Gender-affirming Letters

PLEASE NOTE: WE ARE ONLY ABLE TO PROVIDE LETTERS TO FOLKS IN TEXAS.

If you live in another state, please email us at hello@vadacounseling.com to get a referral to a therapist who can write letters in your state.

Most surgeons and insurance companies follow the WPATH Standards of Care which requires at least one letter from a therapist prior to undergoing gender-affirming surgery. Some clinics also require a letter for Hormone Replacement Therapy (HRT), also known as Gender-Affirming Hormone Therapy (GAHT).

Our staff has years of experience providing support letters for HRT/GAHT, top surgery, bottom surgery, and various other feminizing, masculinizing, or non-binary affirming interventions. We’re also happy to give you referrals to doctors and surgeons as well as education and resources for hormone therapy and puberty blockers.

We believe in improving access to transgender healthcare and eliminating unnecessary gatekeeping, so we provide these letters for free. Forreal. We don’t charge for the consultation appointment or the letter itself.

HOW DO I GET A LETTER FROM YOU?

We try to make this process as smooth and easy as possible:

  1. Book a free virtual consultation for gender-affirming support letter here.

  2. Receive an email with a link to your client portal. In the portal, you can enter your demographic info, read our practice policies, notice of privacy practices, and sign the informed consent form. You will also need to fill out a questionnaire that we will use to write your letter.

  3. On the day of the consultation, click on the appointment link that was emailed to you. You don’t need to bring anything with you, but feel free to bring a list of questions or concerns you may have about the letter, insurance, doctors, etc.

  4. During your appointment, the therapist will review the questionnaire with you to make sure they understand what your experiences, goals, and potential concerns. Ask the therapist any questions you may have and let them know about any resources or referrals you may need. (We’ll also ask about this in case you forget!)

  5. Within 72 hours, you’ll receive a first draft of your letter to review, as well as any resources or referrals needed. If you have any edits/corrections to make to the letter, please let your therapist know.

  6. Once the letter has been reviewed and approved by you, the therapist will send you a final PDF version of the letter for you to give to your surgeon and/or insurance company.

what if i need 2 letters?

For bottom surgery (and occasionally other procedures), your insurance company or surgeon’s office will likely require you to have letters from two licensed health or medical professionals. Sometimes they will require letters from two different therapists, or a therapist and a psychologist, or a therapist and a doctor, etc. It’s another confusing hoop to jump through.

Whichever is needed, we’re happy to write one letter and refer you to other therapists or psychologists for the other, depending on what license or experience is required.

can you help me find a docTOR?

Absolutely! We’re big on sharing resources and can refer you to a gender-affirming doctor or surgeon based on the experiences of our clients, friends, and ourselves.

We’re most familiar with doctors and surgeons in Texas, but if you’re going out of state for surgery, we’ll do our best to find some great options for you.

Similarly, if you’ve had a really positive (or negative) experience with a doctor or surgeon, please let us know so we can update our referral lists!