Evaluation and process improvement project to assess the needs of primary care behavioral health providers to increase competence and confidence surrounding gender affirming care and knowledge of World Professional Association of Transgender Health, Standards of Care version 8 (WPATH SOC8) letters of support within primary care model. A work group consisting of integrated behavioral health providers has developed and implemented a survey to assess the knowledge, skills, and experience of current providers as well as gather information on interest in training and preferred modalities. Templates for visit content, documentation, and letter writing have been developed and are currently in beta testing with work group members. Development of training course including multiple modules for providers to complete as desired will be rolling out this summer.