(trans)prose

Caleb has been in weekly psychotherapy with me for about two months (initial consultation was 7/16/07), subsequent to receiving mental health care from [clinic] in [location] where he received medication and counseling for depression. Caleb was prescribed medication (Lexapro) for management of depression and mild anxiety. However, he stated that he was not understood or supported by the staff at [clinic] regarding his gender identity. He discontinued medication at about the same time he began therapy with me, and during the past two months is adjusting well to this discontinuation. He denies symptoms of depression during inquiries, and does not present depressive symptoms behaviorally. I have, and will continue, to monitor depressive and anxiety symptoms. At present, he is not showing adverse effects, nor are symptoms evident.

Caleb presents as an intelligent, personable, and competent 21 year old individual. He has been successful academically, was enrolled at [university], but is currently not attending college due to financial difficulties, and to a lesser extent, social stressors specific to gender identity. He is currently working part-time, has an active network of social support, and plans to return to school after beginning his transition, such that he will be accepted both socially and legally as male. He indicated that his family of origin is supportive of his identity and transition from female to male. 

I have said to Caleb that “you do your homework well.” By this I mean that he has thoroughly explored the processes and implications of gender transition, from beginning the real-life experience, which he is currently doing, to hormone therapy, which he is ready for. Caleb is also knowledgeable about options for surgical procedures to facilitate his transition. At present, however, he is looking forward to beginning hormone therapy.

Caleb is committed to working with me in psychotherapy as he makes his transition. I fully recognize that hormone therapy often influences mood, and will continue to monitor his progress throughout his transition. Social stressors during his transition will be addressed, as will other concerns that might interfere with personal and occupational functioning.

In summary, I fully support Caleb in his transition from female to male. From my interviews with him, it is my opinion that he experiences gender identity disorder, evident since childhood. Caleb and I will continue to work together, and in consultation with you and other physicians, so that Caleb can realize his inherent identity and receive the support of professionals during his transition.

Please do not hesitate to call me if you have any questions of concerns. I am available by phone or email should you require further information, and would be delighted to consult with you. Thank you so very much for your support of Caleb’s request for medical care.

Sincerely yours,

[doctor's name], Ph.D.
Licensed Psychologist
[state license number]