Letters for gender-affirming medical care

If your medical provider or insurer asks for a mental health letter, this page explains how the assessment works and what the letter can cover. You don’t need to start ongoing therapy to request one.

Start with your provider’s requirements

Requirements can differ by provider, procedure, and insurer. At the consult, tell me what has been requested and we’ll check whether my credentials and assessment meet it.

If you have the requirements in writing, tell me at the consult and we’ll arrange a secure way for you to send them.

What the process involves

1. A free consult

   You tell me what your provider or insurer asked for, and we check whether I can provide it.

2. An assessment

   One or more sessions on your goals, the parts of your history that matter for the letter, and what you understand about the care you’re seeking.

3. Documentation and next steps

   If a letter is appropriate, we go over what it will say and send it to your provider the way they want it.

How many sessions it takes, and whether I can write the letter, depends on what’s being asked for and on what we find.

My approach

I work from an informed-consent stance and write letters in line with WPATH Standards of Care, version 8. The assessment takes your identity as a given and sticks to what the letter actually needs to cover.

The provider or insurer decides whether to accept a letter. I can’t guarantee that they will, but we can go over their requirements and your questions before you go ahead.

Who this service is for

This service is for adults who are physically in Pennsylvania during assessment sessions and need documentation for gender-affirming medical care. We’ll confirm the specific request at the consult.

Fees and timing

The assessment is billed at the standard session rate, $195 per 50-minute session, and usually takes one session. At the free consult we’ll confirm the fee, what it includes, and how quickly I can turn the letter around for your request.

You may also want to read

• Ongoing gender-affirming therapy
• Information for referring providers