Gender-Affirming Surgery Letters & Evaluations

I provide independent psychological evaluations and letters of support for adults seeking gender-affirming surgery. Evaluations are completed through secure telehealth and are designed to be thorough, collaborative, and respectful of your autonomy.

Letters are available for procedures including:

  • Facial surgeries (e.g., FFS)

  • Chest masculinization / top surgery

  • Breast augmentation

  • Vaginoplasty and vulvoplasty

  • Phalloplasty and metoidioplasty

  • Orchiectomy

  • Hysterectomy

  • Other gender-affirming procedures

What To Expect

The evaluation focuses on the information relevant to your planned surgery and recovery. We will typically discuss:

  • Your gender history and surgical goals

  • Your understanding and expectations of surgery

  • Relevant medical and mental health history

  • Informed decision-making

  • Social support and postoperative assistance

  • Housing, transportation, work/school leave, and recovery plans

  • Any concerns that could meaningfully affect surgery or recovery

I use a structured psychosocial assessment and surgery-recovery education process informed by the Gender Affirmative Supportive Surgery Evaluation Tool (ASSET 2.0).

The goal is not to determine whether you are “trans enough.” It is to complete a clinically thorough evaluation, help you prepare for surgery and recovery, and provide appropriate documentation to your surgeon and/or insurance company.

How the Process Works

1. Check your requirements. Ask your surgeon and insurance company whether they require a letter and whether they have specific documentation requirements.

2. Schedule your evaluation. Evaluations are completed through secure telehealth in jurisdictions where I am authorized to practice.

3. Complete the evaluation. We will review your surgical goals, relevant history, informed decision-making, and preparation for recovery.

4. Letter preparation. When the evaluation supports proceeding with surgery, I prepare an individualized letter addressing the relevant clinical and documentation requirements.

Experience in Transgender Health

Transgender health has been a major focus of my clinical, research, and professional work for more than nine years. I have worked with hundreds of transgender and gender-diverse individuals and families.

My background includes:

  • Co-author of the WPATH Standards of Care, Version 8 (SOC8)

  • WPATH Global Education Initiative SOC8 Certified Member and Mentor

  • Former WPATH Board Member (student representative)

  • WPATH member since 2014

  • Published transgender-health researcher

  • Experience training and mentoring other healthcare professionals in transgender health

Learn more about me here.

Request Consultation or Appointment

Frequently Asked Questions

  • “WPATH letter” is an informal term commonly used for documentation supporting gender-affirming medical or surgical care. It may also be called a letter of support, referral letter, surgical-readiness letter, or letter of medical necessity.

  • It depends on your surgeon, procedure, and insurance plan. Requirements vary, so I recommend confirming exactly what documentation is needed before your evaluation.

  • The number of appointments depends on the procedure, your individual circumstances, and the requirements of your surgeon or insurance plan. My goal is to complete a thorough evaluation without unnecessarily prolonging the process.

  • Yes. Evaluations are completed through secure telehealth for clients located in jurisdictions where I am authorized to provide psychological services.

  • There is no single transition pathway that applies to everyone. Requirements can differ depending on the procedure, surgeon, and insurance plan. Your individual gender goals and circumstances are considered as part of the evaluation.

  • No. You do not need to complete a predetermined course of psychotherapy with me before undergoing an evaluation.

    A surgical-readiness evaluation is different from ongoing psychotherapy. If you already have a therapist, you generally do not need to transfer your therapy to me in order to complete an independent evaluation.