Gender Affirming Surgery Letters
I provide behavioral health letters of support that are often requested or required for a gender affirming surgical procedure.
Please read more about my personal view on surgical support letters to ensure that I am able to offer what you are looking for.
I do not guarantee that I will write you a surgical support letter. However, I will be able to tell you in one session whether I will be able to write you a letter or not, and if I do not write you a letter, I will refund your session fee.
My letter reflects my clinical assessment as a psychologist. It is not a determination of medical necessity — that determination is outside a psychologist's scope of practice — but insurers and surgeons typically accept it as the required behavioral health support letter.
You do not need to prove your transness to me.
FAQs
Aren’t these letters just an additional barrier?
I conduct these assessments in a manner that attempts to reduce gatekeeping and be as minimally invasive as possible. It is possible that your insurance and/or your surgeon may require me to include specific phrases, statements, diagnosis, or information about you in order to accept my letter as sufficient. I will be as transparent with you as possible about these requirements.
What is the age cutoff for adults - 18 or 19?
It depends on what state you live in, what state you intend to receive medical care in, what state your insurance is in, and what state you are in when I perform the assessment for a letter. We can talk about this!
Are there any location based limitations?
You must physically be in a state that I am licensed in when I am performing your assessment for your letter. I am currently able to offer this specific service in Connecticut and New York, given the shifting legal landscape around gender-affirming care nationally — even though I see clients for general therapy in many more states via telehealth. You must be in Connecticut or New York when we do our interview, even though it is conducted via telehealth. If you are choosing to travel for this process, please let me know so that I can support you with a safe travel plan.
Where do i get information about legal matters?
Advocates for Trans Equality (A4TE) - https://transequality.org/
Know Your Rights: Healthcare - https://transequality.org/resources/know-your-rights-healthcare
Movement Advancement Project (MAP) - https://www.lgbtmap.org/
Map of “shield” states for transgender healthcare - https://www.lgbtmap.org/equality-maps/healthcare/trans_shield_laws
Map of bans on medical care for transgender youth - https://www.lgbtmap.org/equality-maps/healthcare/youth_medical_care_bans
Erin in the Morning - journalist covering transgender news and legislation - https://www.erininthemorning.com/
Lawyers for Good Government Policy Resource Hub - https://transrights.lawyersforgoodgovernment.org/
Adults
For adults, I offer two options:
Streamlined Surgical Letter — choose this option if you have already thought through most of the aspects of your surgery. You know who your surgeon is, you know what procedure you’ll be getting, you have an aftercare plan, you might even have a current therapist that you’ve talked about these things with. I’ll help you run through the requirements for a letter and do my best to take only 1 or 2 sessions.
Comprehensive Surgical Support and Letter — choose this option if you think it would be helpful to talk through some of these decisions. We can talk about how to advocate for yourself with a surgeon who is talking too fast or if you’re confused about the process. I can help guide you on where to look to learn about different procedures. This option will also include a surgical support letter, and usually lasts 2 or more sessions.
Youth
For youth, I only offer Comprehensive Surgical Support and a Letter. This option is at least 2 sessions long, one with the youth, and one with a legal guardian. I also usually consult with another provider that is supporting you in your care — such as a therapist, endocrinologist, or surgeon.
We will go through the standard requirements for a letter as well as work together to ensure that you have appropriate supports in place. I will help create a plan for how to ensure that you get all the information you need to be fully informed about the decision you are making, and to give yourself the best chance of psychological wellbeing afterwards.
Many of the young people and families I work with are also navigating neurodivergence alongside gender identity. I believe that your neurotype should not impede your ability to access gender affirming care.