Gender-affirming care.

Gender-affirming care is an approach, not a separate service. It means a safe place for people of every gender to bring anything to a psychologist, from anxiety to grief to a breakup. Nobody has to explain or defend who they are first. For trans, gender diverse and non-binary people, it also means knowing the extra things you may need, from coming out to letters for hormones or surgery. In person in Prahran, Melbourne, and online anywhere in Australia, with gender-affirming, LGBTIQA+ affirming psychologists.

tl;dr

At a glance.

Who it is for: Adults of every gender. Including trans, non-binary, gender diverse and questioning people, and Sistergirls and Brotherboys
What we offer: Therapy for anything you might see a psychologist about, in a space where your gender is respected. Plus the additional support trans, gender diverse and non-binary people often need, including WPATH-aligned letters for hormones and surgery
Who you will see: Brydan Xavier, a member of WPATH and AusPATH and a council member of AsiaPATH, who writes letters for hormones and surgery. Minh Anh Nguyen sees clients for therapy
Letters: Usually three to six sessions, written with you, and you read the letter before it goes anywhere
Our position: Your gender is not a symptom. We oppose conversion practices in every form, and they are illegal in Victoria
Where: We see adults in person at our Prahran clinic in Melbourne, and online anywhere in Australia
Referral: You can contact us to start the process. You need a GP referral before your first appointment
Age: Adults 18 and over only

What it means here

What gender-affirming care means here.

Gender-affirming care is an approach. It shapes how every session here runs, for every client, whatever their gender. It means your name and pronouns are used without fuss. Your gender is never treated as the problem to solve. And you are not asked to educate your psychologist before you get help.

It is also just therapy

Most people who come to us are not coming about gender. They are coming about the same things anyone sees a psychologist for: anxiety, low mood, trauma, burnout, relationships, family, grief, work, study, or a sense that something is off. Being trans, non-binary or gender diverse does not change that. It only changes whether you can talk about those things somewhere safe. Here you can.

And the additional needs

Trans, gender diverse and non-binary people often carry extra things too. Working out who you are. Coming out, or deciding not to. Medical steps like hormones or surgery, and the letters some of them need. Legal and social changes. Minority stress: being misgendered, questioned, watched or unsafe, and what that does over years. We know this ground, so you do not have to map it for us.

You do not need the right story

There is no script you have to perform to be believed here. You do not need to have known since childhood. You do not need to hate your body. You do not need to be binary, or certain, or finished working it out. We take you at your word about who you are.

What people bring us

The things people come to us with.

Everything anyone brings to a psychologist, plus the things that can come with being trans, gender diverse or non-binary. Some of these, all of these, or something else entirely.

The same things anyone brings

Anxiety and low mood

Worry, panic, heaviness, and the days that do not start. Treated as what they are, not as a side effect of your gender.

Anxiety →

Trauma

Including harm that happened because of who you are, which is real trauma and is treated as such.

Trauma and PTSD →

Relationships and family

Partners, parents, children, friends and exes. Every relationship structure is welcome.

Work, study and burnout

Including the particular exhaustion of being the only one like you in the room.

ADHD and autism

Autistic and ADHD people are more likely to be trans or gender diverse. Being neurodivergent does not make anyone less able to know their gender.

ADHD →

Working it out

Questioning

Wondering, with no conclusion yet and no pressure to reach one. We ask questions rather than supply answers.

Coming out

To yourself, to a partner, to family, at work, to everyone or to no one yet. At any age.

Being non-binary

In a world built for two options. Including the tiredness of explaining it.

Medical steps

Letters for hormones

When a prescriber asks for one. Many adults in Australia can start hormones without a letter, under the informed consent model. We will tell you if that is you.

Letters for surgery

WPATH-aligned assessments and letters for the surgeon, the hospital, or the insurer.

Before and after surgery

Preparing, recovering, and the feelings that can surface afterwards, including relief, grief, or both.

Everything around it

Minority stress

Being misgendered, questioned, or unsafe, and what that does over years. Named and worked with rather than absorbed.

Changing course

Some people pause, stop, or change direction. That is part of the range of experience too, and it gets the same care, without judgement either way.

Letters

Assessments and letters, and how we write them.

Letters are a common reason people first contact us, and often the part they are most anxious about. So here is how it works, plainly.

Whether you need one

In Australia, many adults can start gender-affirming hormones through a GP or sexual health clinic using an informed consent model, without a letter from a psychologist. AusPATH's Australian Standards of Care for Informed Consent describe this. Some prescribers still ask for a letter, and most surgeons do. If you are not sure whether you need one, ask us first. We would rather save you the sessions.

What the standards say

We work to the World Professional Association for Transgender Health's Standards of Care, version 8 (WPATH SOC8, 2022). For adults, SOC8 generally asks for one assessment letter from a qualified professional for surgery. Some surgeons, hospitals and insurers still ask for two. We check what yours needs before we start.

What happens in the sessions

Usually three to six sessions. We talk about your gender and what you want, what you understand about the step you are planning, and what support you have around it. That is it. It is not a test of whether you are trans enough.

Other health conditions

Depression, anxiety, trauma, or a neurodivergent brain do not rule you out. Where something could make recovery harder, we plan for it together so the support is in place. That is the purpose of the assessment: making the step go well, not deciding whether you deserve it.

The letter itself

We write it with you, in language that respects you, using your name and pronouns. You read it before it goes anywhere. If something in it is wrong, we fix it.

Over time

Walking alongside you, not gatekeeping.

Our care is gender affirming and neurodiversity affirming, trauma informed and identity inclusive. We walk alongside people as they navigate liminal spaces. We are not gatekeepers.

Medium to long-term support

Getting to surgery often takes months, sometimes more than a year. Private health insurance hospital cover can have a waiting period of up to 12 months, and surgeons have their own waitlists. It helps to know your procedure, surgeon, likely date and insurance waiting period. It also helps to know whether your surgeon needs the letter from a Clinical or Registered Psychologist. With that, we can map out the steps towards your goals together. Along the way, we can support you with:

practical planning before and after treatment
social, legal and other affirmation steps
mood, sleep, and eating and body image
neurodivergence, paperwork and systems
trauma, including identity-based trauma that hormones or surgery don't resolve on their own
fears about needles, hospitals, anaesthesia or flying
OCD and other anxiety

None of this is ever a requirement for gender-affirming treatment.

Screening for everyone

We offer every new client screening for trauma, neurodivergence, and eating and body image, whatever brings them to us. These are more common for trans and gender diverse people, and often masked. 81.5% of gender diverse Australians have experienced child maltreatment, compared with 62% overall. Trans and gender diverse people are 3 to 6 times more likely to be autistic. In Australia, 15% of trans adults report an autism diagnosis and 11% report ADHD. About 1 in 4 trans young people have had an eating disorder diagnosis. Masking, and screening tools built around cisgender people, make these easy to miss, so we ask in affirming ways and read results with gender and neurotype in mind.

Medicare

A Mental Health Treatment Plan needs your GP to confirm an eligible mental health condition. Being trans is not one on its own. If eating or body image is part of what you are navigating, an Eating Disorder Plan may help. It gives up to 40 psychology sessions in 12 months for people who meet eating disorder criteria. Some people are eligible for a GP chronic condition management plan, and the Extended Medicare Safety Net helps once out-of-pocket costs pass a yearly threshold. Current details are on our fees and funding pages.

For carers and the people around you

If you are caring for someone else while navigating your own affirmation, Carer Gateway (1800 422 737) and Tandem can help. Partners, family and friends supporting you can find help through TransHub, Rainbow Door and Queerspace.

Words you will hear

A short glossary.

Terms from clinics, standards and community. Some are clinical, some are ours. Use whichever words fit you, and we will use them too.

AusPATH

The Australian Professional Association for Trans Health, the peak body for trans health professionals in Australia.

Deadname

A name someone no longer uses. Using it on purpose is a form of harm.

Gender dysphoria

The DSM-5-TR term for distress that can come from a mismatch between your gender and your sex assigned at birth. Not everyone who is trans has it.

Gender incongruence

The ICD-11 term. The World Health Organization moved it out of the mental disorders chapter and into sexual health, because being trans is not a mental illness.

Informed consent model

Starting hormones by understanding the benefits and risks and agreeing to them yourself, with a doctor, rather than needing someone else's approval first.

Minority stress

The extra load carried by people who are stigmatised: discrimination, threat, having to hide, and the vigilance that comes with all of it.

Non-binary

A gender outside the categories of man and woman only, or not in them at all. An umbrella for many identities.

Sistergirls and Brotherboys

Terms used by some Aboriginal and Torres Strait Islander people for gender diverse identities, belonging to community rather than to clinicians.

Our page on Sistergirls and Brotherboys →

WPATH SOC8

The World Professional Association for Transgender Health's Standards of Care, version 8, published in 2022. The international reference point for trans health care.

What we do not do

What you will not get here.

People often arrive braced for a fight. So, plainly:

No conversion practices. We do not offer anything that aims to change or suppress your gender identity, whatever it is called. In Victoria, conversion practices are illegal.
No gatekeeping dressed up as caution. We do not require you to live in a particular way for a set time, to present a certain way, or to tell a particular story.
No teaching us first. You should not have to explain what non-binary means, justify your pronouns, or educate your psychologist before you can be helped. We come prepared.
No treating your gender as the problem. If you want to talk about something that has nothing to do with gender, that is fine too. Being trans is not the headline of every session.

Getting started

How it starts.

You can stop at any step, and none of it commits you to anything.

01 Talk to a Client Experience Officer
A free 15-minute conversation with one of our Client Experience Officers (our CEOs). Use whatever name and pronouns you want, and ask whatever you like, including whether you need a letter at all.
02 Your GP
You can contact us to start the process. You need a GP referral before your first appointment. If you want the Medicare rebate for therapy, ask about a Mental Health Treatment Plan too.
03 The first session
What you want, what you need, and what you would rather not get into yet. If a letter is the goal, we plan the sessions around it.
04 The work
Therapy, a letter, or both, at your pace. We quote any assessment in full before it starts.
05 Afterwards
Some people stop once the letter is done. Others keep coming for support through the next steps. Either is fine.

Questions

Questions people ask about gender-affirming care.

Do I have to want to talk about gender?

No. Plenty of people come to us for anxiety, grief, work or relationships, and gender barely comes up. Gender-affirming care means you are safe here whatever we are talking about.

Do I need a letter to start hormones?

Often not. Many adults in Australia start through a GP or sexual health clinic using an informed consent model. Some prescribers still ask for one. Ask us first and we will help you work out whether you need it.

How many sessions does a letter take?

Usually three to six. It depends on what the letter is for and what the surgeon or insurer asks for, not on proving anything.

Do I need a diagnosis of gender dysphoria?

Some surgeons and insurers want letters that use the DSM-5-TR or ICD-11 terms. We talk with you about the wording and why it is being asked for before we use it.

Can I get a letter if I have other mental health conditions?

Yes. Depression, anxiety, trauma, ADHD or autism do not rule you out. Where something could make recovery harder, we plan the support together.

Do I have to be sure, or binary?

No. You can come to us while still questioning, and non-binary people are as welcome as anyone.

Can this happen online?

Yes, therapy and letter assessments both, anywhere in Australia.

Will you use my name and pronouns?

Yes, from the first conversation, including in anything we write. If your legal name has to appear on a form, we will tell you where and why.

What does it cost?

Therapy fees are on our fees page. Assessments and letters are quoted in full before anything starts, so there are no surprises.

Can my partner or family come?

If you want them to, yes, for some or all of a session. It is your call, not theirs.

I am under 18. Can you help?

We see adults only. QLife and Minus18 can help you find support for young people.

Are you LGBTIQA+ affirming psychologists in Melbourne?

Yes. Every psychologist here works in a gender-affirming, LGBTIQA+ affirming way, in person at our Prahran clinic in Melbourne and online anywhere in Australia. You can contact us to start the process, and you need a GP referral before your first appointment.

Do you see trans, gender diverse and queer clients in Melbourne?

Yes. We are trans-affirming and queer-affirming psychologists, in person at our Prahran clinic in Melbourne and online anywhere in Australia. You can bring anything, and gender only comes up if you want it to.

Beyond us