Gender-Affirming Care Services
You are in the right place
For many transgender & nonbinary folks, pursuing aspects of a medical transition can be a life-changing endeavor, bringing increased experiences of hope, joy, affirmation, and peace. Sometimes, doctors prescribing gender-affirming hormone therapy (GAHT), surgeons completing gender-affirming surgeries (GAS), or insurance companies require documentation from mental health professionals that support a client’s pursuit of care and justify the care as “medically necessary”. This is common when clients are using their health insurance to cover the cost of services.
If this describes your situation, you’re in the right place. I also provide short-term services for clients who need a brief assessment and supportive documentation to continue on their journey of connecting authentically with themselves.
Your Guide to Affirmation
I have personal experience navigating a medical transition for my own physical and emotional wellness. My goal is to assist you with meeting requirements from other providers with the fewest opportunities for gatekeeping possible.
Gender-Affirming Surgery Letter Assessments:
step one
My standard WPATH letter assessments take place over 3 one-hour sessions. After you reach out, we’ll schedule our first session and clarify billing information. I’ll send you the standard intake forms I send to all clients through a secure online Simple Practice portal.
step two
Our first session will be a typical intake: I’ll spend about an hour getting to know more about you as a person, what’s brought you to pursuing affirming surgery, and collect some general background information.
step three
The following two sessions will be focused more specifically on collecting relevant information for your surgery. I will be asking you questions about your gender journey and other topics relevant to current WPATH Standards of Care to ensure your letter meets these qualifications (click here to view them for free - jump to Appendix D).
In my assessments, I ask questions that are not required by the WPATH SOC. These questions focus on balancing the content of the letter between addressing gender dysphoria and justifying the need for surgery, and the presence of gender euphoria and what impact you expect surgery will have on your overall wellness. I do my best to incorporate empowering and hopeful statements in my letters to justify the necessity of the procedure, rather than you proving it to me, your surgeon, or your insurance company.
Depending on the depth of your answers, these assessments occasionally go longer than 3 sessions. I will let you know if that is necessary, at which time we’ll schedule a final 4th session to make sure we cover the necessary information.
step four
After our final session, I will take 1-2 weeks to compile the information we discussed into a letter that meets your requirements for surgery in the most affirming and empowering way possible. I will send you an unsigned draft to review; once I receive approval from you, I’ll sign it, upload it to your Simple Practice portal, and send you and/or your surgeon’s office a copy.
Informed Consent Session:
Gender-Affirming Hormone Therapy:
step one
My standard Informed Consent sessions to begin gender-affirming hormone therapy (GAHT) take place one 90-minute session. After you reach out, we’ll schedule our session and clarify billing information. I’ll send you the standard intake forms I send to all clients through a secure online Simple Practice portal.
step two
The first half of our session will be a typical intake: I’ll spend about 45 minutes getting to know more about you as a person, what’s brought you to pursuing GAHT, and collect some general background information.
step three
The latter 45 minutes will be focused more specifically on discussing your knowledge about the likely benefits & potential risks of beginning GAHT. My approach to these sessions is straight-forward: I’m here to talk with you about the pros & cons of what you’re signing up for.
step four
After our session, I will take up to 1 week to compile the information we discussed into a letter that meets your requirements for starting GAHT in the most affirming and empowering way possible. If you were given a form by your doctor that requires my signature, I’ll complete it wherever necessary. In either case, I will send you an unsigned draft to review and for you to sign as necessary; once I receive a copy with your signature, I’ll upload it to your Simple Practice portal for documentation purposes.
Frequently Asked Questions
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When you’re working with me, you will never have to prove that you are “trans enough” to pursue any form of gender-affirming treatment. Simply the fact that you are contacting me for this documentation indicates to me that you’ve thought about this decision and feel confident pursuing it. My goal is to empower you to continue feeling informed and confident in your choice, no matter what choice you ultimately make.
My assessments focus more on your understanding of the treatment, potential risks and side effects, the benefits you expect following the treatment, and creating a plan to navigate any risks if they happen to you. I may ask you questions about the possibility of certain circumstances and what steps you’d take to address them, but I only ask them in service of helping you feel prepared for possible outcomes - never as a way of discouraging you or talking you into any decision.
Above all, this journey is yours to make. My role in this process is to help you get the care you need, not to judge whether you deserve to get it.
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Assessments meeting current WPATH Standards of Care are often required to support a client’s pursuit of care. Conducting these assessments allows clients to speak with a professional about the pros & cons, risks & benefits of the care they’re seeking, as well as ask any relevant questions they have before consenting to the treatment. This is known in the healthcare profession as informed consent: a patient’s right to be fully informed about a decision before consenting to it. The principle of informed consent exists in every realm of healthcare, from signing waivers before getting dental braces to conversations with doctors about the side effects of new medications and everything in between.
As the current system for gender-affirming healthcare is designed, these informed consent conversations often happen directly with your doctor or surgeon AND an outside mental health professional (especially for those using insurance to cover the costs). There is a lot of room for improvements to this system that could decrease the bureaucratic hoops and barriers to navigate while still ensuring informed consent prior to treatment. I strive to help clients understand & navigate these hoops as smoothly as possible while advocating for change for the future.
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Some larger organizations - like hospital systems or nonprofits - may have more capacity and funding to conduct these WPATH Letter Assessments in one session. Often, these singular sessions can last 2-3 hours at a time in order to collect the necessary information, assess informed consent, answer any questions you may have, and provide helpful referrals. This is approximately the same amount of time it would take for my assessment process; the major difference is that I spread out the 2-3 hours rather than them being condensed.
One primary benefit of separating assessments by the hour is that it allows for more streamlined insurance billing that can make assessments more financially affordable for clients. Even when clients are paying for sessions out of pocket, it can be useful to have time between sessions to reflect & consider our conversations during the assessment, and consider more questions you may have to bring into the next session.
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If we are using your health insurance to cover the cost of the assessment, you will only be responsible for paying your out of pocket requirements per your health insurance plan (your deductible amount, copay or coinsurance, etc.) Please contact your health insurance provider for clarification on what your responsibility would be for outpatient mental/behavioral healthcare. For more context on what these terms mean, please visit the Insurance tab.
If you are planning to pay for sessions without health insurance, typical billed rates are as follows:
Initial session: $255
Subsequent 60-minute sessions: $200
Subsequent 45-minute sessions (optional): $175
Subsequent 30-minute sessions (optional): $145
If these rates are not affordable for you, please visit the Sliding Fee Scale page for my policies on making my services affordable. I am open to ongoing discussions on reduced private pay amounts, and I offer payment plans to reduce financial strain.
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If we are using your health insurance to cover the cost of the assessment, you will only be responsible for paying your out of pocket requirements per your health insurance plan (your deductible amount, copay or coinsurance, etc.) Please contact your health insurance provider for clarification on what your responsibility would be for outpatient mental/behavioral healthcare. For more context on what these terms mean, please visit the Insurance tab.
If you are planning to pay for sessions without health insurance, typical billed rates are as follows:
Initial session: $255
Subsequent 45-minute sessions (optional): $175
Subsequent 30-minute sessions (optional): $145
If these rates are not affordable for you, please visit the Sliding Fee Scale page for my policies on making my services affordable. I am open to ongoing discussions on reduced private pay amounts, and I offer payment plans to reduce financial strain.
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Imagine: you start out feeling guarded about speaking to a therapist and feel resentful or confused about needing to speak to a stranger before accessing surgery. Then, after a few sessions, you find that it feels good to talk about your feelings with someone who gets it, and can help provide additional insight or perspectives about your journey.
This happens to a lot of clients I’ve seen in the past. I’m always open to discussing this as an option if you change your mind during the assessment and would like to pursue long-term services with me, rather than only short-term assessment services.
I’m always happy to discuss this option with you when you’re interested. If I don’t have capacity in my schedule to continue long-term sessions with you, I’ll provide referrals for you to continue therapy with a provider who may have more availability.
