Do you need a psychologist’s letter to start hormones in Australia?

Many adults in Australia can start gender-affirming hormones through a GP without a letter. Here is how the informed consent model works.

By Brydan Xavier, Director and Principal Psychologist 25 September 2026 About 3 min read

tl;dr

At a glance.

Adults in Australia usually don’t need a psychologist’s letter, a WPATH assessment or a psychiatrist to start hormones.
Most start through a GP under AusPATH’s informed consent standards.
Some prescribers still ask for a letter. If yours does, we can help.
Surgery is different: most surgeons do ask for a letter.

Short answer: often not.

A lot of people contact us asking for a letter so they can start hormones. Sometimes they need one. Often they do not, and we would rather tell you that before you spend money on sessions you do not need.

The informed consent model

In Australia, many adults can start gender-affirming hormones through a GP or a sexual health clinic using what is called an informed consent model. You and your doctor talk through what the hormones do, what the risks and side effects are, what is reversible and what is not, and what monitoring you will need. Then you decide.

The Australian Professional Association for Trans Health (AusPATH) publishes the Australian Standards of Care for Informed Consent: Gender Affirming Hormone Therapy. It was updated in April 2026. It is written for doctors, and it describes exactly this process.

The point of the model is simple: you are an adult who can make decisions about your own body, and your doctor's job is to make sure you have the information to do that well.

When a letter might still be asked for

Some prescribers still ask for a letter from a psychologist or psychiatrist. That can happen when:

a particular doctor or service has its own policy
there are complex physical or mental health factors the doctor wants another view on
you are seeing a specialist service rather than a GP

If that is you, we can help. A letter for hormones is usually quicker than one for surgery.

Finding an affirming GP

AusPATH keeps a directory of trans-affirming health providers. In Melbourne, Thorne Harbour Health runs a peer-led trans and gender diverse clinic in Abbotsford (it used to be called Equinox). TransHub has a guide to finding a doctor in each state.

Before you start

Fertility: hormones can affect fertility. Talk with your doctor about whether you want to preserve eggs, sperm or embryos first.
Support: starting hormones is often a joyful step. It can also bring up a lot. It helps to have people around you, and therapy is there if you want it.
Surgery is different: most Australian surgeons still ask for a letter before gender-affirming surgery.

If you are not sure what you need, ask us. That is what the free 15-minute call with our Client Experience Officers is for. See our gender-affirming care page for more.

Questions

Quick questions.

Can a GP prescribe hormones without a letter?

Yes, many can. AusPATH’s informed consent standards are written for GPs and describe how.

Do I need to see a psychiatrist first?

Not usually. Adults in Australia can usually start through a GP.

What if my doctor asks for a letter anyway?

We can help. A letter for hormones is usually quicker than one for surgery.

Can I get support while I start hormones?

Yes. Starting hormones can bring up a lot, good and hard. Therapy is there if you want it, at your pace.

Free guide: gender-affirming care at The Liminal Clinic.

A plain-language guide to how we work, hormones and surgery, Medicare, legal and social steps, support for family and carers, and services across Victoria and Australia.

New clientsGet the free guides

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