Compassionate, affirming assessments that support your right to receive the care you deserve.
Gender-Affirming Surgery Assessments & Letters
Many surgeons require a psychological assessment and letter of support before performing gender-affirming procedures. We provide these assessments in a nonjudgmental, affirming environment — designed to support your access to care, not to create barriers to it.
- Washington State
- Top, Bottom & Breast Surgery
- Affirming & Nonjudgmental
Is This You?
- You're pursuing top surgery, bottom surgery, a breast reduction, or a radical breast reduction
- Your surgeon requires a psychological assessment or letter of support
- You want to work with a clinician who affirms your identity and respects your autonomy
- You feel nervous about the assessment process and want it to feel safe
- You're not sure what to expect or how many sessions the process takes
- You want clear communication about what the assessment involves before you begin
- You are in Washington State and need an in-state licensed clinician to complete your letter
You already know yourself. This process is designed to support you — not question you.
What This Assessment Provides
- A formal psychological evaluation required by your surgeon or care team
- A support letter that meets common surgical program requirements
- A process that is affirming, respectful, and oriented around your goals
- Clear communication about timeline, requirements, and what to expect
- A completed letter typically within a defined, predictable number of sessions
- Ongoing therapy support if desired before, during, or after your procedure
Our goal is to make the assessment process as straightforward and affirming as possible.
What Is a Gender-Affirming Surgery Assessment?
A gender-affirming surgery assessment is a psychological evaluation required by many surgeons before performing gender-affirming procedures, including top surgery, bottom surgery, breast reductions, and radical breast reductions.
The assessment typically involves one or more clinical sessions designed to understand your history, goals, and readiness for surgery. When criteria are met, the clinician provides a formal letter of support that your surgeon can use as part of your care documentation.
This is not an evaluation to decide whether you 'deserve' care. It is a clinical process designed to support your access to the procedure you are seeking. We approach these assessments with the understanding that gender-affirming care is medically necessary for many individuals, and we take that responsibility seriously.
Our Approach to Assessments
We believe the assessment process should feel supportive, not interrogative. Our clinicians approach these evaluations with a clear commitment to your autonomy and with deep respect for your identity and self-knowledge.
We begin by explaining the process in full before any formal assessment begins — what we'll cover, how many sessions it typically takes, what the letter will say, and what happens next. You will not be surprised by anything.
Our clinicians are experienced in gender-affirming care and keep current with relevant clinical standards. We are clear about requirements so that the letter we provide meets your surgeon's needs.
Who This Is For
This assessment service may be right for you if you are:
- Located in Washington State and seeking an assessment from an in-state licensed clinician
- Pursuing top surgery, bottom surgery, breast reduction, or radical breast reduction
- Working with a surgeon or care team that requires a psychological letter of support
- Looking for a clinician who is affirming, experienced, and takes your goals seriously
- In need of a clear, predictable process with an experienced evaluating clinician
Frequently Asked Questions
How many sessions does the assessment take?
The number of sessions varies based on your history and the documentation required by your surgical program. Many assessments are completed in 2–4 sessions. We'll give you a clearer estimate after an initial conversation about your specific situation.
What does the letter say?
The letter summarizes the clinical assessment, confirms your identity and surgical goals, and provides the professional recommendation required by your surgeon. We'll review the letter with you before it's finalized, and we'll make sure it meets your care team's specific requirements.
Will I feel judged during the assessment?
No. Our clinicians approach these assessments with an affirming framework — your identity and goals are not under debate. The process is designed to support your access to care, and our role is to provide the documentation you need, not to act as a gatekeeper.
What surgeries do you provide assessments for?
We provide assessments and letters for top surgery, bottom surgery, breast reductions, and radical breast reductions.
Do you offer ongoing therapy alongside the assessment?
Yes. If you would like ongoing therapy support before, during, or after your procedure, we're happy to provide that as well. The assessment and ongoing therapy can be with the same clinician or handled separately depending on your preference.
Is this available only in Washington State?
At this time, we provide gender-affirming surgery assessments through our Washington-licensed clinicians. This service is available via telehealth for individuals located in Washington State.
Ready to Get Started?
Connect with the practice or explore the team.
Schedule a free consultation to discuss the assessment process, what to expect, and whether this is the right fit for your needs.