
Gender- Affirming Care Letters
As part of our Aligned Care Services, we offer services and assessments for those seeking support for gender-affirming care and surgery. This includes gender-affirming care letters! ​

Letters and other LGBTQIA+ services offered virtually or in-person.
FAQs
What is WPATH?
The World Professional Association for Transgender Health (WPATH) is an organization that promotes evidence-based care, education, research, public policy, and respect in transgender health. The organization envisions a world wherein people of all gender identities and gender expressions have access to evidence-based healthcare, social services, justice and equality. The WPATH also publishes the Standards of Care (SOC) which provides ethical guidelines for healthcare professionals treating transgender and gender diverse individuals as it relates to psychiatric, psychological, medical, and surgical management. With this, Sustainable Wellness refers to WPATH's Standards of Care when providing services for gender-affirming care letters.
What are gender-affirming care letters?
At Sustainable Wellness, we are able to write gender-affirming care letters to support those who are seeking access to gender-affirming healthcare, including surgical and non-surgical interventions. Gender-affirming care letters are often required by insurance companies, surgeons, and other medical professionals to demonstrate a client's readiness for and understanding of gender-affirming procedures.
How do I obtain a gender-affirming care letter?
To obtain a gender-affirming care letter, you will first complete an initial consultation and assessment with one of our clinicians. Once the assessment has been completed, your clinician will write a letter. Following this are optional individual therapy and or skills coaching services. Read through our 5-step process on how to obtain a letter for gender-affirming care along with our additional support services.
Do you accept insurance for these services?
We are in fact able to accept insurance for these services! Services can be billed for in-network or out-of-network benefits. Please reach out to us ahead of time so that we could verify your insurance benefits. Please note that verification of benefits is not a guarantee of coverage. We also offer this service as self-pay. Self-pay rates can be found on each clinicians' page.
Please note that therapists who provide gender-affirming care letters are basing letters on a professional assessment and not a definitive diagnosis. Along with informed consent and autonomy, a multidisciplinary approach is paramount for such services. At this time, services for gender-affirming care letters can be covered by insurance. We also offer our services as self-pay. Please contact us for further questions regarding service fees.
1
Initial Consultation
Free of charge, your first step is to have an initial 20 minute virtual consultation with one of our clinicians to discuss WPATH standards, details about the affirming care service you’re looking for, what we can offer, and any questions you have regarding goals.
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2
Assessment
After your initial consultation, your clinician will conduct an assessment to evaluate your readiness for non-surgical or surgical interventions, ensuring you meet the criteria for medical necessity and have the necessary support. This stage involves discussing factors such as your understanding of the procedure, your ability to consent, and any potential psychological or medical conditions that could play a role in the process. The assessment phase typically takes 1-2 sessions to complete.
If your clinician determines that you do not meet eligibility for a letter, the clinician will engage in an open and transparent conversation with you about these reasons, including recommendations for next steps.
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3
Gender-Affirming Care Letter
Once you've completed the assessment and established readiness for your specific procedure, your clinician will write a letter following WPATH’s standards of care. Once obtained, it’s your responsibility to review the letter with your clinician to ensure it accurately reflects your situation and your goals.
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4
Individual Therapy (optional)
While therapy may be helpful for some, it is not mandatory prior to the initiation of non-surgical or surgical interventions. If you and/or your clinician determine that therapy would be helpful, your clinician may make a clinical recommendation to support the next steps of your process. Therapy services may be provided by your clinician, another clinician at the practice, or a provider outside the practice, as appropriate.
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5
Skills Coaching (optional)
Skills coaching is offered to those who do not wish to participate in individual psychotherapy, but could still benefit from additional support leading up to, or immediately following, a non-surgical or surgical intervention. If you and/or the clinician determine that skills coaching is no longer appropriate, the clinician may provide additional recommendations or referrals for additional ongoing support. Please note: skills coaching is only offered to those seeking gender affirming care letters at this time.
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Getting ready for your initial consultation?
Before getting started, download some of our resources and "need-to-knows" below!