It is a very well formulated German letter and I will do a quick and dirty translation, I hope that it is not to crude.
My letter was something like this:
<Surname> Theresa is since July 2015 with diagnosis of IDC F64.0 respectively DSM blalbla in Psychotherapy in my practice.
This statement is in female form to honor my patients feeling even though my patient is still registered in male form.
The reason for psychotherapy is an ongoing transident feeling since childhood that my patient consistently tried to suppress. My client has a strong discomfort with her assigned gender at birth and wishes to live an be accepted as a member of the opposite gender. She wants to start HRT. Further planned are the change of the civil status, a name change and GRS.
Psychotherapeutic, clinical-psychological and psychiatric diagnosis: IDC-10, F64.0 MtF
From current point of view it is very unlikely that the sense of belonging to the desired gender as woman will change.
A short summary of the treatment. Like when did I visit the other shrinks (Clinical psychologist and Psychiatrist)and their diagnosis.
From psychotherapeutical view there is no objection to start HRT. As case leading psychotherapist I confirm consensus with <mentioning shrinks again> the diagnosis of F64.0 MtF and the possible start of cross gender hormone therapy.
