I think you are a bit confused as to the standards. Most professionals continue to follow the WPATH guidelines. This requires a minimum of one year of counseling by two therapists. One can be an LCSW or equivalent. The other must be a PhD psychologist or MD psychiatrist. Two mental health letters are also required prior to any surgical interventions plus one from the endocrinologist responsible for HRT, which must also be administered for at least a year before anything further is done.
In recent years, there has been a trend towards self identification (especially for older trans people), and some abuses have occurred. In my experience, however, the best way to deal with people who think they are trans is to let them figure it out for themselves. Being trans myself, and having years of experience in the community and the benefit of a lot of research, it is not unusual for people to take years or even decades to figure themselves out. Many start off, thinking they are cross-dressers and only later realize that they are actually trans. It is difficult to discern as a third party observer, because it is often not an either or situation. The trans community exists on a continuum from one gender binary to the other and everything in between. There are even those who are gender fluid and vacillate between the feminine and masculine. They can get complicated to understand.
The key is to be supportive of people as they engage in an exploration of themselves. Rather than trying to guide them to a preconceived goal, the key is to ask appropriate questions and provide necessary information so the person can figure it out for themselves. It is each individual who knows best what he or she or they are .
I am aware of some of the rethinking that has occurred in Netherlands and Finland. If you take a closer look at what is going on, certain well-known psychologists have noted that in particular teenage girls who are autistic are more susceptible than the general population to believing they are trans. Many of them later change their mind or regret steps that they have taken towards transition. This has resulted in more intense research being done into the relationship between autism and being trans in teenage girls.
As with any other field of human endeavor, we are always learning. The one thing we do not need to do, however, is to return to the days of gatekeeping where there were strict standards imposed by the medical community approving and disapproving people identities rather than respecting the perceived identities of affected individuals. Professionals should be supportive, but not impose their judgment on others. It is one thing to be sure that we are making correct decisions. It is something else entirely for a third party to decide who is and who is not legitimately trans.
Current standards seem to be working, as suggested by the statistics. For decades the satisfaction of the trans community that has undergone GAS has been tracked. The level of regret is less than 3%. Of those who express regret and/or detransition, the vast majority do so because of external disapproval from friends, family or employers, not because of true trans regret.
By any therapeutic standard that is a tremendous success rate. If something is not broken, let’s not be too quick to see problems where none exist. The appropriate standard of trans care has been established for decades. It is accepted by every professional Medical Association. Continued research and refinement is good. A total rethink is unnecessary and inappropriate. It merely reflects, continued ignorance of the science and broad-based cultural transphobia. Education is the key, not reevaluation of people claiming to be trans. Leave those determinations up to the affected individuals and the professionals who treat them. As with the current debate over abortion, it is not appropriate for society at large and the politicians to set the standards. It is really no one else’s business. As with the current debate over abortion, it is not appropriate for society at large and the politicians to set the standards.
Addendum: The radical right has been successful in creating the perception that we are letting children transition willy-nilly, and giving them puberty blockers and/or HRT without any restrictions. This is a lie. The standard of care for children is mental health therapy until they begin to undergo puberty. If they still consider themselves trans at that time, puberty blockers can be administered to give them time to be absolutely sure. When they are discontinued, normal puberty occurs without any negative side effects.
On the other hand, if the child is in fact trans, HRT can be administered so that they can avoid going through an unwanted puberty. That is the best time to treat trans individuals. Suggestions that we should wait until their brains fully mature at age 25, is a red herring. Psychologist have known for decades that children can understand their gender as young as age 4 and differentiate between the sexes at age 3. Our sense of identity is innate. It is not learned and does not develop over time. There is no social contagion. People cannot be talked into being trans or talked out of it. We are who we are. Every day medical science proves this more and more. There is a lot of research establishing the fact that the brains of trans people are different than the brains of cis normative people. Every bit of research that is done only adds to the overwhelming evidence of this fact.
I agree with you that we have to be careful not to let people transition who are not in fact, trans. Every ethical medical professional knows this as well. No one wants to make a mistake. High-level satisfaction with the interventions done on those who have transitioned is an indicator that we almost always get it right, notwithstanding the horror stories that are pushed by the culture warriors to create fear in the general population.
