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The Informed Consent Model

While our practice does not require a letter from a therapist or mental health professional for adult patients under most circumstances, we recognize that therapists can be an invaluable source of support for patients undergoing a medical gender transition. When possible, we recommend that our patients seek out professional psychological support for their surgical journey when it is right for them. It is important to note that if you are pursuing insurance coverage of your surgery, you will need to get at least one letter from a mental health provider if your health insurance provider follows the WPATH Standards of Care for coverage of surgery. While letters can be helpful at times to establish patients have proper support going into surgery, they can also be seen as a barrier to accessing surgery. 

Informed consent is a particularly important process for transgender and gender diverse (TGD) people because it gives them autonomy over their own healthcare. Historically, TGD people have had a difficult time accessing quality gender affirming health care in part because of gatekeeping and discrimination on behalf of mental health providers and other professionals. While therapist-mediated support and their therapeutic process is highly valuable in the gender transition journey, the informed consent model honors TGD patients’ self-knowledge and ability to make informed decisions regarding medical interventions they want to access. The GCC acknowledges that, regardless of insurance coverage requirements, adults who have acquired necessary knowledge are able to determine for themselves if they are ready and willing to access surgery. This extends to trans people who do not fall within the binary; patients of all genders are able to determine their own surgical goals in collaboration with their surgeon and other providers. 

Knowing You’re Ready for Surgery

The decision to get surgery can feel like a big one, and it can be helpful to seek external support and resources for help if you need it. Seeking counseling with a therapist or other licensed mental health professional, or support through in person and online support groups to speak to others who have a similar experience, can be helpful to discern your own motivations and feelings regarding surgery. Having an established relationship with a mental health provider can be helpful if you need letters of support for surgery as well. Ultimately, the decision to get surgery should be self-directed and a result of your own needs and motivations, not through external pressures or expectations. Some people are able to make this decision rather quickly, and others need more time. However long it takes you, and whatever resources you need, it is okay as long as it is going at a pace that feels comfortable to you!

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