Are you looking for a letter for an upcoming surgery?

We consider it an honor to be invited along on your gender journey. We are truly excited to support you in this next step towards medical affirmation.

• This process is meant to be collaborative. Please check in at any time if it does not feel that way.
• Our practice capacity may result in a delay. Please plan ahead to allow ample time. Unless otherwise discussed, please allow up to 2 weeks after we meet for a letter draft and 1-2 business days after finalizing to fax to your surgeon.
• By the end of the first appointment, we will confirm whether we can provide a letter, as well as indicating potential follow up questions and recommendations for further follow up.
• We will coordinate care as relevant prior to completion of the letter.
• The surgery assessment process is in line with GALAP values. We offer insurance sessions, sliding scale rates, and pro bono sessions for these assessments/letters.
• The assessment relationship ends after the letter is provided.
• We can discuss further options if you are seeking ongoing treatment with our office.

Your Responsibility:

With this being a collaborative process, we have requests of you both before the assessment and during the assessment. By following these, we will be able to provide you the best service.

Pre-Appointment To Do:

• Paperwork: Please complete at least 24 hours ahead of time. Please complete any surgery related information.
• Releases of Protected Health Information
  • Required: The surgeon(s) you are considering for surgery.
  • Requested: Your primary mental health therapist and/or prescriber.
  • Your primary care doctor and/or hormone prescriber.
• Supportive Documentation:
  • “Certificate of Coverage” – insurance company’s medical necessity criteria for the medical procedure (search online, ask for something from the insurance company, or the surgeon’s office may be able to help)
  • Surgeon Requirements for the letter plus instructions on how to send it.
  • Primary Behavioral Health Letter if seeking a second mental health letter from us.

Components of Assessment:

• Your experience of gender dysphoria and how surgery might be helpful.
• Exploring your thoughts about psychological impacts and risks/strengths and areas of social/mental health support.
• Planning for the procedure itself as relevant.

Our Responsibility to You:

• Validate you and support your autonomy in the process.
• To be efficient, thorough, and intentional.
• Assess the criteria based on the various guidelines/requirements.
• For the letter to reflect accurately your experience of dysphoria and the benefit of surgery, as well as your ability to make an informed decision.
• Coordinate care with the other mental health and medical processionals on your team as appropriate.
• Collaborate around your goals and language in the letter as well as identify questions for follow-up with the surgeon’s teams.
• Minimize barriers and gatekeeping that impact the community.