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The Gender Affirmative Letter Access Project
Biography
ABOUT US
We are a group of transgender, nonbinary, and allied mental health and medical providers based in the U.S. who have come together to:
a) State our position on the requirement that transgender and nonbinary people and/or people seeking gender-affirming medical interventions acquire a letter of support from a mental health provider;
b) Make public our commitment to making letters, when required by medical systems who adhere to the WPATH SOC, accessible and free.
POSITION STATEMENTS
We advocate for an informed consent model of care as it would apply to any medical service or surgery.
People seeking gender-affirming medical care have a right to information in order to evaluate risks and benefits and feel empowered in their medical decision-making.
Information sharing DOES NOT need to be in the form of individual sessions with mental health providers unless chosen by the client. There are other methods of making this information accessible, including: classes, print materials, online materials, and greater transparency from medical providers. These resources may not be available or established in all health care systems, but this is a standard of care that all systems should be investing in building.
We are aware that people who do not fit a certain narrative about what it means to be “transgender” often receive subpar care and face more barriers to receiving the care they need. We acknowledge that this greatly impacts people of color and indigenous communities, nonbinary people, and neurodivergent people.
Putting mental health providers in a position of gatekeeping negatively impacts the client-provider relationship and leads to abuses of power. Furthermore, therapy services should always be consensual; requiring clients to pay for services which they are, in some cases, not needing or wanting, is unethical. This is not client-centered care.
WHY IT MATTERS
It may be years before clinical practice shifts toward a more socially just model. We aim to raise awareness in order to shift the culture of compulsory letters by eliminating the share of cost from our clients. We recognize that this movement is only an intermediary step towards a more ethical, just, and accessible model of gender-affirming care.