Surgery Letters • WPATH SOC v8 • Oregon and Washington
You already know what you need
We write the letter
Gender-affirming surgery assessments consistent with WPATH Standards of Care v8 and an informed consent model. Collaborative, not gatekeeping. Available by telehealth to residents of Oregon and Washington.
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Not a test of whether you’re “trans enough”
There’s no bar to clear here. Your own account of your life is the evidence.
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You set the pace
One intake or continue with individual therapy, the plan that works for you, not a schedule handed to you.
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Questions welcome before you schedule
Ask what’s involved, what it costs, how long it takes. No commitment to find out.
WPATH Standards of Care v8
Informed Consent Model
Letters for gender-affirming surgical/medical care
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WHAT THIS IS
Not permission.
A perspective.
This assessment isn’t about granting permission for you to be who you are. Our job is to understand your history, your goals, and your readiness and write it down clearly.
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Collaborative, not gatekeeping
Nothing gets written about you that you haven’t heard first.
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You’re the expert on your gender
No story to perform, no milestone to hit. Your account of your life is the evidence.
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Written for the people who need it
Written to meet surgeon and insurer requirements the first time.
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Also offered: gender-affirming therapy →
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WHAT AN ASSESSMENT INCLUDES
Four parts. No surprises.
Every assessment looks a little different, but they generally include the following.
A clinical interview
A conversation about your gender, your goals for surgery, and what support looks like in your life right now.
A review of history and current functioning
Medical and mental health history, and how things are going day to day; the context surgeons and insurers ask about.
A written letter
Prepared for your surgical consultation and for insurance, in the language those readers require.
Room to ask questions
Space to ask anything and to go at a pace that feels okay. There’s no clock running on you here.______________________
HOW WE WORK
We’re not going to pretend this system is fine.
Assessment requirements can feel dehumanizing; justifying your own body to a stranger to access care. We do our part with as little friction as possible.
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Dignified
No trick questions, no hidden criteria. You’ll know what we’re asking and why.
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Affirming
You won’t spend the session explaining basic terms. This is lived, not learned.
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Efficient
Most assessments are brief, and waiting has already cost you enough.
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Also offered: gender-affirming therapy →
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COMMON QUESTIONS
The things people ask first
If your question isn’t here, ask it. No obligation to book anything.
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It depends on the procedure and your surgeon’s requirements. The general rule of thumb: any procedure above the waist requires one letter. Any procedure below the waist requires two.
Bring us what your surgeon or insurer asked for and we’ll tell you honestly whether we can provide it.
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No. An assessment can be a standalone service. If you’d like ongoing therapy too, that’s available but it isn’t a requirement for a letter.
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It documents your gender history, your readiness to consent, and how the procedure fits your goals in the language surgeons and insurers look for.
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Most people finish in a single intake, with the letter following shortly after.
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If you are using insurance, it will depend on your insurance plan (copays, coinsurance, or deductibles based on your plan). Our biller is happy to provide an estimate of benefits associated with your plan. If you do not have insurance, we have limited slidine scale options available on a case-by-case basis.
Reach out if you have questions. We’ll tell you what’s involved before you commit to anything.
Still have questions? Click the link below to book a free 20-minute consultation
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READY WHEN YOU ARE
Let’s get you the letter
Assessments are available to residents of Oregon and Washington. Reach out with questions about the process, cost, or timeline. We’re happy to answer before you schedule anything.
Gender-affirming surgery assessments by telehealth throughout Oregon and Washington: Portland, Salem, Eugene, Bend, Seattle, Tacoma, Spokane, Vancouver, and everywhere between.
Looking for ongoing care? See gender-affirming therapy · See trauma therapy →