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Around the globe, trans and gender diverse people have a wide range of access to health care, psychological as well as physical, that is unique to their home country’s context. Some of the contributing factors are nations’ health care systems, laws and policies surrounding discrimination, adequate resources, and under-trained health care professionals. Unfortunately, inability or difficulty in accessing transition related health care and support leads to negative impacts on mental health. In this article, the authors describe the unique contexts related to transgender health care in Canada, Japan, South Africa, and the United States. We focus specifically on the financial cost of transition for trans and gender diverse people, including gender affirming surgeries as well as mental and health care more broadly. We discuss the role of mental health professionals as advocates for gender affirming care and the fundamental human right to health care. We include discussions of therapy, assessment, medical care such as hormone replacement therapy (HRT) and surgeries, and additional invisible costs. We highlight the importance for all mental health professionals to be aware of the impacts to trans and gender diverse people’s mental health when their fundamental health care needs are not met. Furthermore, we provide recommendations for how mental health professionals can advocate for their clients’ access to transition related care.

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