Gender Affirming Letter Writing

You deserve access to trans affirming healthcare.

At the end of the day, that’s what it comes down to. Regardless of how you identify or who you are, we believe you deserve health and happiness. If you identify as trans, nonbinary, gender non conforming or any other identity, our therapists believe you deserve access to the healthcare that will help you live in a way that’s congruent with your identity.

Affirming letters may be a tool to help you get competent care.

Sometimes, systems require you to have a letter from a mental health professional to begin gender & identity affirming interventions such as hormone replacement therapy (HRT), surgery, or even name changes. Essentially, professionals have been asked to assess you and give an opinion on how this intervention will impact you. Naturally, we believe you are the expert on your own health, life, and mental health. And we support your right to make your own healthcare decisions. But sometimes these assessments are still required.

Affirming Letters in as little as One Session

Aspire Counseling has clinicians who have completed training from Van Ethan Levy to complete an assessment and write a gender-affirming letter in as little as one session. Van is a Non-Binary clinician who is a leading expert on gender identity. They are the author of the book “Exploring My Identity (ies)” and an advocate for trans community.

But really, how many sessions does it take for you to write me a letter?

Generally, you’ll have a brief phone consultation just to make sure we’re on the same page about what you’re looking for. Then, you’ll meet for one formal assessment session. The therapist will have a template pulled up and be working on your letter while the two of you meet. Most of the time this process can be completed in a single session, though it may be longer than a traditional 45-minute counseling session since this is an assessment. In rare cases, you may need to set up a second appointment if you don’t get through all of the necessary information for the therapist to complete the letter.

What if I want ongoing mental health care?

Great! We can help with that too! We’re big fans of counseling & therapy. In fact, we think everyone can benefit from working with a counselor at various points in their life! Ongoing trans-affirming counseling is another service Aspire Counseling is committed to providing. So, please let us know if you’d also like to establish an ongoing therapeutic relationship and we’ll set you up with a free consultation to discuss that as well!

Will you always provide a letter at the end of the assessment?

Yes. We will provide a letter at the end of the assessment. We can’t promise that it will automatically be accepted by the insurance company or treating physician, but we’re using a template that we’ve attended training on and have been told has worked with a wide range of insurances and treatment providers. Of course, we will be honest in our letter but we aren’t here to be gatekeepers. In fact, we want to make it as easy as possible for you to get gender-affirming healthcare! So, even if you do have other mental health concerns (because truly, who doesn’t?) we still believe you deserve to be recognized for who you are and supported. So, please be open, honest, and direct.

Do I need a letter for HRT/name change/surgery?

Often, you may be able to get the care you are searching for without a mental health evaluation or letter. Many of our clients are pleasantly surprised to learn that their healthcare provider is happy to provide a prescription for hormones after even a single conversation about their needs, the benefits, and the risks. However, in some situations, providers are still requesting an assessment and letter from a mental health provider. Furthermore, there may be times where the insurance is the one requesting the assessment and letter. Our suggestion is never to assume you do or don’t need a letter. Instead, reach out to the parties involved to see what will be required. If you do learn that an assessment and letter are required get as much information as you can (Do they have a template they’d like to use? Are there specific things that must be included?) and then give us a call so we can get you scheduled for a letter-writing assessment.

Do I have to answer really invasive questions to get a letter?

We are going to ask minimally invasive questions because we’re staying laser-focused on gathering the information we need to complete the letter. That said, we know it’s inherently uncomfortable to have these conversations with us, sometimes you’re being asked to share information that you honestly shouldn’t have to share with anyone you just met and you always have a right to either ask us why we’ve asked a specific question or to decline to answer that question.

What if I’m still just exploring and looking for resources?

Great! We love that you’re looking for all the information you can as you explore your own identity. We cannot recommend Van Ethan Levy’s Book “Exploring My Identity(ies)” highly enough! We also have other resources listed on our LGBTQIA+ Affirming Counseling page.