Letters of Support for Gender Affirming Care
In many cases, before someone can access gender affirming care, like gender affirming hormones (GAHT) or gender affirming surgery, insurance and the medical provider/s will require a letter.
Typically, this letter must be completed by a mental health professional. In some cases, this mental health professional must hold a doctorate degree. It’s always important to check with the requesting provider or your insurance to make sure the letter is written by the appropriate professional.
Some call this a letter of support, while others may call it a WPATH letter, letter of reference, clearance letter, or gender affirming care letter.
Despite different names, these are all the same.
I am aware of the long and problematic history these letters have created for the gender diverse community and do not agree with pathologizing anyone unnecessarily; however, I also know these letters are frequently required.
I want to make this process as easy and painless as possible so you can get the care you need. My focus is not only on qualifying or disqualifying patients for surgery. Instead, I see it as an opportunity to ensure you can have surgery and recover in healthy and successful way.
I also believe before any major life event it can be beneficial to talk to a therapist. Meeting with a mental health professional prior to your surgery can be a crucial aspect of the surgical procedure process and can ensure you get any required care before a situation gets out of hand. It is also a great way to learn more about yourself and how you can meet your goals.
I provide letters of support for ALL gender affirming care procedures (top & bottom surgery).
Let’s Get You A Letter
What Can I Expect?
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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.
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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!
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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) for self-harm or suicidal ideation
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
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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.
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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.
Rates & Payment
I am a PSYPACT provider. This means am able to see patients 18+ in all the following states: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming.
All appointments are 100% virtual using a platform called Simple Practice. All insurance payments are collected using a platform called Headway and all non-insurance payments are collected using a HIPPA secure platform/app called IVY.
To learn more about PSYPACT click here
To learn more about Simple Practice click here
To learn more about IVY click here
Letter of Support (self-pay):
Letter for Gender Affirming Hormones (GAHT): $150
Letter for Gender Affirming Surgery: $200
Discounted rates available for future letters/appointments. For example: if you receive a letter for GAHT and then need a surgical letter in the future this appointment will be discounted
Accepted Insurance (FLORIDA, MICHIGAN & VIRGINIA Residents Only):
Aetna, Carelon Behavioral Health, Cigna, Oscar, Oxford, United Healthcare, United Healthcare Medicare Advantage, Quest Behavioral Health, Blue Cross Blue Shield of Massachusetts (virtual network only), Horizon Blue Cross and Blue Shield of New Jersey (virtual network and FL residents only)
Please note: if your plan is affiliated with Medicaid or Medicare, I will not be able to accept your insurance at this time
