Letters of Support for Gender-Affirming Treatment
Affirming, individualized consultations and letters of support for people seeking gender-affirming medical or surgical treatment.
A good fit when
Your treating clinician, surgical program, or insurer has requested a mental health consultation or letter of support for gender-affirming treatment.
What is a letter of support?
A letter of support is an individualized clinical document for a treating provider, surgical program, or insurer. When clinically appropriate, it summarizes the consultation, relevant findings, and recommendations related to the gender-affirming care you are seeking.
It is not a test of whether your gender identity is valid. The consultation centers your goals, your understanding of the requested treatment, and any support needs. Your medical team remains responsible for procedure-specific counseling and medical decisions.
When might you need one?
You might need a letter when your treating clinician, surgical program, or insurer requests mental health documentation before gender-affirming treatment. Not every treatment requires a letter, and requirements vary by recipient and insurance plan.
Before scheduling, ask the receiving team whether a letter is required, what it must address, who may write it, and how recent it must be. Share those requirements with the practice so we can discuss whether this consultation is appropriate. A letter does not guarantee insurance coverage or treatment approval.
Support centered on your goals—not proving your identity.
Dr. Jacy Holmes, PsyD provides individualized consultations and letters of support for gender-affirming medical and surgical treatment. My approach aligns with the World Professional Association for Transgender Health (WPATH) Standards of Care, Version 8 (SOC8), with respect for your identity, autonomy, and treatment goals.
Contact the practice to confirm eligibility and the scope of the requested letter.
Each consultation is tailored to your treatment goals, relevant history, and the requirements of the provider or insurer receiving the letter.
Areas we can explore
Your goals and lived experience
A respectful discussion of your gender history, the care you are seeking, and what you hope treatment will support. There is no single way to be transgender, nonbinary, or gender diverse.
Informed consent and treatment understanding
Discussion of your understanding of the requested treatment, expected benefits, potential risks, alternatives, and fertility or reproductive considerations when relevant. Your medical team provides procedure-specific counseling and consent.
Health, wellbeing, and practical supports
Review of relevant mental health history, current concerns, supports, and practical needs for treatment or recovery. A mental health diagnosis or neurodivergence does not automatically rule out gender-affirming care.
The recipient’s documentation requirements
Review of what your treating provider, surgical program, or insurer needs, so the consultation and any letter address the actual request. Not every treatment requires a letter.
What the consultation and letter may include
- An individualized, affirming clinical interview
- Review of relevant history and records when appropriate
- Discussion of informed consent, treatment goals, and support needs
- Review of applicable provider or insurance documentation requirements
- A letter of support when clinically appropriate, describing the consultation, relevant findings, and recommendations
- Coordination with your treatment team with your permission
You leave with
A clear discussion of your goals, the documentation request, and next steps
An individualized letter of support when clinically appropriate—not a generic form or automatic approval
Recommendations for additional support or coordination when useful
Aligned with WPATH Standards of Care, Version 8 (SOC8).
My approach is affirming, collaborative, and individualized. Gender diversity is not a mental illness, and this consultation is not about deciding whether your identity is valid. The focus is on understanding your treatment goals, informed decision-making, and any relevant support needs.
Read about WPATH Standards of Care, Version 8Provider, surgical-program, and insurance requirements vary, including whether a letter is needed and how recent it must be. A consultation does not guarantee a letter, insurance coverage, or approval by a treatment team. Comprehensive psychological or neuropsychological testing is not automatically part of a letter consultation. Please contact the practice to confirm eligibility, scope, fees, timing, and what your provider requires before scheduling.
The right evaluation starts with the right question.
Ready when you are