RT Journal Article SR Electronic T1 Gatekeeping hormone replacement therapy for transgender patients is dehumanising JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP medethics-2018-105293 DO 10.1136/medethics-2018-105293 A1 Florence Ashley YR 2019 UL http://jme.bmj.com/content/early/2019/03/08/medethics-2018-105293.abstract AB Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.