Hello coldwut: My pdoc knows about my gender identity issues. But it has not made any difference one way or the other. However, concerns such as pronouns & hormones, etc. are not of significance to me. I don't know how psychiatrists typically handle this in general. At least where I live, all psychiatrists do is prescribe & monitor psych med's. They're really not interested in anything else. The rest is left to therapists, if a patient has one. On the other hand, I would guess that having a letter of support, or a referral, from your pdoc would certainly be of benefit. So it certainly can't hurt to mention it I wouldn't think. And perhaps it may help.