Below are guidelines developed in collaboration and consultation with medical and mental health providers across the U.S. These guidelines were developed based on guidance from WPATH, professional licensing boards, professional ethical standards, and consultation with experienced practitioners and community members. The WPATH standards promote a harm-reduction model, which these guidelines echo. These guidelines will change over time and are not required to be followed. The intention is to offer guidance for practitioners to provide effective care that protects providers and patients.

• Discuss documentation with patients including if they would like their pronouns in the chart or not.

• Consider updating names for cisgender clients if they use a name other than their full legal name (Ex: Michael goes by Mike, update this in Mike’s chart to normalize use of non-legal names across genders).

• Inform patients who can or cannot see their pronouns, gender identity, sexual orientation, and other personal identifying information in their chart.

• Inform patients of how to change this information (i.e., who do they ask to update their name, pronouns, etc.).

• Avoid using Gender Dysphoria (F64.0) as a diagnostic code unless it is required for access to treatment.

• If possible, avoid use of pronouns for any patient when writing notes, instead using, “patient,” “student,” or “client,” depending on your role and setting.

• Focus documentation on mental health, how client is coping, and how you supported them, not on policies or specific threats.

• When possible, refrain from disclosing transgender status in documentation.

• Transgender people have and will always find ways to access hormones and gender affirming care. As providers, it is our responsibility to respect their decisions and ensure they have what they need to be safe (i.e., information, resources, community).