
Corrections and questions
If you think we have described SOC-8 or this appraisal wrongly, please tell us through our editorial contact page. Corrections are logged on our corrections page.
Eden Openly is an independent clinical health-education publication. It receives no funding from, and has no commercial relationship with, any provider of gender-related healthcare or any pharmaceutical company. Our full position is set out in our statement of independence, and every interest is listed, with its date, in our register of declared interests.