Gender-Affirming Surgery Letter Evaluations
Let's keep gatekeeping
to a minimum.
I provide telehealth evaluations for gender-affirming surgery and, when clinically appropriate, WPATH SOC 8–compliant letters of support for your surgeon and insurance. My approach is affirming and informed-consent based. My job is to support your care, not stand in the way of it.
A letter written with care,
& minimal gatekeeping.
Evaluations are a standalone service — you don't need to be an ongoing therapy client. If a letter is clinically appropriate after your evaluation, it's written on letterhead and tailored to your surgeon's and insurer's requirements. I follow WPATH Standards of Care (SOC 8) and an informed consent model throughout.
Evaluations for Gender-Affirming Procedures
You need this if: you're 18 or older and your surgeon or insurance company requires a letter of support from a licensed mental health provider before gender-affirming surgery.
Most surgeons and insurance companies require a letter of support from a licensed mental health provider. I provide evaluations and, when clinically appropriate, letters meeting WPATH Standards of Care (SOC 8) for clients physically located in California, Oregon, or Washington at the time of the evaluation.
My letters are thorough and personal, written about you rather than filled in from a template — and without the paternalism too many trans folx have had to navigate to get here. I update them regularly to reflect current insurer and surgeon requirements, which helps keep insurance pushback to a minimum.
SOC 8 only requires one letter, but some surgeons still ask for two. If you already have one letter and need a second, I can provide that too.
What to expect
start to finish.
The evaluation is a clinical conversation, not an interrogation. I'm not here to test whether your gender identity is real — I'm here to gather what's needed for a thorough, accurate evaluation and, when clinically appropriate, a letter that helps trans and gender diverse folx access the care they deserve.
- You must be physically located in California, Oregon, or Washington during your session.
- Video must remain on for the entire session — no exceptions. This is a safety and documentation requirement.
- Valid government-issued ID must be uploaded securely before the session begins.
- You must be 18 years of age or older to receive a surgery letter evaluation.
- Sessions are held via secure HIPAA-compliant telehealth.
Reach Out & Schedule
Get in touch via the form below and let me know what procedure you're seeking the evaluation for and who your surgeon is. A $100 deposit reserves your time and is credited toward the total fee. Before your session, you'll upload a valid government-issued ID securely through the portal.
Evaluation Session (30–60 min)
We meet via secure telehealth, typically for one session. I assess gender identity, gender dysphoria symptoms, and treatment readiness using DSM-5-TR criteria, along with a risk-benefit discussion of your affirming care options.
Your Letter, If Clinically Appropriate
If a letter is clinically appropriate, I write it on professional letterhead, tailored to your surgeon's and insurer's requirements. You'll have a chance to review it before it's sent, and if anything needs adjusting to better reflect your situation, we address it then. A letter is not guaranteed.
Delivery & Provider Consultation
The letter goes to you or directly to your surgeon and insurance company, and it's valid for one year from the date of the letter. Up to 30 minutes of consultation time with your medical team is included. Revised letters and letters for future procedures are included too — no additional fee.
Transparent pricing,
no surprises.
Evaluations are private pay, $225 total. A $100 deposit reserves your time, and the remaining $125 is due for the evaluation. That covers the evaluation, a letter if clinically appropriate, up to 30 minutes of consultation with your medical team, and any future revisions or letters for additional procedures. There are no additional charges after that.
HSA and FSA cards are accepted, and I provide a superbill you can submit for out-of-network reimbursement. Have Cigna? I'm in-network, so Cigna members can have their evaluation billed directly instead.
I'm also licensed in New York (LMHC #015648), but evaluations aren't currently available there. New York folx are welcome for therapy, and I can share referrals for New York–licensed evaluators.
Need a letter?
Let's get started.
Standalone evaluations · $225 total · Telehealth in CA, OR & WA
Common
questions.
Do I have to be your ongoing therapy client to get a letter?
Do you use a gatekeeping model?
How long does the process take?
How much does the evaluation cost, and can I use insurance?
The evaluation is $225 total. For private pay, a $100 deposit reserves your time and is credited toward the total. HSA and FSA cards are accepted, and I provide a superbill you can submit for out-of-network reimbursement — many plans reimburse part of the fee.
I'm in-network with Cigna, so Cigna members can have the evaluation billed directly.
What if I need letters for multiple procedures?
Is a letter required for all gender-affirming surgeries?
What do I need to bring to the evaluation?
What does WPATH SOC 8 mean, and does it matter?
Which States do you provide evaluations in?
I provide evaluations to clients located in California (LPCC #4340), Oregon (LPC #C8199), and Washington (LMHC #LH60684311) via secure telehealth. You need to be physically located in one of those states during your evaluation.
Evaluations are not currently available in New York. New York folx are welcome for therapy, and I can share referrals for New York–licensed evaluators.
Let's connect.
This form is delivered via Paubox HIPAA-compliant secure messaging — your information is encrypted end-to-end. Fill it out and my intake coordinator will be in touch within one to two business days.