The letters indicate the number of circling approaches to the airfield. It doesn't matter if they are based on traditional navaids or GPS.
At Laughlin, we had a TACAN-A procedure to get the T-38s in under certain circumstances. When we got an RNAV capable airplane, the Texan II, we put in a GPS-B to get the T-6s in under similar but slightly lower weather mins. The TACAN-A is out of the books, but the GPS-B stands as the second circling approach to Laughlin AFB, but is the only one in the books. The USAF publishes, names and builds approaches to the same criteria as NACO/TERPs.
When you have the Z/Y/X letters they designate approaches with slightly different ways to get to the same final approach segment. This is like the Y2K problem. What happens when civilization survives long enough to get 13 different circling approaches to the same airfield and the straight in has 13 different ways and we crash together at the letter "M"?
Hope this helps.