Studies › WPATH SOC · Last reviewed 2026-05-16

WPATH SOC and the Dutch Protocol

1. SOC-6 (2001) and SOC-7 (2012)

SOC-7 was the first WPATH version to explicitly support GnRHa treatment starting from Tanner stage 2. SOC-7 referenced Cohen-Kettenis and Delemarre as methodological source.¹

2. SOC-8 (September 2022)

SOC-8 introduced several substantive changes:

• Earlier draft versions contained minimum ages for cross-sex hormones (14), mastectomy (15), breast surgery (16) and genital surgery (17).
• These age thresholds were removed via a correction days after publication.
• At the same time a new chapter on "eunuch identities" was added.

3. Relation to the Dutch Protocol

The SOC-8 relaxations are analysed by several critics (Cass 2024, Levine et al. 2022) as a substantive deviation from the original Dutch design, which centred on a strict phased approach with explicit age thresholds. The Cass Review concludes that WPATH guidelines have no independent evidence base alongside that of the original Dutch studies.²

4. WPATH Files (2024)

In March 2024 Environmental Progress / Mia Hughes published internal documents and chat messages from WPATH members, which showed, among other things, doubts about informed consent in minors and the degree of empirical evidence. See /evaluations/wpath-files-2024/.