This page refers to referral letters (also known as WPATH letters or letters of support) sometimes desired or required to access gender-affirming medical interventions.


I write letters and complete letter-writing assessments 100% free of cost. Yes, really really!

If you've reached a point in your transition that you're in need of a letter, let's connect about how I can help break down this barrier. I try to keep the process pretty straightforward because gatekeeping is not in line with my personal values or professional ethics.

I operate as much as possible on the Informed Consent model - under the presumption that you are a self-determined person with insight and awareness about how to use your bodily autonomy. In order to do this within a system that continues to use gatekeeping, I frame letter writing and the assessment as a way of improving outcomes and hope to end each assessment session by sharing a new consideration or idea with the individual.

  • Provider Requirements:

      • If you're seeking a letter for hormone therapy, you do not need an identified provider.

          • For hormone therapy, Planned Parenthood of Florida operates on the informed consent model and does not require a letter.

      • If you're seeking a letter for chest surgery (removal or augmentation) or gonadectomy (hysterectomy or orchiectomy), you must have an identified surgeon and ideally had an appointment or consultation with your surgeon.

      • If you are seeking a letter for facial surgery or genital reconstruction, you must have identified a surgeon and had a surgical consultation prior to the letter-writing assessment session.

  • For the letter, I must write that you are mentally, emotionally, practically, and financially prepared for the intervention, as well as being aware of the risks, benefits, and implications. This means that it's important for you to have done research in advance regarding what to expect. This is also why I require having a surgeon and consultation in certain circumstances.

Here's a bit about my letter-writing process so you can make an informed choice.

  • There is NO therapy required for letters. If you desire ongoing therapy, you can schedule a consultation here.

  • If you've read the above and wish to move, the first step will be to complete the required forms for your assessment session.

      • All forms must be completed prior to the scheduling the session.

      • I will use this information to guide the letter-writing session and will pre-write some of the letter in advance.

      • If you are seeing a therapist or psychiatric provider, I will also send a release of information to be completed before the appointment. It's entirely your choice whether or not to sign the release, but I require it in order for me to write the letter.

  • After the forms are submitted, you'll reach a link to schedule the assessment session. This will be on the "Thank You" page, following submission of the form.

      • Assessment appointments are held on Mondays from 1-4pm and occasional Fridays. Appointments are typically booked out 2-3 weeks and availability is limited.

  • We will meet for the appointment session through a HIPAA-secure version of Google Meet.

      • During the session we'll review any necessary pieces of information from the forms, and review the letter together.

  • After the letter is completed, I securely send the letter to you by email.

      • I will send the letter to you by password-protected email. The letter is then yours to send to whomever you decide.

If you've read all of this page and are ready to schedule your appointment, select whether your letter is for hormone therapy or for surgery.