Assessment for a Gender Affirming Surgery Letter

We understand that being assessed by a mental health care provider is required for gender-affirming surgeries and is not necessarily a choice you have made. At Transcend, we believe in gender-affirming mental health care and informed consent.

Below, we outline the options available for you or a loved one seeking a clinical letter, along with what clients should expect while seeking this service.

Assessment 1-3 Sessions

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

What you can expect:

  • Sessions for assessments begin at one hour and clients should expect to meet for one to three 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 a letter, the clinical letter will be prepared within 2 weeks of the final appointment and the clinician will email/fax the letter 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 a clinician to assess, whereas therapy would be a more long term relationship that would focus on supporting and improving a client's mental health as opposed to providing a supportive one time service.

  • We are happy to maintain being a resource to you, whether that means follow up questions about the surgery process, the letter, insurance questions regarding gender affirming surgery coverage, or being a therapist that 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, and 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), body contouring procedures, aesthetic procedures, and procedures designed to prepare individuals for surgery (i.e., hair removal).

Fee Options:

  • Self Pay

    • To be determined upon consultation.

  • Eligible Insurance Pay

    • $200 for first session, billable to eligible insurance.

    • $175 per session after first 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.