WPATH Letters and Gender-Affirming Surgery Assessments in Michigan
Did you know that transgender, non-binary, and gender-diverse care is one of our main focuses at Transformative Therapy? One of our co-founders, Parker, is transgender, and providing a safe place where knowledgeable therapists can help you gain access to gender-affirming care has always been a main priority.
This service is provided in person at our Lansing, MI office or by virtual appointment across Michigan.
Most of the letter work we do is for people seeking gender-affirming surgery. Your surgeon needs one, or maybe two, letters from a mental health therapist supporting your need for gender affirming surgery. Most insurances will not cover the surgery without the letter. Even if you are not using insurance, your surgeon may still want a letter.
Surgeries we write letters for include:
Grouped by area:
- Chest. Chest masculinization, chest or breast augmentation.
- Genital. Orchiectomy, vulvoplasty, vaginoplasty, metoidioplasty, phalloplasty, scrotoplasty, vaginectomy, hysterectomy, oophorectomy.
- Facial. Facial feminization or masculinization.
- Throat and voice. Tracheal shave, voice surgery.
- Body. Contouring, implants, fat grafting.
WPATH Standards of Care
We follow the WPATH Standards of Care when completing a surgery readiness assessment and a letter of support. WPATH is the World Professional Association for Transgender Health. Their Standards of Care are the guidelines surgeons and insurers generally follow. Insurers treat these guidelines as the benchmark for medical necessity, and that’s why the letter exists at all.
Before writing a letter of support, we will complete a surgery-readiness assessment using the informed-consent approach. What this means is you’re the expert on your own identity and goals. During the assessment, we will discuss and review your medical, mental health, and social history. We will ask questions and talk through anything that you may not have considered regarding surgery. The surgery readiness assessment is not a test or something you can fail. If there are any areas of concern, we will work together to develop a plan to address them.
We can write letters for gender-affirming hair removal
Permanent hair removal at the surgical site is a prerequisite for some bottom surgeries. It takes months, and people often find out late. SOC-8 counts it as gender-affirming care.
We write letters of support for permanent hair removal, including laser, when your provider needs one to bill your insurance. Bring us what they asked for.
Two electrologists, Suzy and Mel, work in the same building as we do because we are all part of Wild Ferns Wellness, a collective that offers services centered on the needs, voices, and joy of LGBTQIA2S+ and BIPOC clients and communities. Suzy and Mel are affirming and very experienced at permanent hair removal for trans, nonbinary, and gender diverse folks. They are right down the hall from us, and you can start now if you desire to. They can’t bill insurance, so that work is self-pay. Better you hear that from us now than three appointments in. Visit wildfernswellness.com to learn more.
We can write letters for gender-affirming vocal training
If you’re working with a speech-language pathologist who bills insurance, we can write a letter of support for that work.
Voice coaching and speech-language pathology aren’t the same thing. An SLP is a licensed health care provider and can usually bill insurance. A coach can’t. Wild Ferns has a vocal coach, and that work is worth doing. Ash is a certified vocal coach with an educational background in teaching and music, and Ask is passionate about helping their trans and non-binary siblings find their conversational and musical voice. Learn more at wildfernswellness.com
Questions people ask
How many sessions does this take? Depends on what your surgeon and insurer require, and on what comes up. We’ll know more at your first appointment. Generally, these are completed in one to three appointments.
Do I need one letter or two? Depends on your surgeon and your plan. Ask your surgeon for their requirements, and we’ll work from those.
Do I have to be a regular client here? No. Some people come to us just for the assessment.
Meet the team
Finding the right therapist matters A LOT.
Our team brings different specialties, styles, and lived experiences. Browse our team and use the filters to find your match.
Research shows the single biggest predictor of whether therapy helps isn’t the specific method your therapist uses. It’s the relationship between the two of you. When you trust your therapist, feel safe with them, and agree on what you’re working toward together, therapy works better. That bond, what researchers call the therapeutic alliance, matters more than whether someone uses CBT, EMDR, or any other approach.
People who feel genuinely connected to their therapist tend to feel better faster, stick with therapy longer, and feel better sooner. The opposite is true too: when the fit isn’t right, it’s harder to open up and easier to give up.
This is exactly why we care so much about matching you with the right person, not just any available therapist. Feeling heard, safe, and understood, including in your identity and culture, is what makes the hard work of therapy possible. We do our best to find you a great match and your input matters.
Insurance and fees
We work hard to make therapy as accessible as possible. We accept several insurance plans, including several Medicaid plans, and offer a grant to cover therapy, as well.
The fastest way to get scheduled is to click Request Appointment. The form asks about your insurance, what you are seeking therapy for, your availability, and what your preferences are for a therapist. Your completed request provides us with what we need to match you with a therapist.
We aim to get you scheduled within 48 hours of receiving your appointment request. You deserve quick support and should not have to wonder whether and when you will hear back.
Have questions? View our FAQ, call us at 517-798-6745 or send us a message. If you call, you’ll reach our voicemail. We return voicemails and messages within 24 hours on weekdays.
Crisis Lines
If you’re in crisis or need support right now, you don’t have to wait for an appointment.
- Blackline 1-800-604-5841
- Suicide and Crisis lifeline Call or text 988
- Trans Lifeline 1-877-565-8860
- Trevor Project Call 1-866-488-7386 or text Start to 678-678
If you’re in immediate danger, call 911.