Documentation Service
Gender Affirmation Letters of Support
WPATH-aligned, informed-consent letters for hormone therapy and gender affirming surgical care, written from a place of trust rather than gatekeeping.
What Gender Affirmation Letters of Support Looks Like
WPATH-aligned, informed-consent letters for hormone therapy and gender affirming surgical care, written from a place of trust rather than gatekeeping.
WPATH Alignment
My letter writing follows the WPATH Standards of Care, version 8 (SOC-8), informed by ongoing community feedback and the informed-consent model.
- Letters reflect SOC-8 language and structure where insurance and surgical teams expect it.
- The letter affirms capacity for informed consent rather than rendering a diagnosis as a gate.
- Where you prefer, letters can be written using affirmative, non-pathologizing framing while still meeting documentation standards.
Process and Timeline
Step one. Free 30-minute consultation. We meet on HIPAA-secure video. You share what you are seeking the letter for, who the receiving provider is, and what your timeline looks like. I share what the letter involves and the fee.
Step two. One to three intake sessions. Most letters require one or two intake sessions. Complex history may add a third.
Step three. Drafting. After intake, I draft the letter using the SOC-8-aligned template adapted to your specific care goal and the receiving provider's documentation requirements.
Step four. Review and sign-off. You review the draft. I edit based on your feedback. I send the signed letter to the receiving provider, with a copy to you for your records.
Total timeline. Typically two to four weeks from consultation to signed letter, depending on session scheduling and case complexity.
Fees
Letter writing is billed at the standard individual session rate of $80 per intake session, plus a separate letter drafting fee. Final fee structure is reviewed during the free consultation.
Letter writing itself is generally not billable to insurance, though intake sessions may be reimbursable as out-of-network mental health visits depending on your plan.
Common Questions
- Letter writing itself is generally not billable to insurance, though the intake sessions may be. We can talk through the specifics during the free consultation.
- It depends on what you are seeking and which provider is receiving the letter. Many hormone therapy providers require one letter. Many surgical teams require one or two letters depending on the procedure. The receiving provider tells you what they need.
- Yes. Letter writing is its own service. Many people come for a letter without ongoing therapy, and we work together for the intake sessions and the drafting.
- Send it. I write toward what your provider needs while keeping the letter true to your story.
- Not at this time. I refer to colleagues with adolescent training when a minor needs a letter.
- A previous denial is not a verdict. We will talk in the consultation about what happened, what the receiving provider needs, and whether I am the right person to write the letter. If I am not, I will refer you.