May 26, 2005
Dear Dr. [Primary Care Physician]
I am writing this letter on behalf of [birth name] AKA Elliot [last name]. (I will use the name Elliot and masculine pronouns out of his preferences and identification.) I have been working with Elliot on a weekly basis, starting 2/24/05, and we will have had 13 sessions as of this date. Elliot is a 23-year-old gender dysphoric biologic female, who wishes to begin hormone treatment at this time. Prior to beginning treatment with me, Elliot had made himself well-informed about transgender issues, through readings, on-line contact, and connection with a community of individuals who identify as transgender. He was also in the process of living in a male identity, primarily through clothing and binding, as well as talking about his masculine gender identity with several friends. During the time that Elliot and I have worked together, he has taken many additional steps in becoming masculinized, including seeking out unisex or male restrooms whenever feasible, informing family members, current colleagues and summer internship personnel of his transformation process, becoming further informed about options and implications of hormonal and surgical procedures, and actively participating in a variety of forums in which transgender issues can be discussed.
In our work, I have found Elliot to be an exceptionally self-aware, responsible, well-integrated, considerate, and stable individual. In my opinion, he does not have any type of mental illness or disorder which would either complicate treatment with hormonal therapy or raise questions about advisability or appropriateness. As suggested above, I also believe that he has “done his homework,” and has a good understanding of the process he is undertaking, as well as the judgment and maturity to take on such decisions for himself. Please feel free to contact me if you have any further questions, or feel it would be helpful to actively collaborate to a greater extent.