They need us: advocacy for trans liberation through affirmative letters of support

We are reaching a point in history when the transgender community needs support more than ever from mental health clinicians. According to the Transgender Legal Defense & Education Fund (TLDEF) and Gay & Lesbian Alliance Against Defamation (GLAAD), all leading major medical organizations recognize gender affirming care as medically necessary. Despite this, in the United States in 2025, there have been over 1,000 proposed anti-trans bills. This anti-trans agenda increases the threat to gender affirming medical care and many transgender people fear losing access to gender affirming care so are urgently seeking surgery. Guided by the World Professional Association for Transgender Health Standards of Care Version 8 (WPATH SOC 8), it is more important than ever for models of clinical work to advocate and support transgender people’s liberation and thriving despite the attack on their human rights. This article focuses on transgender care in the United States, and the mental health clinicians’ role in gender affirming care and writing letters of support.