Gates & Gatekeepers: An Affirming Approach to Letter Writing

Access to healthcare, particularly for the transgender population, is more crucial than ever. As a gender-affirming clinician, you must challenge existing systems and help clients navigate them. Mental health clinicians play a vital role in this process by writing letters that support access to life-saving transition services.

This course will transform your approach to gender-affirming care letters. You'll gain practical tools to balance clinical and ethical requirements with client-centered, empowering practices. Learn to create effective, respectful letters of support that increase access to care while prioritizing client dignity and autonomy—navigating the "gates" while resisting the role of "gatekeeper."

This course is facilitated by Traci Medeiros (She/They)


This is an intermediate course for affirming clinicians who want to support the transgender community by writing competent and ethical letters of support for transition services.

In an effort to make the world safer and increase cultural competence in the mental health field for transgender, non-binary, and gender non-conforming individuals, gather & Grow Education is proud to offer this course free of charge.

2 CE credits are available with a donation and submission of course evaluation and distance learning post-test.

see more via the Course promotion flyer (to the left) and donation info below the course content.

All materials must be reviewed and process activities completed in order to receive full credit for the course.


Process Activities

Section 1 (Slides 1-13)

  • Course Description

  • Educational Goals

  • Learning Objectives

  • Historical Context

  • Current Standards of Care

  • The Purpose of Letters

  • Informed Consent

Resources & Links


Section 2 (Slide 14-24)

  • Diagnosis, Criteria, & Treatment

  • Transition Services

Resources & Links


Section 3 (Slides 25-34)

  • Writing an Affirming Letter

  • Affirming and Sustainable Structure

  • Humanizing the Process

Resources & Links


CE & Course Completion Certificates

Ce credit for this course is available by donation of $5, $10, or $25 (follow links below to donate). Students, associates, and other providers may also request a non-ce certificate of completion via donation. by offering some of our courses for free and CE credit by self-selected donation we hope to create as much accessibility as possible for education that makes the world safer for our marginalized communities.

$25 is the true value of the course and administration.

please, support as you are able.


Keywords: Continuing Education, CEPA, LMFTs, LCSW, APCC, Gender-Affirming Care, LGBTQ, Transgender, Non-Binary, Gender Non-Conforming, Transition, Transition Services, Letters, Letters of Support, Surgery Letters, Mental Health, Wellness, Provider Education