Criteria and Requirements for Scheduling a Gender Affirming Consultation

Male to Female Vaginoplasty

  • 1 year of hormones
  • 1 year of living in chosen gender
  • 1 letter of support from provider who prescribes hormones
  • 1 letter of support from mental health provider (see attached)
  • 1 letter of support from different mental health provider
  • 1 medical referral from primary care provider

Male to Female Breast Augmentation

  • 1 year of hormones
  • 1 year of living in chosen gender
  • 1 letter of support from provider who prescribes hormones
  • 1 letter of support from mental health provider (see attached)
  • 1 medical referral from primary care provider

Female to Male Top Surgery

  • 1 year of living in chosen gender
  • 1 letter of support from provider who prescribes hormones
  • 1 letter of support from mental health provider (see attached)
  • 1 medical referral

Contact us with any Procedure or Letter of Support Questions








Criteria for Mental Health Provider Letter of Support

  • Statement confirming the diagnosis of gender dysphoria using current DSM 5 criteria.
  • Assure the client is a good candidate for surgery, which the surgery should be stated
    specifically in the letter.
  • Assure the surgery is the next reasonable step.
  • Assure the client has no coexisting behavioral health conditions (i.e. substance abuse
    problems, or other mental health illnesses), which could hinder participation in gender
    dysphoria treatment.
  • Assure any coexisting behavioral health condition(s) are adequately managed.
  • A statement that the client exhibits a strong and persistent cross-gender identification.
  • A statement that the client exhibits persistent discomfort with his/her sex or sense of
    inappropriateness in the gender role of that sex.
  • A statement that the dysphoria causes clinically significant distress or impairment in
    social, occupational, or other important areas of functioning.
  • The date the client started living full-time in the opposite gender.

Criteria for Hormone Therapy Provider Letter of Support

  • The date the client started hormone therapy
  • A statement that the client has been adherent to their hormone therapy.
  • A statement that the provider believes surgery to be the next reasonable step in the client’s treatment.
  • A statement that the client has no medical comorbidities that would interfere with
    surgery.