WPATH letter writing for gender affirming surgeries

Providing Gender-affirming surgery letters for trans and non-binary folks

You've made the decision to take the next step to start accessing gender-affirming treatment in the form of hormones, voice therapy, or surgeries. Your insurance or surgeon requires a letter from a mental health professional prior to approving your procedure(s)/treatment(s). It can be such a pain in the ass to have to jump through all the hoops just to become the person you've always known you were on the inside. I follow the World Professional Association for Transgender Health (WPATH) standards of Care. 

Breakdown of a WPATH assessment session

Step 1: Assessment
Before a letter can be provided, we’ll complete an assessment together so I can better understand your history, lifestyle, and needs.

Step 2: Gender-Identity Evaluation
We’ll also complete a gender-identity specific evaluation to assess for gender dysphoria and the medical necessity of gender-affirming procedures, in line with WPATH guidelines.

Plan for 60-90 minutes for this stage.

Step 3: What to Expect in Session
Some of what we discuss may be difficult, including past traumatic experiences or discrimination you’ve faced. Please know that this is a part of the process, and we’ll go at a pace that works for you. In session, I will always use your chosen name and pronouns.

Step 4: Your Letter
Insurance companies need to be able to identify you, so your legal name will appear on any letters. Your chosen name and pronouns will continue to be used in all of our sessions.

Step 5: Ongoing Support (Optional)
I often work with clients before and after surgical interventions, offering support before, during, and after recovery. If this is of interest, let me know during your intake session.

FEES

For a WPATH assessment/evaluation and letter the fee is $185 (US) or 185 euro in the Netherlands. If you want to continue follow up sessions they are 45-50 minutes each at the cost of $150 (US) and 150 euro in the Netherlands.

BOOK NOW

This service is a good fit if:

  • You are a looking to start or continue gender-affirming care. 
  • You are looking for a letter of support for gender-affirming surgery(ies). 
  • You identify as transgender and/or non-binary, or gender diverse. 
  • You are required by your surgeon and/or insurance to have a letter of support from a mental health professional. 

Book now

This service is NOT a good fit if:

  • You do not identify as transgender, non-binary, or gender diverse.
  • You are NOT seeking gender-affirming care.
  • You are looking for any type of conversion /reparative therapy (which is illegal and unethical). 
  • You are not willing to discuss your gender identity, gender expression, and/or sexuality. 

I would love to support you on the next step of your journey

Alicia Garber, headshot of owner/therapist at Inner Fire Counseling

I'm Alicia, a Clinical Counselor licensed in Idaho, Utah, and Oregon.  And an NIP registered psychologist in the Netherlands. I have specialized training in working with the members pf the LGBTQIA2S+ community, as I am a member myself.  If you'd like to learn more about me click the button below. 

About Me
Image of the US highlighting Oregon, Utah, and Idaho

WPATH LETTER WRITING FOR RESIDENTS IN THE FOLLOWING LOCATIONS:


IDAHO

  • Boise
  • Pocatello
  • Twin Falls
  • Idaho Falls

UTAH

  • Salt Lake City
  • Ogden
  • Logan
  • Park City

OREGON

  • Portland
  • Bend
  • Salem
  • McMinnville


Book Now

Frequently Asked Questions

Please reach me at innerfirecounseling@gmail.com (zivver) or click here to contact me if you cannot find an answer to your question(s). 

WPATH stands for the World Professional Association for Transgender Health. They are a professional organization that provides clinical guidance for health professionals to assist transgender and gender diverse people with safe and effective pathways to achieve lasting personal comfort with their gendered selves, and to maximize their overall health, psychological well-being, and self-fulfillment. Their standards of care are used by insurance companies to decide if you are approved or denied gender-affirming care. 

The assessment and evaluation along with a letter (if medically necessary) cost $185 (US( or 185 euro in the Netherlands.

No, I do not. I am not paneled with any insurance companies as I live outside the United States. I can provide a superbill which you can submit to your insurance for possible out of network (OON) reimbursement in the US only. Not possible at all for the Netherlands.

It takes between 60-90 minutes typically to complete the assessment and evaluation and the letter is provided (if medically necessary) within one week at the latest. 

No, I can do the assessment and evaluation in one session.

This can absolutely happen as long as I have availability in my schedule that matches your own. I often provide support pre and post surgery for clients. 

If you live in Idaho, Oregon, or Utah we are still good as those are the states I'm licensed in the U.S, and can see anyone 18+ in the Netherlands as well. If you live outside those states  or the Netherlands due to licensure restrictions I would NOT legally  be able to provide you with any services.