According to WPATH, the criteria for hormone therapy are as follows: 1. Persistent, well-documented gender dysphoria diagnosis by a qualified mental health professional; 2. Capacity to make a fully informed decision and to consent for treatment; 3. Age of majority (which varies in different countries and states). Recommendations for adults accessing hormones and surgeries? - Criteria - Number of letters - Qualifications of professionals providing letters - Hormones prior to surgery - Living in gender confirming role Informed consent – this means something different to everyone.