Gender Affirming Care 

Gender Affirming Therapy is a therapeutic stance that focuses on affirming a patient's gender identity and does not try to “repair” it.

If you or a loved one are in the process of transitioning or are looking to have a gender affirmative surgery, I want to help.

I am an openly Queer Licensed Clinical Social Worker in the state of New York and offer psychological evaluations for gender affirmative surgery candidacy (ages 18 and up).  I am dedicated to helping the transgender, non-binary, genderqueer, and gender-expansive community by providing this evaluation service along with individual therapy (if desired or recommended). 

As a Gender Therapist, I regularly complete gender affirming training, instruction, supervision, and consultation, which allow me the privilege to provide specialized psychotherapy services to transgender and gender expansive clients. My approach to your assessment and care is affirming and empowering, and is informed by lived experience.

I recognize that transphobia and transmisogyny are interwoven into our society and that the mental health profession has had an unfortunate history of perpetuating these ideas.  I am committed to being part of the change for good and live more fully within our values – you deserve nothing less.

What is a gender affirmative surgery evaluation? 

Under the current guidelines, transgender, non-binary, and gender non-conforming clients seeking gender affirmative surgeries must have letters from mental health providers attesting to whether they meet the guidelines for surgical intervention established by the World Professional Association for Transgender Health (WPATH). 

WPATH’s SOC 9 clearly states that gender-affirming procedures are medically necessary to treat gender dysphoria, and are NOT simply cosmetic. 

Anyone who is seeking an attestation letter must meet with a mental health provider for an evaluation (typically just an interview, but occasionally more than one session) to determine whether they are good candidates for surgery.  Based on the results of the evaluation, I will write a letter summarizing your candidacy and their recommendations. 

What is Included in a Gender Affirmative Surgery Evaluation?

What can I expect

Step 1: Schedule a 20 minute consultation to discuss your specific needs. At the end of the consultation we will discuss scheduling options for your evaluation. 

Step 2: Prior to your interview meeting, an email will be sent to you with a link to a private client portal in which you will complete initial paperwork and inventories prior to your interview session.

Step 3: Complete 90-minute clinical interview appointment.

Step 4: I will contact your medical provided for professional consultation

Step 5: I will provide your with the results of your evaluation and will follow your directions on where to send your letter (gender affirming therapy can be explored in additional (optional) appointments, if requested). 

What is the cost?

No waitlist.

Currently available for adult residents of, or those in, New York, USA. 

*As an advocates for equity and social justice, I do not want the ability to pay to keep you from receiving a letter from a mental health professional.  Please reach out to me if you have financial need.

FAQ for Gender Affirmative Evaluations and Letters: 

In order to obtain insurance coverage, there is a burden of proof placed upon trans* people; without a diagnosis of gender dysphoria to prove the medical necessity of a specific procedure, most insurers will deny the requested gender-affirming care. Whether or not I agree with the mandate of diagnosing trans people with a mental health disorder for the purposes of obtaining insurance coverage for medically necessary care (I don’t), I work within the system to meet the needs of my clients and to approach this work in a manner that is transparent and non-pathologizing.

I recognize the inherent gatekeeping role that mental health providers have in this compulsory letter-writing process, and we seek to reduce any undue gatekeeping while also having to work within the structure of the WPATH Standards of Care. I will work with you to conduct a person-centered, collaborative assessment of your history and needs. This means I will be transparent and explain why I am asking certain questions and what I am writing.

I strongly believe in a client’s right to self determination and fiercely remove unnecessary gate keeping in the process of gender expansive client’s being able to seek affirming care. 

My process is designed with your rights in mind.  

Some of the things I might ask about include:

I understand that there is no one gender story narrative.  Your story is unique and does not have to be tied together with a sense of certainty.  I understand that your past and current emotional wellbeing could be impacted by both gender dysphoria and the effects of living in a cis-normative society, and I will give you the support you deserve.

In addition to me asking you questions, I also welcome questions from the interviewee.  I recognize how hard it is to get to this point, and I want to be here for you however I can.

In New York, some insurance companies require all letters to be written by doctoral level (PhD or PsyD) clinicians. Some insurance companies and surgery centers allow master’s level clinicians (LMFT, LCSW, LPC) to provide letters, but not all will.  To make matters a bit more complicated, some insurances and some procedures may require multiple letters from different providers.

Typically, one letter of readiness is needed for top surgery (chest masculinization or augmentation mammoplasty) and for feminizing facial surgery (FFS), while two letters from two separate mental health professionals who have each independently assessed the patient are needed for genital surgery (e.g., orchiectomy, vaginoplasty, metoidioplasty, etc).

Before scheduling a session, it can be helpful to talk with your insurance company and/or surgery center about what they each require in the letter and who can write the letters. 

Coverage varies widely by insurer and the state your insurance plan is based in; in NY State, where our practice is located, insurance plans are required to cover gender-affirming care just as they would other types of medically-necessary medical care.