Frequently Asked Questions About Using Informed Consent for Access to Trans Health (ICATH)

ICATH promotes the idea that people of all gender presentations can access gender affirming healthcare through making informed decisions.  ICATH promotes autonomy, the right to self-determination, and access to gender affirming health care without a requirement to go to therapy that pertains only to trans people.  People who are transgender, intersex, and gender non-conforming should not HAVE to go to therapy to get the gender affirming health care they want and need, and should self-determine what kind and amount of therapy is right.

In some standards of care, this step of accessing gender affirming health care services through therapy takes several months to a year, and often requires the individual to take on a diagnosis of Gender Dysphoria, formerly known as Gender Identity Disorder.

The process for getting a letter can be costly and harmful. ICATH empowers people to get the medical care they require with the same standards that non-trans people use to acquire gender affirming health care.

How much does it cost to use Informed Consent?

There is no cost to use ICATH or any materials included on this website. Informed Consent is not a product, it is a model, a standard of care that honors an individual to make an informed decision about the health care they wish to access.

Do I have to pay for an ICATH appointment? Why?

ICATH advocates/providers are medical and mental health care providers who embrace the use of informed consent for their clients and patients accessing gender affirming care. ICATH is not an agency.  Providers assign fees to their work in order to compensate for time and business costs.

How much does it cost to see an ICATH therapist/advocate?

Rates vary from provider to provider. Many clinics and advocates/therapists have insurance and low-cost/sliding scale payment options.

ICATH is not an accrediting body, nor is it a code of ethics involving external sanctions. If you are seeking care, verify that your therapist/advocate and medical providers are licensed to practice according to the laws and regulations in their state or country. Those using informed consent in their practice are entitled to link to their website and to describe themselves as providers who support their consumers to access gender related care using informed consent.

How does it work?

Informed consent is an idea that is used throughout medicine, and so the application to accessing hormones and surgery is similar.  The process for using Informed Consent for Access to Trans Health is best outlined here.

Do I have to have a letter from a therapist/advocate to have gender affirming healthcare from a medical provider?

Not always.  Sometimes a medical provider will provide hormones or surgery without a letter. If possible, do contact the doctor of your choice to establish a relationship and to voice your intent to transition medically.   Sometimes the medical provider will prescribe hormones/surgeon will operate without a letter from a therapist/advocate. You should expect that they will go through the process of obtaining Informed Consent with you by reviewing the expected outcomes of treatment as well as any potential side effects.

Please note that most/all non-trans people are able to obtain this kind of medical care without any such letter.

What kind of doctor can prescribe hormones? Endocrinologist? General practitioners?

Most people seeking hormone therapist are able to do so through a general practitioner, and do not need to go to a specialist like an endocrinologist. However, other health conditions may necessitate care from a specialist, such as an endocrinologist.

There are already standards of care that medical providers follow when administering hormone replacement therapies.

How is consent given?

Consent is given by the patient (or their guardian, if under 18) at the medical office where they seek care. Patients can indicate to their provider that they are informed of the benefits, risks, impacts etc of their treatment and thereby consent to receiving the gender affirming health care they seek.

Is there a list of providers that use informed consent?

ICATH does not maintain a list of providers.

  • ICATH is not designed to determine or promote who is/isn’t competent to provide services to people who are transgender, intersex or gender non-conforming.
  • If you are seeking healthcare, please refer to local resources for the best referrals and be sure to ask your providers about their experience working with transgender, intersex, and gender non-conforming clients/patients.
  • If you are a provider new to working with transgender, intersex and gender non-conforming people, there are resources you can use to educate yourself on how to serve all people with respect and sensitivity.
  • If you are new to using informed consent and have questions about its application after reading through the website, please visit our list of trainings (forthcoming, temporarily unavailable.)
  • ICATH is a concept that anyone can embrace and promote.
  • Providers do not need ICATH’s permission,’ or ‘endorsement’ to use ICATH.
  • If you are seeking healthcare and wish to use Informed Consent to access gender-affirming healthcare, please DO share ICATH with your current providers!

How can I become an Informed Consent Provider?

Any provider can work with informed consent in their practice.  There is no cost associated, nor is any training required.  Some providers who use informed consent for clients/patients seeking gender specific care may choose to link their website to Please do so if you feel this would be helpful for your clients.

What kind of training is available?

There are no current trainings offered, please follow us here on WordPress, and on our facebook group and community for updates