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. 2022 Nov;67(11):828-830.
doi: 10.1177/07067437221102725. Epub 2022 May 22.

"Mental Readiness" and Gatekeeping in Trans Healthcare

Wesley Verbeek  1 , Wayne Baici  1   2 , Kinnon R MacKinnon  3 , Juveria Zaheer  1   2 , June Sing Hong Lam  1   2
Affiliations

"Mental Readiness" and Gatekeeping in Trans Healthcare

Wesley Verbeek et al. Can J Psychiatry. 2022 Nov.

Abstract

Gatekeeping refers to clinicians' strict application of eligibility criteria to determine a trans patient's "fitness" to engage in medical transition, resulting in significant barriers to gender-affirming care. Gatekeeping often uses "mental readiness" as a prerequisite to medical transition, which contributes to patient distress and systemic discrimination. Changing international trans health guidelines (the new World Professional Association for Transgender Health Standards of Care version 8) recommends clinicians shift from a gatekeeping model towards an informed consent model, which improves access to care. This commentary offers recommendations on how clinicians can reconsider existing "mental readiness" frameworks around medical transition to facilitate improved access to care.

Keywords: access to care; gatekeeping; gender-affirming care; informed consent; mental health; transgender; transition.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

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