The Gender Diverse Care Coalition of New Hampshire endorses an informed consent framework when writing letters of medical necessity, as an essential element of gender affirming care. The WPATH Standards of Care state that these letters can be done in one session, an acknowledgement that informed consent is generally the standard for making medical and other care decisions; in fact gender affirming medical care is one of the only areas of medicine for which psychotherapy is required. This requirement is not due to outcome risk: research consistently shows significant reductions in both anxiety and depression for those who engage in this care (DOI https://doi.org/10.1007/s13178-019-00394-0). Instead, the requirements seem to be a relic of historic and systemic transphobia (http://dx.doi.org/10.1136/medethics-2018-105293).
Informed consent in this context means beginning with the assumption that the client knows themselves best, and is equipped to determine what is best for their life. The discussion of risk, benefits and possible outcomes, when done within this framework are therefore all done in service to the client’s self-determination and self efficacy. The GDCCNH utilizes the GALAP pledge as well as ICATH as foundational documents.