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I’m happy to write letters in support for starting gender- or sex-affirming hormone treatment, proceeding with gender- or sex-affirming surgeries, and/or making changes to gender or sex markers or names.

My goal is to provide a client / patient with a letter after 1-3 sessions, preferably after the first session.  The second or third sessions might be more for us to discuss further certain things.  I’m open and willing to make as many edits or revisions to the letter until it’s accepted by whatever entity.  I don't want to be a gatekeeper / barrier / hurdle / block to folks wanting and needing medically necessary treatment.

This evaluation process for the letter can be done in person at my office in Tacoma, WA (Note: the building restrooms are unfortunately not gender-neutral or all-gender) or over video/telehealth if you’re physically located in WA, HI, or a PSYPACT state at the time of our session(s).

You’re welcome to use your insurance for this process.  If so, we would put something like Gender Dysphoria as the diagnosis.


Here’s a list of other providers who offer letters:

The Gender Affirming Letter Access Project

Van Ethan Levy’s list


WPATH, World Professional Association for Transgender Health

Standards of Care Version 8

Note: Even I'm not accepting new clients/patients for therapy, I'll somehow make space in my schedule for folks wanting letters.

Another note: Thank you to the first client who contacted me for a letter, for which I did research, training, and consultation.

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