SummitStone aims to provide quality of care to diverse populations within our community and is committed to our treatment philosophy that care starts with yes. In an effort to improve access and remove barriers to needed care for transgender, nonbinary, and gender diverse clients, our staff have been trained to provide gender affirming care, including letter writing for individuals seeking access to gender-affirming healthcare. Insurance companies often require a letter of support from a qualified mental health professional when seeking gender affirming medical care or procedures.
SummitStone follows the Standards of Care developed by the World Professional Association for Transgender Health (WPATH). If you are over 18 and in need of a letter of support, and have Medicaid or earn less than 300% of the federal poverty guideline, please call 970-494-4200 and indicate that you are looking for a letter to support your gender affirming health care. We will connect you with a therapist who will review your needs and work with you to accomplish your goal.
What is Gender Affirming Care?
Gender Affirming Care is any treatment that helps a transgender, nonbinary, or gender non-conforming person in their transition process. Professionals specializing in gender-affirming care provide a judgment-free environment to help patients explore their gender identity.
Studies repeatedly have demonstrated that that affirming therapeutic spaces, safety in the therapeutic relationship and access to gender affirming treatment is correlated to improved psychological experiences and a decrease in depression, anxiety, and suicidal ideation. Lack of access to inclusive care is linked to higher rates or suicidality, especially for youth.
Current Status of Gender Affirming Care in America
Due to government legislation:
- More than 58,000 transgender youth and young adults across 15 states are in jeopardy of losing access to gender-affirming care.
- More than a third of the 150,000 transgender youth ages 13-17 in the U.S. live in the 15 states that have restricted access to gender-affirming care or are currently considering laws that would do so.
- More than 4,000 young adults ages 18 to 20 would also be at risk of losing access to gender-affirming care under the three proposed bills that would apply to young people over the age of 18.
This legislation is contrary to professional organizations:
- Gender-affirming care is recommended for transgender youth by the American Academy of Pediatricians and the Endocrine Society and is viewed by the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Psychiatric Association (APA) as evidence-based patient care.
- The American Medical Association supports insurance coverage for gender-firming care for transgender people (The Williams Institute 2022).
President Biden issued an Executive Order on Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer and Intersex Individuals,” which included a focus on expanding and protecting gender affirming care nationally.
What Might Gender Affirming Care Look Like?
- Changes in gender expression and role (which may involve living part-time or full-time in another gender role, consistent with one’s gender identity)
- Hormone therapy to feminize or masculinize the body
- Changes to change primary and/or secondary sex characteristics (e.g., breasts/chest, external and/or internal genitalia, facial features, body contouring)
- Psychotherapy (individual, couple, family, or group) for purposes such as exploring gender identity, role, and expression
- Addressing the negative impact of gender dysphoria and stigma on mental health, alleviating internalized transphobia, enhancing social and peer support
- Improving body image or promoting resilience
- In-person and online peer support resources, groups or community organizations that provide avenues for social support and advocacy as well as support resources for families and friends
- Voice and communication therapy to help individuals develop verbal and non-verbal communication skills that facilitate comfort with their gender identity
- Hair removal through electrolysis, laser treatment or waxing
- Breast binding or padding, genital tucking or penile prostheses, padding of hips or buttocks
- Changes in name and gender marker on identity documents
Role of Treatment Providers
When serving individuals who may present with Gender Dysphoria (clinically significant distress or impairment related to a strong desire to be of another gender), providers are recommended to do the following:
- Directly assess gender dysphoria. Not all transgender or gender diverse people experience dysphoria.
- Provide counseling and supportive psychotherapy to assist individuals in exploring their gender identity, alleviating distress related to their gender dysphoria, and ameliorating any other psychosocial difficulties.
- Assess and treat any coexisting mental health concerns.
- If the client (and guardians if applicable) are in agreement, refer clients for additional physical interventions with a medical provider to alleviate gender dysphoria.
- Educate and advocate on behalf of gender dysphoric individuals and their family members in their community. This is particularly important in light of evidence that children and adolescents who do not conform to socially prescribed gender norms may experience harassment in school
- Provide individuals and their families with information and referral for peer support, such as support groups for parents of gender-nonconforming and transgender children.
Best Practice Approaches in Care
When supporting and treating individuals with gender dysphoria, health professionals should broadly conform to the following guidelines:
- Mental health professionals should help families to have an accepting and nurturing response to the concerns of their gender dysphoric child, adolescent, or family member.
- Psychotherapy should focus on reducing the individual’s distress related to the gender dysphoria and on lessening any other psychosocial difficulties.
- Treatment to change a person’s gender identity and expression to become more congruent with sex assigned at birth has been attempted and does not work, especially long term. Such treatment is no longer considered ethical.
- Mental health professionals should not impose a binary view of gender.
- Hormonal or surgical interventions are appropriate for some, but not for others.
- Clients and their families should be supported in making difficult decisions regarding the extent to which clients are allowed to express a gender role that is consistent with their gender identity, as well as the timing of changes in gender role and possible social transition.
- Health professionals should support clients and their families as educators and advocates in their interactions with community members and authorities such as teachers, school boards, and courts.
- Mental health professionals should strive to maintain a therapeutic relationship with gender-nonconforming children/adolescents and their families throughout any subsequent social changes or physical interventions. This ensures that decisions about gender expression and the treatment of gender dysphoria are thoughtfully and recurrently considered.
Ethical Considerations for Gender Affirming Care
- For many people, gender affirming healthcare is supportive of finding relief from anxiety, depression, and dysphoria.
- For some people, it has been difficult or impossible to create a solid sense of self and identify without medical intervention and transition.
- Delaying gender-affirming care has created worsened mental health concerns in individuals who are certain that they want it.
- For some people who have not been certain, it has still been the right choice.
Stance on Conversion Therapy
SummitStone Health Partners recognizes and acknowledges the harm that is caused by “conversion therapy,” including depression, violent victimization, and suicide. In accordance with the Colorado law and the values of our organization, SummitStone does not condone or participate in any form of therapy intended to change and individual’s gender regardless of age, expression, or parental/familial request. Engaging in any form of conversion therapy is a violation of Colorado law, professional ethical regulations of SummitStone and is grounds for immediate termination.
Ways to Demonstrate Respect & Support
- You don’t have to understand what is means for someone to be transgender, nonbinary, or gender diverse to respect them
- Use the name a person asks you to use
- Try not to make assumptions about people’s gender
- If you’re not sure which pronouns to use, ask!
- Advocate for policies that support an individual’s right to dress, live and use the bathroom they choose in public settings
- Talk to transgender, nonbinary and gender diverse individuals to learn more about who they are
Learn more at Transequality.org