Gender-Affirming Care in a Changing Global Landscape

Amrita Sarkar 2 April, 2026

Gender-affirming care is a structured, compassionate, and person-centred approach, aligned with global standards such as those outlined by World Health Organization (WHO) and the World Professional Association for Transgender Health (WPATH). The WPATH Standards of Care Version 8 emphasise an individualised, multidisciplinary approach to care, informed consent, and the removal of unnecessary barriers, while recognising the diversity of gender identities and experiences. These standards guide providers in delivering safe, ethical, and evidence-based interventions across clinical and community settings.
The primary objective of this approach is to support individuals in managing distress associated with gender incongruence while promoting overall physical and mental well-being. A central component is the establishment of a Gender Affirmative Care Team (GACT), comprising trained multidisciplinary professionals, including clinicians, counsellors, and social support providers. These teams are equipped to respond to the varied and evolving needs of transgender and gender-diverse individuals.
Integrating individuals with lived experience into care delivery frameworks is recognised as a good practice. Their inclusion enhances the relevance of services, builds trust, and ensures that care approaches are grounded in real-world perspectives and community needs.

Strong clinical governance systems are essential to ensure quality, consistency, and accountability in service delivery. A structured two-step process is recommended:

1. Informed Consent: Individuals are supported to make well-informed decisions regarding their care, in accordance with National Medical Commission (NMC) standards. This process ensures clarity on available options, expected outcomes, and potential implications.

2. Comprehensive Documentation: All consultations and care decisions are systematically recorded. This includes the use of ICD-11 classifications for gender incongruence (HA60 for adolescents and adults, HA61 for children, and HA6Z for unspecified cases). Accurate documentation supports continuity of care, facilitates coordination among providers, and strengthens professional accountability.

This approach contributes to Sustainable Development Goal 3 by strengthening access to quality healthcare services and promoting mental health and well-being across diverse populations. By improving the availability and responsiveness of gender-affirming services, the programme helps address gaps in care and supports better health outcomes.

In addition, it aligns with Sustainable Development Goal 5 by fostering more inclusive systems that recognise and respond to diverse gender experiences. Strengthening service delivery in this manner contributes to reducing systemic barriers and enhancing participation of gender-diverse individuals within healthcare and social support systems.

Healthcare providers must maintain familiarity with relevant legal frameworks, including the HIV Act, Mental Health Act, and the Transgender Persons (Protection of Rights) Act and its amendments. Such awareness enables providers to navigate institutional requirements effectively while ensuring that care delivery remains ethical and consistent with national guidelines.

Given the evolving global and national landscape, there is a clear need to strengthen systems delivering gender-affirming care. Investments in multidisciplinary teams, standardised clinical protocols, and robust documentation practices can significantly improve service quality, accessibility, and consistency.

A structured and responsive approach to care contributes to improved health outcomes, builds trust in healthcare systems, and ensures continuity of services across diverse contexts, while also advancing progress towards broader global development priorities.

By Amrita Sarkar

Advisor: Transgender Wellbeing & Advocacy at Alliance India

References:

https://icd.who.int/en/

https://wpath.org/publications/soc8/

https://sdgs.un.org/goals

https://www.who.int/standards/classifications/frequently-asked-questions/gender-incongruence-and-transgender-health-in-the-icd