Gender Affirming Letters

  • Lesbian

  • Bisexual

  • Gay Queer/Questioning

  • Transitioning/MoC/FoC

  • Pansexual

  • Asexual

Gender Affirming Letters.

Spoken Balance will conduct evaluations and write letters of support for those who need access to gender-affirming medical care. 

Ongoing therapy is not required for letters. If you desire ongoing therapy, you can schedule a consultation here.

These letters could include, but are not limited to, the following:

  • Feminization procedures (ie., facial, vaginoplasty, metoidioplasty, etc)

  •  Masculinizing procedures (ie., phalloplasty)

  •  “Top" surgery

  •  “Bottom” surgery

  •  Voice modification

  •  Orchiectomy

  •  Vaginectomy

  •  Facial hair removal

  •  Genital tucking and packing, and chest binding

For those with financial barriers, Spoken Balance is committed to providing letters (and associated appointment) at no cost to those who are uninsured and/or underinsured. You can read more about Spoken Balance’s commitment in increasing access to care here. Please plan accordingly as letters can take up to 10 calendar days to be completed.

Letter writing details.

  • Your clinician must write you are mentally, emotionally, practically, and financially prepared for the intervention, as well as being aware of the risks, benefits, and implications.

  • If you're seeking a letter for chest surgery, hysterectomy, or orchiectomy, you must have an identified surgeon and ideally had an appointment or consultation with your surgeon.

  • If you are seeking a letter for facial surgery or genital reconstruction, you must have identified a surgeon and had a surgical consultation prior to the letter-writing assessment session.

  • This site is a comprehensive overview of the “Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People

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