Letters of Support for Gender Affirming Medical
and Surgical Treatments (GAMSTs)

If you are seeking gender-affirming treatment, your medical provider, surgeon, or insurance company may specifically require a letter of support written by a licensed mental health professional with a doctorate. Always check with the authority requesting this letter to confirm requirements for the letter writer, so that you don’t have to jump through any potentially unnecessary hoops.

I am honored to provide this important service to reduce barriers to the care that is unanimously supported by these organizations as safe, effective, and medically necessary when clinically indicated:

  • American Medical Association, American College of Physicians, American Psychological Association, American Psychiatric Association, American Academy of Family Physicians, the Endocrine Society, American College of Obstetricians and Gynecologists, and the World Professional Association for Transgender Health (WPATH)

Access support, not gatekeeping

The WPATH Standards of Care (version 8) provide clinical guidelines for healthcare professionals to safely and effectively deliver gender-affirming care. These standards also encourage trained letter writers like me to focus on an “informed consent” approach, rather than being the one to make the call as to whether you are “really” transgender or nonbinary. This means assessing:

  • Your capacity to provide your own informed consent in general

  • How well you understand the treatment you are pursuing

  • What you know about your surgeon or medical provider’s expertise in gender-affirming care

  • How well you understand the risks and benefits, including impact on fertility/reproduction (if that is an important factor for you)

  • Your plan for care, including available support systems and capacity to manage post-surgical care (when needed)

  • Your mental health history, to identify if you may need additional support in preparation for your gender-affirming care

  • Your experiences of gender euphoria and how this treatment will help support more of the same!

Overall, the goal of the letter is to emphasize that you are ready and feel informed about your treatment plan.