We are certified and versed in a variety of tools to support this process, including the Gender Affirmative Supportive Surgery Evaluation Tool (ASSET) and the World Professional Association for Transgender Health (WPATH) Standards of Care. 

Completing your assessment can range in time, typically between one and three sessions, depending on surgery type and individual history. The time an assessment will take will vary, and the reasons will be an open conversation between you and your clinician, to which you are welcome to bring questions or concerns. At times, the assessment results may include a referral to a co-clinician for ongoing therapy or other services.

Assessment sessions are 50 minutes, and clients should expect to meet for 1 to 3 sessions.

The assessment typically includes four sections:

• Overview and informed consent for discussion

• Gender history

• Mental health assessment

• Surgery preparedness

If it is determined that your clinician will provide you with a letter, it will be prepared within 2 weeks of the final appointment, and the clinician will email or fax it to the necessary parties at your request. 

Completing this assessment is not the same as receiving mental health therapy. This assessment is meant to be a short-term assessment, lasting only a few meetings, with the main goal for the clinician to assess, whereas therapy would be a more long-term relationship that would focus on supporting and improving a client's mental health, rather than providing a supportive one-time service.

We are happy to continue being a resource to you, whether that means follow-up questions about the surgery process or the letter, or insurance questions regarding gender-affirming surgery coverage, or being a therapist you reach out to in the future for therapy services. 

Below is a non-exhaustive list of surgical procedures obtained from the 8th Version of The Standards of Care for the Health of Transgender and Gender Diverse People, for which we write letters for:

• Facial feminization surgery (including chondrolaryngoplasty/vocal cord surgery)

• Gender-affirming breast surgery

• Body contouring procedures

• Orchiectomy

• Vagino/vulvoplasty

• Aesthetic procedures

• Procedures designed to prepare individuals for surgery (i.e., hair removal)

• Facial masculinization surgery

• Gender-affirming chest surgery

• Hysterectomy/ oophorectomy

• Metoidioplasty

• Phalloplasty (including placement of testicular/penile prostheses)

• Self Pay

• $200 per session, payment plans available upon request.

• Eligible Insurance Pay

• $200 per session, billable to eligible insurance. 

Please note that in order to bill your eligible insurance, your clinician will need to submit a diagnosis code to your insurance.