Gatekeeping in the Transition Process

Gatekeeping within the transgender community is a term used to describe limiting or controlling access to medical interventions, such as hormone [Page 279]therapy and gender-affirming surgery, based on select criteria that determine eligibility or ineligibility for such interventions. The “gatekeeping model” was historically used by mental health and medical providers to distinguish “true transsexuals” (the term used to describe transgender people at the time), who were deemed to be adequate candidates for medical interventions, from other transgender people who expressed interest in medically affirming interventions but did not meet set criteria required and thus were denied access to treatment. The gatekeeping model originated with the medical model of transgenderism in the early 1950s, and despite several changes in the implementation of gatekeeping, forms of this ...