A Guide for Working With Transgender and Gender Nonconforming Patients

Many health care professionals will likely provide services to at least one transgender and gender non-conforming (TGNC) patient during their career. TGNC individuals are now more accepted by society as overall awareness of this historically marginalized group increases. However, some health care professionals — including psychiatrists — do not think they are qualified to provide health care services to TGNC individuals, and thus shy away from doing so. To improve services and access to mental health care for TGNC individuals, it is critical more psychiatrists become familiar with the history and culture of this population and best practices for treatment.

History and Epidemiology

View a brief history and review information on epidemiology, gender identity and sexual orientation.

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Definitions of Gender, Sex, and Sexual Orientation and Pronoun Usage

View information about pronouns and key definitions.

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Gender Dysphoria Diagnosis

The history and differential associated with gender dysphoria.

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Medical Treatment and Surgical Interventions

An overview of gender-affirming procedures that are available.

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Best Practices

Learn about best practices and providing trans-affirming care across medical disciplines.

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Writing Letters of Support to Insurers and Surgeons

Learn about the basics of writing support letters for gender-affirming procedures.

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Gender-Affirming Therapy

View basic concerts when providing psychotherapy to those who are gender diverse.

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Learn and understand helpful terminology when working with the TGNC community.

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Resources & References

View important resources and references made in this guide.

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Online Course

Transgender Mental Health

This course provides a basic overview of transgender mental health. It introduces core concepts of working with gender variant patients, and provides a roadmap to providing gender-affirming care.

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About the Guide

This introductory guide offers an array of topics that will be essential in understanding how to work with TGNC patients. It provides basic information to raise awareness of the needs of TGNC patients and how to incorporate gender-affirming care in psychiatric practices. This toolkit does not represent official APA policy, but offers a perspective from physicians that work with this community on a regular basis. The objective of this toolkit is to help a broader range of psychiatrists become familiar with best practices for treating TGNC patients. Psychiatrists can consult Resources & References section for further reading.


Although TGNC patients have been treated psychiatrically, medically, and surgically for the past 100 years, standards of care regarding this patient population are still in infancy. Thus, research is still needed to develop more effective treatment.

Many experts have studied gender and sexuality throughout their careers. This toolkit represents just one view of how to work with TGNC patients, based largely on the WPATH Standards of Care. This toolkit aims to provide a progressive treatment approach that will allow clinicians to treat TGNC patients with respect and with a focus on preserving patient autonomy.

NOV 2017

Physician Reviewed

Eric Yarbrough, M.D.
Jeremy Kidd, M.D., M.P.H.
Ranna Parekh, M.D., M.P.H.