Letters for Gender-Affirming Surgeries
Letters of “mental health support” written by licensed clinicians are typically required by surgeons and insurance companies as part of the process of accessing gender-affirming surgeries.
If you need a one-time assessment for a letter (not ongoing therapy), I may be able to help.
Letters for Gender-Affirming Procedures
*Openings for letter evals available!*
I have helped write letters for trans, nonbinary, and intersex folks seeking surgeries for several years. I’ve also gone through this process as a client!
My framework for this process is for it to be as transparent, simple, and non-invasive as possible. I’m not interested in gate-keeping. I want to help make sure you have the information and support you need, help you in addressing any concerns or hesitations you have, and not be an unnecessary barrier in your path.
More information is available in the drop-down section below.
Letter evaluations are available through commercial insurance and self-pay (info below) for adults in Massachusetts. More information about insurances I currently work with can be found on my Grow Therapy profile. While all booking and billing happens through Grow Therapy, the best way to contact me to start is through my contact page.
Please note that, in order to help establish eligibility for surgery, it's required that you have a diagnosis of Gender Dysphoria. I gather information about this throughout the letter evaluation process in various ways that are hopefully relatively non-invasive. I just want to be transparent that this diagnosis must be in your letter to meet insurance companies' and surgeons' requirements for gender-affirming surgery.
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This offering might be for you if you are an adult looking for a one-time evaluation for a letter of mental health support for gender-affirming surgery.
This offering is not ongoing therapy. Insurance regulations vary; however, a one-time evaluation is appropriate and accepted in many situations. If you are interested in ongoing therapy, I can help identify potential referrals. Some surgeons also request or require that patients have access to therapy before and/or after surgery.
If you are an intersex adult pursuing genital reconstruction surgery through the WPATH pathway due to the incredible barriers to intersex-affirming care by other means, I’m happy to work with you.
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-Get connected. The process starts by contacting me. Via email, we will determine a time that works for the evaluation.
-Make an account with Grow Therapy. If or when you decide to schedule the evaluation, you’ll need to get set up with an account with Grow Therapy. All of my clinical services are offered through the Grow Therapy platform, which manages billing and booking. When you make an account, it will ask you for your contact information, insurance information, and payment information (debit or credit card, for co-pays or co-insurance). Making an account also requires agreeing to Grow’s “practice policy,” which is linked on the registration page.
-Complete paperwork. Once we’ve scheduled a time for the evaluation, I will email you a link to a protected Google form; this form is designed to gather the bulk of the factual information required to be included in your letter by surgeons and/or insurance. This form also includes the release and waiver agreement for the evaluation (view/download the waiver here), which you’ll be asked to digitally sign. This paperwork must be completed at least 24 hours prior to our scheduled meeting, or we will need to reschedule. If you’d rather complete the form together, please just let me know!
-”Evaluation” session. This is our conversation. I will ask you about some of the information you shared on the form, as well as about your hopes and concerns for the procedure(s), and about your understanding of the risks and benefits of surgery. This conversation is generally about an hour long. On rare occasions—generally at the client’s request—we may meet a second time to continue the conversation before the letter. I meet with folks through Grow’s confidential video calling platform.
-Letter. Once all of your questions are addressed and we are able to demonstrate eligibility for the procedure(s), I will prepare your letter(s). This process generally takes up to a week (though often less). Once complete, I will send to you for review. I am happy to make any adjustments or updates if needed. Once it’s ready, it’s yours to share with surgeons as you see fit.
-Down the road. If you need your letter updated (such as to be addressed to a new surgeon), I’m happy to do this. For most situations, I can make updates without needing to have another appointment. If either of us feels that the update necessitates another conversation, we can schedule that!
-Questions. You’re welcome to reach out at any point during the process to ask questions or learn more!
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If you’re looking for other providers for letter support (e.g., you need a letter written by a doctoral-level provider or a provider outside of MA), the GALAP website might be a great place to start. I may also be able to offer additional referrals, if needed.
If you’re looking for ongoing gender-affirming therapy, you can search using Psychology Today’s many filters, or I’m happy to ask my networks for potential referrals.
My clinical services are in-network with most commercial insurances in MA (I’m unfortunately not eligible to accept MassHealth). You can see which insurances cover my services on my Grow Therapy profile. If you choose to bill services to your insurance, your insurance will determine what amount you are responsible to pay (your co-pay or co-insurance), which is billed to a credit or debit card.
A self-pay option also available for folks who don’t have insurance, don’t have insurance that I can bill to, or don’t want to use their insurance. Standard rates for self-pay evaluations (and additional sessions, if required) are offered on a sliding scale of $90-150 per session. The equity rate scale of $30-60 per evaluation (and additional sessions, if required) is available to queer and trans Black & Indigenous folks and other people of the global majority. You can learn more about how my rates work here.
***I also hold one free slot per month for folks who have insurance I can’t accept (e.g., Masshealth) and for whom the sliding scale is inaccessible; if you’re interested in this slot, please let me know when you connect to schedule.***