A Clinician’s Guide to Writing Letters for Gender Affirming Care

Gender Diversity Master Class Series for Providers

A Clinician’s Guide to Writing Letters for Gender Affirming Care

January 21, 2026

3 CE’s Available
The Gender Health Training Institute is approved by the American Psychological Association to sponsor continuing education for psychologists. Gender Health Training Institute maintains responsibility for this program and its content.

Access to medically necessary, gender-affirming care often hinges on letters—yet requirements vary across programs and insurers, and families may face additional language and systems barriers. In this three-hour workshop, Dr. Shawn Giammattei, Juliette Greenham, and Dr. Jen Hastings translate contemporary standards (including SOC-8 and endocrine guidance) into clear, patient-centered letters for adults and youth. You’ll learn exactly what to include—and what to avoid—when drafting support letters for hormones, puberty blockers, and surgeries; appeals to insurers; and legal/administrative needs (name/gender marker, school, and travel). Special attention is given to working with Spanish-speaking youth and caregivers, including interpreter best practices and documentation that protects consent, reduces denials, and builds trust.

What We Will Cover

The role of letters in unlocking care: clinical, ethical, and insurer perspectives
SOC-8 and endocrine guidance distilled for letters
Surgery, puberty blockers, and GAHT letters—capacity, risks/benefits, expectations, and aftercare planning
The developmental context for youth, caregiver involvement, and monitoring language
Using DSM-5-TR respectfully (reducing pathologizing while supporting coverage)
Insurance appeal structure that maps clinical facts to policy language
Legal/administrative letters: name/gender marker, school/college, travel/accommodation (minimal-PHI approach)
Working with monolingual Spanish-speaking families: qualified interpreters, plain-language summaries, and documentation of language access in consent and letters
Common pitfalls (boilerplate errors, missing risk/benefit language, lack of aftercare details) and quick quality checks

Learning objectives:

By the end of this training, participants will be able to:

List at least 6 core elements of a letter of support for gender-affirming medical care for youth and adults.
Identify 3 specific differences between SOC-7 and SOC-8 that directly impact referral letters and insurer expectations.
Describe 4 documentation points that demonstrate decisional capacity and informed consent in letters.
Describe risks/benefits, developmental context, and caregiver involvement,involved in puberty blockers and hormones for youth.
Explain the important intersections and needs of the Spanish speaking families when creating letters of support.
Apply SOC8/Endocrine guidelines when creating insurance appeals.

Presenters

Jen Hastings

Jen Hastings, MD (jen/jen) Board Certified in Family Medicine, has been providing transgender health care for many years. Dr Jen is part of Ibis Reproductive Health, a research group studying the reproductive needs and experiences of transgender and gender expansive people in the US, and a national consultant and educator on transgender healthcare, increasing medical access and understanding.
Jen is also an abortion provider with Aria Medical Group. In Santa Cruz, Jen is the physician consultant with SafeRx and the Health Improvement Partnership, working with Opioid Safety, Behavioral Health integration, Trauma Informed Care and Mindfulness in Medicine.

Shawn V. Giammattei, PhD

Shawn V. Giammattei, PhD is a clinical psychologist & WPATH certified member/mentor, specializing in couple & family therapy with a particular focus on trans youth and their families. He is the founder & CEO of the Gender Health Training Institute & TransFamily Alliance, a research consultant, international speaker, community educator, and professor teaching graduate and post-graduate courses in LGBTQ psychology, family systems, and gender affirming care, as well as the author of several articles and book chapters on gender, sexuality, and family work.

Juliette Greenham

Mexican writer, former strategy director at international organizations and DEI expert at Gender Health Training Institute. Juliette is coaching the most important organizations in Latin America to change their culture towards trans inclusivity, implementing solid policies and procedures. Juliette helps trans families in their Gender Journey, translating gender-affirming care to the Latin American culture, helping families understand it and remove cultural obstacles so they can flow and be at peace with the process.

Session is 180 min including time for Q&A.

3 CE Credits Available

The Gender Health Training Institute is approved by the American Psychological Association to sponsor continuing education for psychologists. Gender Health Training Institute maintains responsibility for this program and its content.