August 26, 2023 2 min read

Changing one's gender markers is a significant milestone for many transgender and gender non-conforming individuals. In South Africa, the process can involve multiple steps, including obtaining medical letters to confirm the change. If you are a patient within the MSH network or looking to become one, this guide aims to walk you through the process of securing a letter to change your gender markers.

For Existing MSH Patients:

Step 1: Contact Reception

If you are an existing patient with an MSH provider, the first step in obtaining your letter is to inquire with the receptionist about the procedure. They can guide you through the necessary steps and inform you of any required documentation. 

Step 2: Book an Appointment

Usually, you will need to book a short appointment to discuss this matter further with your healthcare provider. 

In-person Booking: Phone or WhatsApp the reception desk at +27 (0)61 302 6730 or email to schedule the appointment

Online Booking: Use the relevant booking link here to schedule your appointment online.

Step 3: Payment for Courier (If Applicable)

If you choose the online appointment option, you may also be required to pay a courier fee for the delivery of the original letter. This is because the letter must contain an original signature and stamp from your doctor's office.

Step 4: Obtain a Second Letter

The second letter is written by a person who reviews your medical records and confirms that you are on gender affirming hormone therapy. Your therapist/psychiatrist can provide your second later, but you can also be referred internally within the MSH network of doctors for this purpose.  This makes it possible to obtain both your letters for less than R1500 (in 2023).

For New Patients:

Step 1: Book an Appointment as a New Patient

If you are not an existing MSH patient, you will need to book an appointment as a new patient with one of our doctors who can provide you with the necessary letter. You must have been on gender-affirming care for more than six months to receive a letter.

New Patient Booking: Use the relevant booking link here to schedule your appointment.

Step 2: Attending the Appointment

During your appointment, you'll need to discuss your history of gender-affirming care. If you are not on gender affriming care yet, the process can be initiated by your chosen provider at MSH.

Additional Information:

Please note that specific details like courier fees or internal referral processes may vary by location or specific provider within the MSH network.

It's always a good idea to double-check with your provider on the current policies and procedures, as they may have changed.


Securing a letter to change your gender markers is an essential step in your journey. MSH strives to make this process as smooth and respectful as possible. Should you have any further queries, feel free to reach out to your healthcare provider for assistance.

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