Hormone Letters

Probably the number 1 thing clients who are transgender or gender expansive come to me for is hormone letters (a letter from me to refer the client for gender confirmation hormone therapy).  I have some pretty strong beliefs on hormone letters – mainly that I am NOT a gatekeeper.

I am a member of WPATH (World Professional Association for Transgender Health) and follow their standards of informed consent in their Standards of Care version 7.

So what is informed consent?

The definition is: permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits.

So what does informed consent mean when talking about a hormone letter?

What it means is that I will go over what to expect, good things and bad things and different types of hormone therapy that I am aware of, and also explain that a medical doctor needs to determine physical health and what the process will be for the patient.  I also go over some things such as employment, social, family and living status, acknowledgement and acceptance.  And make sure that the client is ready to transition and if not, the steps they will need to take.

How many sessions does it take to get a letter?

It really depends on the situation.   If the client has already thought and planned out many of the parts of their transition, they may only need one or two sessions and then I will feel comfortable about writing a referral letter for gender confirmation hormone therapy.  Sometimes, though it takes more time.

For example, if a client is living with a family member and going to school full time with only a part time job, and their family is not supportive or accepting, I would work with them to create a plan to transition safely which would be to find other living arrangements and other financial avenues to support themselves, before writing the letter.

While I believe in informed consent and believe that if someone says they are transgender or gender expansive, they most likely are, I will not write a referral letter that would put their safety at risk.  My first job is to do no harm.

I also strongly suggest continued therapy even after the letter.  Transitioning is tough and as much as someone wants to become their authentic self, it is a process.  I try to always remind clients, starting hormones is starting puberty.  Just like a teenager experiences emotional ups and downs, anxiety and physical changes that happen slower or different than expected, so does someone transitioning.

Are you ready to start becoming the authentic you – contact me and we can get started.

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