Writing letters of support: a training for clinicians
A 67-minute training on how to write assessment letters for gender-affirming surgery — ethically, competently, and without gatekeeping. Free to watch. Template included.
I’ve written nearly 300 accepted letters of support. This training is everything I’ve learned doing it, including the history of how we got a system that asks clinicians to authorize other people’s bodies in the first place.
Watch the training · Email me for the letter template
What you’ll be able to do afterward
- Write an assessment letter that meets current surgical and insurance requirements without pathologizing your client
- Explain the history of gatekeeping in trans healthcare, and recognize how it still shapes standard practice
- Respond to “gender exploration psychotherapy” and watchful-waiting arguments with something better than discomfort
- Structure an assessment session that gathers what a letter needs without interrogating anyone
- Adapt a working letter template to your own practice and client
The training
Presented at TransPride YOUnited’s behavioral health track in 2023, and in a revised version at WMCHA’s Weaving Connections conference in May 2026. The version above is the newer one.
Just here for the template? It’s at 47:25 — or email me and I’ll send it. Slides are here.
This is amazing work and a wonderful history lesson, Moira. Thank you. I was thrilled to learn about historical brothers, sisters, and sibs whom I was not yet familiar with. And thank you for your cogent, common sense response to politicized “gender exploration psychotherapy” and “watchful waiting” propaganda.
Kelley Winters, researcher and activist
This is a good amount of information and history — enough to build real confidence and breadth of knowledge for clinicians. It’s also entertaining, and it genuinely pulls on one’s sense of empathy. It’s the perfect piece of “propaganda” to help stop gatekeeping.
Thank you for this. I’ve been so afraid to write these letters, just not knowing where to begin. Now I know what to do, and I will be adding this to my practice.
Anonymous conference feedback
Excellent, excellent, EXCELLENT. I learned so much in this 90 min session. I feel like this should be required education for every clinician.
Anonymous conference feedback
Bring this to your team
If you supervise clinicians, run a clinic, or coordinate a training calendar, I’ll come do this live — for your staff, adapted to your setting, with time for the specific cases people are actually stuck on. I also consult with individual clinicians on letters in progress.
Get in touch · counseling@moiraryan.com
Looking for a letter for yourself? Start here — always free.
