For transgendered people, accessing hormones and surgery has traditionally been a long and difficult path, starting with that first challenging revelation to their doctor, and then often enduring many months or years of psychiatric assessment before they are finally allowed to start hormones and have surgery. This is often referred to as the “gatekeeper” model of care, where doctors are seen as gatekeepers to accessing hormones and surgery.
Unsurprisingly, patients are not attracted to this model, seeing it as having to jump through hoops in order to justify themselves to the medical profession. It is not a model that encourages a good relationship between doctor and patient.
A different model based on informed consent is gaining growing support amongst doctors both here and overseas. In this model, trans people receive detailed information regarding the risks and benefits of hormone therapy from their doctor, and so long as they are able to understand these risks, they can consent to therapy without having to go through such an arduous assessment process.
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