A 22-year-old transgender woman presents to the PMHNP reporting anxiety and depressive symptoms that began intensifying after she started gender-affirming hormone therapy 4 months ago. She describes strong social support from friends but reports being rejected by her family of origin. She denies suicidal ideation but reports significant distress related to slow physical changes and ongoing misgendering at work. The PMHNP plans a comprehensive assessment. Which of the following best reflects an evidence-based, gender-affirming approach to this patient's care?