Hormone readiness assessment

A referral letter from a qualified mental health professional may be required to begin hormone therapy.

A mental health provider who recommends hormone therapy shares ethical and legal responsibility with the medical provider who offers gender-affirming hormone therapy. In order to provide a letter of recommendation to physicians who are able to prescribe hormone therapy, a hormone readiness assessment can be conducted by us.

For our practitioners to best support the decisions of our clients, we must have functioning working relationships and sufficient information about them. It is essential for us to offer our clients a prompt and attentive evaluation in order to alleviate their gender dysphoria and provide them with appropriate medical services.

What can I expect from the assessment?

All decisions regarding healthcare, including hormone use, are ultimately made by the client.

Nevertheless, we as mental health professionals, have a duty to assess and provide information to assist clients in making informed decisions and becoming adequately prepared.

Blake Psychology follows the WPATH Standards of Care for decisions regarding feminizing/masculinizing hormone therapy.

During the assessment, the practitioner is trying to understand your gender dysphoria. They will ask about your expectations for treatment, support systems, and current mental health status, and ensure you understand informed consent.

The assessment can help clients who are considering hormone therapy to be:

Psychologically prepared

• The client has made a fully informed decision with clear and realistic expectations
• Risks and benefits have been discussed
• Is ready to receive treatment in accordance with the treatment plan
• Is able to involve family and community as needed

Practically prepared

• The client has considered the psychosocial impact
• Clients of childbearing age should explore reproductive options before beginning hormonal therapy (WPATH Standards of Care, section IX)

Do I need counseling in order to obtain the letter from you?

Counselling is not typically required to get a prescription for hormones although it can be very helpful for some people. It may be required or recommended if:

• You’re unsure whether hormone therapy is right for you,
• You do not have a plan in place to announce your transition to significant others, family members, friends or in a work setting, or do not know how to announce your transition
• You have significant mental health or substance abuse concerns.

Transgender health care is an interdisciplinary field, so your Blake Psychology practitioner might assist in coordinating services and referrals among a client’s overall care team.

What information does my letter for gender-affirming hormone therapy contain?

Referral letters include documentation of a client’s personal and treatment history, progress, and eligibility. The letter can be sent to physicians who are able to prescribe hormone therapy, and clients are also entitled to receive a personal copy.

Please note that we cannot guarantee the issuing of a letter in advance. While you may wish for a letter that says something specific, letters are based on clinical judgment, and can only be written if the clinician has determined that it is appropriate.