Gender-Affirming Letters of Support

Every letter follows the World Professional Association of Transgender Health (WPATH) Standards of Care Version 8.

The first step in the process is to schedule an intake and complete an interview. During this intake interview/initial session I ask a series of questions. We also talk about your goals, your preparedness for this next (and exciting) step in your life, knowledge of the procedure/plan, risks/benefits, tobacco use/cessation steps (if necessary), mental health and physical health history, social support, etc.

Believe it or not meeting with a mental health professional prior to your surgery is also a crucial aspect of the surgical procedure process and can ensure you get the required care before the situation gets out of hand post-surgery. It is also a great way to learn more about yourself and how you can meet your goals.

I view my job as ensuring you will be successful in your goals and with the requirements requested of you by your medical team.

My goal is to make sure we cover topics that could make you less likely to have a positive outcome from any medical intervention. I want you to be successful, happy, and healthy!

Many seeking gender affirming care already suffer from depression, anxiety, eating disorders, PTSD, and other problems. While mental health history is typically NOT a reason to delay or deny surgery it can be if symptoms and difficulties are not well managed, or a patient is unwilling to go to therapy.

Gender affirming care's goal is to improve your quality of life, but there are some things that could prevent this from happening. For example:

Current or active psychosis

Untreated bipolar disorder or current manic episode

Severe and active eating disorder

Active substance use or intoxication

Current plan or intent to harm oneself/severe and active self-harm

Recent hospitalization (either voluntary or involuntary in the last 6 months) for self-harm or suicidal ideation with no planned follow-up or support either therapeutically or with medication

Recent suicide attempt with no planned follow-up or support either therapeutically or with medication

Currently smoking or vaping ANY product (many surgeons will not perform surgery until after you quit)

Inadequate/limited post-surgical support

Difficulties adhering to medical recommendations/instructions

I do my best to provide letters after one visit; however, since everyone's health and mental health history, as well as current experiences are different I can't make any promises. Your safety and preparedness is my main priority.

If for any reason more than one appointment is needed we will work together during our appointment to ensure we are on the same page and have a plan for moving forward.

My job is not to evaluate whether you are "trans enough". I believe this is wildly inappropriate.

My primary goal is to assess where you are in your life and ensure it is a space and place where you can live authentically, but also recover both safely and in a healthy way with the support you need.

Medical transition steps can come with stressors and hurdles that can easily lead folks to feel emotional and stressed. I also want to make sure you will be able to cope with the many "hoops" folks are often stuck having to navigate as part of this process.

Yes! All letters are templated based on the WPATH guidelines to include all the information most surgeons and insurance want. You are more than welcome to send any documentation or requirements they have sent to you, to me and I can double check all the needed information will be included.

• Name of the doctor or physician you are working with

• Office address, telephone number, fax number, and email address of the surgical coordinator (if available)

• Date of next appointment or surgery 

• Knowledge of the procedure/plan, risks/benefits

• Mental health and physical health history