I have a draft of a letter from my therapist. She has asked for some feedback and is willing to make changes as I see necessary. It would be great if I could get some feedback from you all before my next visit. There are some parts I have already noted for change, but I'm going to type the letter as is, names omitted. So here it is:

To Whom it May Concern,

I've been meeting with (name omitted) in my capacity as a psychiatric social worker to establish a therapeutic relationship and to evaluate his appropriateness for possible feminizing hormone therapy.

Mr. (name omitted) is a pleasant, mild-manner person. Prompt for his appointments he presents with a neat, work-appropriate appearance. He evidences well above average intelligence, no unusual tics or mannerisms and within the normal limits of capacity and ability to exercise good judgement. While he does not evidence symptoms of mental illness whether Axis I or II, (name omitted) reports a long history of feeling like a woman trapped in a male body and of imagining himself (herself) a woman.

Mr. (name omitted) has clearly researched the significant physical, psychological and social ramifications associated with hormone therapy. He fully appreciates the risks involved however remains committed to undergoing treatment if psychologically and medically cleared to do so.

To the best of my ability to ascertain, I believe Mr. (name omitted) is a very appropriate candidate for hormone therapy and possibly surgery to change gender. He's a healthy person, able to appropriately advocate for his own health care and to, in collaboration with his health care providers, make sound decisions on his own behalf.

With his permission, I would be happy to offer what further clinical information I can in support of Mr. (name omitted's) mental health and appropriateness for treatment.

Respectfully,
My therapist

So there you have it, and feedback would be great. If you're still reading, thanks for making it this far.

I don't like the constant reference to Mr. (so and so).  The whole thing seems a little contrived to me.  Is your therapist just writing a general letter?  I would think she would send a letter to a specific doctor recommending you for HRT and if if it were to be general, this seems to wordy and quirky.

Tammy, thanks for taking the time to read and reply. At this point it is very much a general letter. I live in a rural area and I haven't found an endo yet. I've been researching several and it looks like my best choices are about three hours away so that's not too bad.

I had the same concerns as you with the rest of the letter and discussed them during my last session. The constant references to me as male and most of the second paragraph I think are what makes it a strange read. At this point the whole thing is very much a work in progress. I can't really move forward until the end of this month when I find out if my job is included in the next years budget, but I'd like to have this letter ready to go just in case I'm still employed.

Thanks again Tammy, and I definitely welcome any additional feedback or suggested changes.

Hi! I am pre-op and into a second go-round with hormones, leading to SRS in about two years. I have had to have letters of introduction penned for me by a past psychiatrist, and she also referred to me as "Mr"...  Not to worry! This is just medically professional courteousness. After all, can they see the inner you... yet? No. They don't. And this type of person (MD, RN, PsyD, MSW, PSW...) is always "matter of fact". When they can see the internal you, the feminine you (as in after the hormones and the living as a woman test), THEN they will start to refer to you as "Ms". Once you are LEGALLY changed as in your birth certificate and all is "copacetic", then and only then will you see a medical profesional refer to you as a "she".

   But WE all know the truth, don't we...   May God/Goddess bless and keep you safe and happy and sane on your journey. You will never know how happy you may ever be until you can just be who you are, day by day. I hope you get here soon, darlin' !

I second what Tammy said.  That constant use of "Mr." and he is annoying and bordering on hurtful given the nature of the letter.  Starting it off as "(First Last) - hereafter referred to as Ms. (First Last) or she, has been receiving therapeutic counseling for gender identity disorder (or gender dysphoria if appropriate) with me for xx months."

Much of the "mild-mannered" part is unnecessary unless you're applying to be a super-hero.  It should be short and simple. 

"I have found her to exhibit the classic symptoms associated with GID and believe she is ready to begin Hormone Replacement Therapy (HRT).  HRT will start her physical transition, a necessary and critical step in aligning her physical body with her mental gender identification."

If you have any questions please feel free to contact me at any time at (xxx) xxx-xxxx or at email@email.com

Thank you.

Signed as appropriate and listing his/her credentials.

Personnally, I went through the VA and I just told my primary care that I was seeing a therapist (it was documented in the system) and he referred me to the endo.  Simple.  They just need enough to justify the HRT - not a life history.

Just so everyone knows, GID no longer exists according to the DSM V. It's just called gender dysphoria now (or GD).

-Skye

I haven't seen this post before, so please pardon my lateness. Have you already used the letter? If not, you might be interested to hear what a writing expert has to say.

Apart from the Mr./he issue and the fact that GID has been taken out of the DSM, this letter is rather poorly written. I mean, it might be using appropriate clinical language, but it also has

1) some poor phrasing
2) a number of punctuation and mechanical errors
3) a true spelling error ("mild-manner" should be "mild-mannered," although god knows what such an evaluation is doing in your HRT letter)
4) a borderline misspelled word (in U.S. writing, "judgement" is supposed to be "judgment," but I suppose you can argue the point)

If you like, I can edit for grammar, punctuation, and style. Personally, I would be embarrassed that my therapist had written such a letter. She's supposed to be well educated...