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Table 3 Patient identified challenges to obtaining letters of referral for surgery

From: Transgender women’s perspectives on mental health care related to vaginoplasty for gender affirmation

Theme

Participant Response

Long waiting period for appointments

5 (36)

Time intensive

4 (29)

Providers inexperienced caring for trans patients

3 (21)

Resistance from providers

3 (21)

Expense

3 (21)

Insurance issues

2 (14)

Confusion about letter writer requirements

2 (14)

Expiration of letters

1 (7)

None for this participant

3 (21)

  1. Data are n (%)