Surgery Readiness & WPATH Letters

Gender-affirming surgery readiness assessments and WPATH letters in Michigan

Did you know that transgender, non-binary, and gender-diverse care is one of our main focuses at Transformative Therapy? Providing a safe place where knowledgeable therapists can support you in getting your gender-affirming needs met has always been a main priority.

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 insurance plans will not cover the surgery without the letter. Even if you are not using insurance, your surgeon may still want a letter.

We provide gender-affirming surgery readiness assessments in person at our Lansing, MI, office inside Wild Ferns Wellness Center. Our office is located on the Lansing/East Lansing line and just minutes from MSU. There is a CATA bus stop a half block away from us. Our office is wheelchair accessible, and there is an elevator.

Prefer to meet from home? We offer online therapy across Michigan, so you can work with an identity-affirming therapist wherever you are in the state.

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’d like. 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.

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.