Gender‑affirming care: practical steps for outpatient teams
Mirror names, pronouns, and patient‑preferred body‑part language across team and chart.
Add GAHT status and dose changes to intake and med review; monitor sleep and mood around adjustments.
Treat presenting conditions with standard algorithms while documenting rationale, risks, and shared decisions.
Build a short referral list and collaborate with primary care, endocrinology, and gender clinics when needed.
Why this matters
Gender‑affirming care (GAHT) is associated with better mental‑health outcomes. The daily wins live in respectful language, consistent documentation, and predictable follow‑up.
Intake and documentation updates
Identity fields: affirmed name, pronouns, and words patients use for body parts
Clinical context: GAHT status, current agent and dose, recent changes, surgical history, fertility goals, and support system
Monitoring: note mood/sleep shifts with hormone changes; capture baseline and follow‑up vitals when indicated
Team skills and scripting
Front desk and billing: greet and schedule using affirmed name; ensure insurance name matching is handled discreetly
Clinical scripting: “I’ll make sure your chart reflects the language you use for your body. Let me know if you want anything updated.”
Psychopharm reminders on GAHT
Work your usual algorithms for depression, anxiety, ADHD, PTSD, and insomnia
Stay mindful of interactions, physiologic changes on GAHT, and sleep impacts around dose changes
Document rationale, alternatives, and shared decisions
Quick EHR wins (drop‑in smart phrases)
“Affirmed name/pronouns verified. Team updated. Chart reflects patient language for body parts.”
“Reviewed GAHT status and recent dose changes; screened mood/sleep since last adjustment; no acute risks identified.”
Collaboration and referrals
Build a small network: primary care, endocrinology, gender clinics, voice therapy, fertility counseling
Share a brief summary and your follow‑up plan; request med changes be messaged back to you
Follow‑up cadence
Standard psychiatric follow‑up, with an extra touch within 2–4 weeks after substantial GAHT dose changes if mood/sleep are affected
References (web‑friendly)
Johns Hopkins: Gender‑Affirming Hormone Therapy overview
Selected CME/CE resources (UConn CE, UCSD CPD, ASHM)