Letter Requirements

GENERAL: 3 LETTERS required by insurance; 2 LETTERS required by WPATH

  • One from mental healthcare professional (psychiatrist or psychologist with transgender healthcare experience)

  • One from another mental healthcare professional

  • One from your hormone provider

WPATH Approved Letters of Recommendation for gender affirming bottom surgery includes:

  1. The patient's general identifying characteristics.

  2. The initial and evolving gender, sexual and other psychiatric diagnoses.

  3. The duration of their professional relationship, including the type of psychotherapy or evaluation that the patient underwent.

  4. The eligibility criteria that have been met and the mental health professional's rationale for hormone therapy or surgery.

  5. The degree to which the patient has followed the Standards of Care to date and the likelihood of future compliance.

  6. Whether the author of the report is part of a gender team.

  7. That the sender welcomes a phone call to verify the fact that the mental health professional actually wrote the letter as described.

NOTE: Letters are generally not required for patients who have already had gender affirmation surgery and who are interested in surgeries like penile or testis implants, urethroplasty, reconstruction of their current neophallus and neoscrotum, or other related surgeries. However, some insurance companies require letters despite already having had multiple gender confirmation surgeries. 

GU box 12.16.18.png
  • Twitter
  • Facebook Social Icon

G.U. Recon Mang Chen MD 2019  

G.U. Recon Clinic

45 Castro St. Ste 111

San Francisco, CA 94114

Office: 415-481-3890

Fax: 309-328-3827

DISCLAIMER: The content on this website, including all forms, files, documents, text, and photos, are for informational purposes only. It is not intended to replace the care and attention of your physician or other professional medical services. Please speak with your doctor if you have questions about your health. The GU Recon website does not provide specific, individualized medical advice and does not officially endorse any medical or professional service obtained through information provided on this site or any links to this site.

Privacy Notice.