What's in a Letter? Understanding Trans-Affirming Healthcare Documentation
The Role of Letters in Trans-Affirming Healthcare
A letter in the context of trans-affirming healthcare is a written document from a healthcare provider that confirms an individual's gender identity and need for gender-affirming care. These letters serve several purposes:
Confirmation of Gender Identity: Due to the inherent dynamics of power and privilege within the medical-industrial complex, one purpose of a letter is for one healthcare professional to confirm the validity of your identity to another healthcare professional. Although it may be necessary to obtain the care you are seeking, this process can feel dehumanizing. Please don’t go to a provider who causes you to feel like an object.
Access to Gender-Affirming Care: Letters are often required to access various gender-affirming healthcare services, such as hormone replacement therapy (HRT) or gender-affirming surgeries. Although letters are not required for HRT according to the current standards of care, some doctors still require a letter.
Legal Documentation: In some jurisdictions, trans-affirming healthcare letters can also serve as legal documentation for gender marker changes on identification documents, such as driver's licenses.
Emotional Support: Beyond their functional role, when provided by a competent therapist the experience of obtaining a letter can be supportive and affirming– or maybe just less annoying than you thought it might be.
What's Typically Included in a Trans-Affirming Healthcare Letter?
The content of a trans-affirming healthcare letter can vary depending on the specific requirements of the healthcare provider or legal authorities. However, most letters include the following key elements:
The Provider's Credentials: The letter should include the provider's credentials, such as their name, license number, and contact information.
Client Information: It should include the name, date of birth, and any other relevant identification details of the patient.
Gender Identity Confirmation: The letter should unequivocally state the patient's gender identity. Within the medical industrial complex, treatment is only provided when there is a diagnosis. As a result, a DSM-IV diagnosis of Gender Dysphoria is provided. Please know that being transgender is not a disorder. Transphobia ought to be the disorder that is diagnosed. For the purposes of obtaining healthcare, this documentation plays into the language of the medical-industrial complex.
Recommended Treatment: The letter should outline the recommended gender-affirming treatments or procedures, such as HRT, gender-affirming surgeries, or voice therapy. Again, this is the language of the medical industrial complex, which is built on white cis normativity. There is nothing that makes a cisgender person any more normal than a trans person.
Provider's Support: The provider's willingness to engage in ongoing support should be expressed clearly.
Compliance with Standards of Care: In many cases, the letter may reference adherence to established standards of care for transgender healthcare, such as the World Professional Association for Transgender Health (WPATH) standards.
Letters for Gender-Affiraming Healthcare assist trans folks with obtaining the healthcare they desire. If you are seeking a letter for gender-affirming healthcare, please contact me. I provide letters to both new and ongoing clients. You do not have to be in ongoing therapy in order to obtain a letter.
