Psychiatrists have long been charged with access and coordination of care for transgender persons. This is now challenged by the World Health Organization's removal of diagnoses of mental illness related to gender identity in the 11th revision of the International Classification of Diseases. Using French field experimentations based on informal and primary care and free and informed consent, we discuss key challenges for a new organization of mental health care respectful of human rights. Developing informal and primary care as well as peer support has emerged as promising. Mental health expertise should be transferred from tertiary to secondary care.
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