Gender-affirming medical care can include a variety of procedures intended to help an individual’s physical characteristics more closely align with their gender identity.
Some surgeons, medical programs, or insurance providers may request an evaluation and supporting documentation before certain gender-affirming surgical procedures.
Our licensed mental health professionals provide evaluations and, when clinically appropriate, corresponding documentation for individuals pursuing gender-affirming surgery.
What Is a Gender Confirmation Surgery Evaluation?
A gender confirmation or gender-affirming surgery evaluation is a professional assessment related to an individual’s readiness for a requested surgical procedure.
The evaluation provides an opportunity to discuss your gender history, the procedure you are considering, your understanding of the treatment, your expectations, and other factors that may be relevant to moving forward with surgery.
The evaluation is intended to support informed decision-making and appropriate access to care.
Procedures That May Require an Evaluation or Letter
Requirements vary among surgeons, medical facilities, and insurance providers. Evaluations may be requested for procedures including:
- Chest or breast surgery
- Mastectomy for masculinization
- Breast augmentation
- Vaginoplasty
- Phalloplasty
- Metoidioplasty
- Orchiectomy
- Penectomy
- Facial gender-affirming procedures
- Tracheal shave
- Other gender-affirming surgical procedures
Not every provider or procedure has the same documentation requirements.
What Does the Evaluation Cover?
An evaluation may include discussion of:
- Gender identity and gender history
- Your reasons for pursuing the procedure
- Your understanding of the proposed surgery
- Expectations regarding surgical outcomes
- Mental health history and current emotional well-being
- Medical and treatment history relevant to the evaluation
- Support systems
- Recovery planning
- Your ability to provide informed consent
- Any concerns that could affect preparation for or recovery from surgery
The evaluation is individualized rather than based on the assumption that every transgender or gender-diverse person follows the same path.
A Supportive Evaluation Process
An evaluation should provide room for open and respectful discussion.
Its purpose is not to question whether your gender identity is valid. Rather, the evaluator considers the particular procedure being requested, your understanding and expectations, and any relevant circumstances that should be considered as part of responsible preparation for surgery.
When concerns are identified, the evaluator can discuss them with you and explain any recommendations that may help address those concerns.
What to Expect
Evaluations are completed virtually by video with a licensed mental health professional.
During your appointment, you will discuss your history, the procedure you are considering, your understanding of the treatment, and other relevant areas.
Documentation or a surgical support letter may be provided when the evaluation supports it and the applicable requirements have been met.
