surgery letter guidelines.

Before surgery, I was required to meet to get three letters: one from a psychiatrist, one from a therapist and one from my hormone prescribing doctor. The psychiatrist letter needed to be an evaluation of me from as little as one session to as many as they needed to accurately access me. The therapist needed to be from someone I had been seeing for minimum one year. My hormone prescribing doctor was needed to assure the insurance companies that I had been on hormone replacement therapy for at least two years.

Here are the guidelines I was given from my surgeon’s office:

***Please note all letters must be signed by the provider and printed on letterhead. The letters can be faxed, emailed, or mailed to our office.
The mental health letters must include:

1. Patient legal and preferred name

2. Patient date of birth

3. Date provider/patient relationship began and frequency of contact

4. Statement that patient has the capacity to make fully informed decisions and consent to treatment

5. Statement that patient has been diagnosed with Gender Identity Disorder/Gender Dysphoria and exhibits all of the following:

i. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment; and

ii. The transsexual identity has been present persistently for at least two years; and

iii. The disorder is not a symptom of another mental disorder; and

iv. The disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

6. The patient has undergone a minimum of 12 continuous months of hormone replacement therapy (please note this varies between procedures and insurance plans)

7. Documentation that the patient has completed a minimum of 12 months of successful continuous full time real-life experience in their new gender, across a wide range of life experiences and events that may occur throughout the year  (please note this varies between procedures and insurance plans)

8. If the patient has significant medical or mental health issues present, they must be reasonably well controlled.

The hormone provider letter can be much simpler. It should state:

1. Patient’s legal and preferred name

2. Patient date of birth

3. Date provider/patient relationship began and frequency of contact

4. Date hormone therapy began

5. That the patient has been undergone a minimum of 12 continuous months of hormone replacement therapy

6. That hormone therapy is specifically for the treatment of GID/Gender Dysphoria

Nash Azarian