gender reassignment surgery psychological evaluation

Psychological Assessments for Gender Affirmative Surgery

If you or a loved one are in the process of transitioning or are looking to have a gender affirmative surgery,  we want to help .

Deep Eddy Psychotherapy offers psychological evaluations for gender affirmative surgery candidacy for our clients (ages 18 and up).  Our clinicians are dedicated to helping the transgender, non-binary, genderqueer, and gender-expansive community by providing this evaluation service along with individual, group, and couples therapy . 

gender reassignment surgery psychological evaluation

We also recognize that transphobia and transmisogyny are interwoven into our society and that the mental health profession has had an unfortunate history of perpetuating these ideas.  Our therapists are committed to being part of the change for good and live more fully within our values – you deserve nothing less.

Ready to sign up to get an evaluation?  Don’t wait –  contact us  today.  Please read on to learn more about gender affirmative surgery evaluations and answers to common questions.

What is a gender affirmative surgery evaluation? 

Under the current guidelines, transgender, non-binary, and gender non-conforming clients seeking gender affirmative surgeries must have letters from mental health providers attesting to whether they meet the guidelines for surgical intervention established by the  World Professional Association for Transgender Health  (WPATH). 

Anyone who is seeking an attestation letter must meet with a mental health provider for an evaluation (typically just an interview, but occasionally more than one session) to determine whether they are good candidates for surgery.  Based on the results of the evaluation, the provider will write a letter summarizing your candidacy and their recommendations. 

Do you need an evaluation for hormone replacement treatment (HRT)?

No.  In Texas (and in most other states), we now use an informed consent model in place for HRT.  So, you no longer need letters from mental health providers in order to receive HRT.

What does a gender affirmative surgery evaluation assess for?

At Deep Eddy Psychotherapy, our clinicians recognize the inherent gatekeeping role that mental health providers have in this compulsory letter-writing process, and we seek to reduce any undue gatekeeping while also having to work within the structure of the WPATH Standards of Care.

Our clinicians who provide this service have a welcoming and affirmative stance toward gender-diverse clients and want to help clients receive the gender-affirming medical care they seek. We have training and experience in this area, and we actively consult with each other about the process.

We say all of this so that you can rest easier knowing that our process is designed with your rights in mind.  Our goal is not to keep you from getting the surgery you need, but rather to ensure that you are the right fit and have the support you need to succeed.

Some of the things your evaluator might ask about might include:

  • Your gender story
  • Past and current emotional wellbeing
  • Social supports you can lean on
  • What sorts of surgical interventions you are seeking
  • Your understanding of the risks and benefits of surgery

Our providers understand that there is no one gender story narrative.   Your story is unique  and does not have to be tied together with a sense of certainty.  Likewise, our providers understand that your past and current emotional wellbeing could be impacted by both gender dysphoria and the effects of living in a cisnormative society, and we want to give you the support you deserve.

In addition to us asking you questions, we also welcome questions from the interviewee.  We recognize how hard it is to get to this point, and we want to be here for you however we can.

Who can write an attestation letter?

In Texas, some insurance companies require all letters to be written by doctoral level (PhD or PsyD) clinicians. Some insurance companies and surgery centers allow master’s level clinicians (LMFT, LCSW, LPC) to provide letters, but not all will.  To make matters a bit more complicated, some insurances and some procedures may require multiple letters from different providers.

Before scheduling a session, it can be helpful to talk with your insurance company and/or surgery center about what they each require in the letter and who can write the letters. 

If you do not have insurance, as advocates for equity and social justice, we do not want the ability to pay to keep you from receiving a letter from a mental health professional.  Please feel free to reach out to us if you have financial need, and we can let you know which clinicians have sliding scale spots open for this service at the time. 

Mental Health Evaluation for Gender Confirmation Surgery

Affiliation.

  • 1 New Health Foundation Worldwide, 1214 Lake Street, Evanston, IL 60201, USA. Electronic address: [email protected].
  • PMID: 29908617
  • DOI: 10.1016/j.cps.2018.03.002

The requests for medically necessary surgical interventions for transgender individuals have steadily increased over the past several years. So too has the recognition of the diverse nature of this population. The surgeon relies heavily on the mental health provider to assess the readiness and eligibility of the patient to undergo surgery, which the mental health provider documents in a referral letter to the surgeon. The mental health provider explores the individual's preparedness for surgery, expectations, and surgical goals and communicates with the surgeon and other providers to promote positive outcomes and inform multidisciplinary care.

Keywords: Gender; Gender dysphoria; Gender-affirming; Mental health; Surgery.

Copyright © 2018 Elsevier Inc. All rights reserved.

Publication types

  • Mental Health*
  • Sex Reassignment Surgery / psychology*
  • Transgender Persons / psychology*

Psychotherapy and Professional Counseling in Dupont Circle

Psychological Evaluation for Gender Affirming Surgery

Diagnosing gender dysphoria, gender affirming surgery is more than just a physical transition.

If your doctor is requesting you receive a psychological evaluation prior to gender affirming surgery, we can help. Before we do, we want you to know where we stand.

There are many ways people transition and different types of transitioning. We at Rock Creek Therapy do not agree with being arbiters of this transition process when physicians request it, and we advocate for change on those grounds. In the mean-time we will work with you to make this as easy a process as possible.

There are several steps we need to accomplish:

  • Confirming a diagnosis in gender dysphoria.
  • Assessing your ability and support system in the recovery process.
  • Though we will not assess for it, we would also like to talk with you about your transition plan and what it means to you.

The assessment is primarily a clinical interview for 60-90 minutes and will cost $300 with a potential for reduced fees based on financial need.

Assessment Inquiry

Contact us today about finding a therapist who is a fit for you.

Location of our Psychotherapy Practice

Rock Creek Therapy is located near Dupont Circle in Washington, DC.

We also conduct online therapy for residents of D.C., Maryland, Virginia, Michigan, Florida, Connecticut, Pennsylvania, and Illinois.

1350 Connecticut Avenue NW, Suite 1020 Washington, DC 20036 United States Directions

Contact Rock Creek Therapy

If you have questions or if you’d like to discuss therapy options contact us at:

(202) 630-8120 or email [email protected] Therapy inquiries or to schedule an appointment

For more about services and therapy session pricing please visit the Psychotherapy Services page

Rock Creek Therapy

1350 Connecticut Avenue NW, Suite 1020 Washington, DC 20036

(202) 630-8120

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COMMENTS

  1. PDF Guidelines for Psychosocial Assessments for Sexual Reassignment Surgery

    A comprehensive assessment for gender dysphoria covers a lot of territory. It includes a gender assessment and a solid basic assessment as well as identifying strengths and resources. Most agencies and clinicians have their own clinical assessment tools. A current Mental Status Exam (MSE) is important for informed consent.

  2. Psychological Assessment for Gender Affirmative Surgery

    Deep Eddy Psychotherapy offers psychological evaluations for gender affirmative surgery candidacy for our clients (ages 18 and up). Our clinicians are dedicated to helping the transgender, non-binary, genderqueer, and gender-expansive community by providing this evaluation service along with individual, group, and couples therapy.

  3. Psychological and Neuropsychological Assessment with Transgender and

    Psychologists should above all avoid harm in performing assessments with transgender, gender nonbinary and gender diverse clients with consideration of the specific functional reason(s) for the assessment (i.e., is the assessment addressing matters of identity, biological influences of sex-based structures or hormones, both or neither) and what ...

  4. Should Mental Health Screening and Psychotherapy Be Required Prior to

    In short, psychological assessment and counseling can be instruments of success in gender transition rather than impediments to the exercise of choice. Still, a skeptic might respond that assessment and counseling are not equally valuable or necessary to all people. If so, these processes should be optional, not obligatory.

  5. PDF Assessment and Treatment of Gender Dysphoria and Gender Variant

    sex characteristics to affirm a person's experienced gender identity, aka sex reassignment surgery. Gender dysphoria (not capitalized): distress caused by the discrepancy between one's experienced/expressed gender and one's assigned gender and/or primary or secondary sex characteristics. Gender Dysphoria (capitalized): a diagnostic ...

  6. PDF Affirmative Psychological Testing and Neurocognitive Assessment with

    The history of assessment and psychological testing with transgender clients is fraught with challenges and barriers to accessing medically necessary gender transi- ... evaluation for hormone therapy and surgery related to gender transition. As the field of transgender health developed, decades of research have reported on ...

  7. PDF Providing Mental Health Assessments for Gender Affirming Surgery

    1-4 BH visits for intake evaluation and surgery readiness assessment----depends on surgery type and client need and your assessment of emotional/mental stability What if the person is requesting a letter and therapy? • At FHC: Complete the intake evaluation and readiness assessment, present the case and add person to the waitlist.

  8. Mental Health Evaluation for Gender Confirmation Surgery

    Mental Health Evaluation for Gender Confirmation Surgery Clin Plast Surg. 2018 Jul;45(3):307-311. doi: 10.1016/j.cps.2018.03.002. Epub 2018 Apr 19. Author Randi Ettner 1 Affiliation 1 New Health Foundation Worldwide, 1214 Lake Street, Evanston, IL 60201, USA. Electronic address: [email protected]. ... Sex Reassignment Surgery / psychology*

  9. Mental Health Evaluation for Gender Confirmation Surgery

    Mental Health Evaluation for Gender Confirmation Surgery. Randi Ettner, PhD [email protected]. ... Long-term follow-up after sex reassignment surgery. Scand J Plast Reconstr Surg Hand Surg. 1997; 31:39-45. Crossref. ... a systematic review and meta-analysis of quality of life and psychological outcomes. Clin Endocrinol. 2010; 72:214-231. Crossref ...

  10. Psychological Evaluation for Gender Affirming Surgery

    Gender Affirming Surgery is More Than Just a Physical Transition. If your doctor is requesting you receive a psychological evaluation prior to gender affirming surgery, we can help. Before we do, we want you to know where we stand. There are many ways people transition and different types of transitioning.