Per WPATH Standards of Care p. 28:

• The client’s general identifying characteristics
• The duration of the mental health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date
• Results of the client’s psychosocial assessment, including any diagnoses
• Procedure needed

• Show “Persistent, well-documented gender dysphoria” (SOC p. 59)
• Narrative of the person’s trans history, including hormone use. If no hormone use, explain why that is clinically appropriate for that person.
• Narrative of gender dysphoria symptoms
• Note any history of gender-related depression, anxiety, self-harm, suicidality, etc.

• Dysphoria specifically related to the facial hair
• Using makeup to hide beard shadow
• Describe specific examples of impairment due to the facial hair (how they are limited presently socially, school, physically, etc.)

• Patient has capacity to make a fully informed decision
• Patient has provided informed consent for hair removal

• Indicate if you recommend permanent hair removal
• If you find it to be accurate, use the phrase “medically necessary,” which is defined in insurance policies simply to mean clinically appropriate care to treat a condition in accordance with generally recognized standards of care
• That hair removal is performed to treat gender dysphoria
• Indicate if hair removal will help to alleviate the person’s gender dysphoria