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Australian Government - Department of Foreign Affairs and Trade

Advancing the interests of Australia and Australians internationally

Australian Government - Department of Foreign Affairs and Trade

Advancing the interests of Australia and Australians internationally

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This sample text is for a letter from a registered medical practitioner certifying the gender of a sex and gender diverse applicant. This letter should be used for applicants who are intersex.

Registered medical practitioner’s letterhead

(including full name and contact details)

I, <medical practitioner’s full name> am the doctor of <name of patient> with whom I have a doctor/patient relationship and whom I have treated (or with whom I have a doctor/patient relationship and whose history I have reviewed and evaluated).

<Name of patient> is intersex and lives in the gender (specify new gender male or female).

OR

<Name of patient> is intersex and is of indeterminate sex.

Signature of medical practitioner

Signature block of medical practitioner

Registration number from the medical board of Australia (or equivalent overseas authority)

Department of Foreign Affairs and Trade

Department of Foreign Affairs and Trade