Sample Letters for Hormone Therapy

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Sample Letter #1:

To Whom It May Concern:

This letter is to serve as documentation that my client, ___________ has completed ___ sessions of psychotherapy at _________________ in ________,______ in fulfillment of the requirements for hormone therapy. Having engaged in psychotherapy from ____ to _______ 200__, ________ is eager to initiate testosterone therapy in order to begin gender reassignment.

Client Profile

___________ is a ___-year old who is biologically female. She is currently (pertinent information about job or college/schooling). ______ referred herself to treatment in _____ of this year to begin psychotherapy as part of the requirements for gender reassignment.

Relevant History

The client was born in _______, ______ and is ______ child. She described her childhood as (pertinent background information to the present relevant to the transition)

With regard to gender history, ______ reported that (pertinent background information that pertains to childhood issues such as being female)

(pertinent background information about family, such as acceptance of the transition or otherwise)

(pertinent background information about 'coming out' as transsexual)

Eligibility Criteria

Over the course of the treatment, ______ has demonstrated more than adequate knowledge of the benefits and potential risks of the testosterone therapy, including the heightened risk of cardiovascular disease. She is also aware that heredity may limit her tissue response to testosterone and that the maximum physical effects of the hormone may take up to two years to become evident.

______ has been living as a man since ________ ______. She began introducing herself as __________, has informed (name of job or school) of her intended gender transition and reassignment, and uses the men's restroom exclusively at both work and school. With the exception of legal documentation, the client refers to herself as _______.

(The following is subjective information as it pertains to the person for which this letter was written for) The client has also informed her family of this decision and experienced significant parental objections resulting in the withdrawal of all financial support. As a result, the client has had to move off-campus to a cheaper living situation and is also working part-time in order to meet her tuition and living expenses. She continues to maintain an A-average in all her classes.

Readiness Criteria

Over the course of treatment, ______ acknowledged that her decision to live as a man has resulted in a significant reduction of personal distress surrounding gender identity. With the exception of her voice which occasionally results in awkward social situations, the client is able to successfully "pass" as a man. She hopes that testosterone therapy will sufficiently deepen her voice and allow for the presence of facial hair.

Diagnostically, ______ meets criteria for Gender Identity Disorder. There is an absence of problems related to mood, anxiety or substance abuse. The client does not evidence any symptoms of psychosis or disturbances in personality. It is recommended that the client continue with the psychotherapy as she begin her gender transition in order to address any issues that may surface. Given that the client's insight and judgment are within normal range, it seems likely that any prescribed medication will be taken in a responsible manner.

Summary

___________ is a ___-year old biologic female with a diagnosis of Gender Identity Disorder. ______ engaged in psychotherapy from ___ to ____ 200_ (___ sessions) to fulfill the requirements for testosterone therapy. She hopes to eventually undergo gender reassignment and fully transition from female to male.

The client has met all the eligibility and readiness criteria outlined in the official Standards of Care for the treatment of transgendered individuals. There is no evidence of psychopathology or impaired judgment. Given the preceding report, I certify ______ to be a fit candidate for testosterone therapy. Please feel free to contact me at (***-***-****) if there are any further questions regarding this client.

Signed...