gender reassignment surgery letter template

Gender-Affirming Surgery Letters 101

Learn how to get a letter for gender-affirming surgery from a medical provider. FOLX offers surgery referral letters for all kinds of gender-affirming procedures!

This article was updated 7/12/23. The illustrations are by Leo.

This article reviews the basics of getting a letter for gender-affirming surgery from a medical provider. At FOLX, we write letters for all kinds of gender-affirming surgeries. Not every person wants or needs a gender-affirming surgery, but for those who do, this guide reviews the types of letters you’ll need.

What are surgery letters?

Usually, both the surgeon and the insurance company require a letter of support for gender-affirming surgery. The letter helps a surgeon who is just starting to get to know you evaluate your needs, and understand your situation and medical history in a more thorough way. A letter of support will inform the surgeon and insurance company about the type of surgery you want. Letters of support may be required for both the surgeon and the insurer to evaluate your coverage for: top surgeries (male chest construction or breast augmentation); bottom surgeries (removal of ovaries or uterus, testes or penis, constructing a new penis or vagina); and  facial feminization or tracheal shaves. The insurance company wants to make sure that the procedure is medically necessary, that you understand what this surgery involves, and that it will be safe and effective.

Different letters of support for your gender affirmation 

There are a few different kinds of letters you may need. These include:

• Introduction from a medical provider to a surgeon as they get to know you and evaluate you for appropriate surgical options
• Mental health letters of support, which are sometimes needed for gender-affirming procedures
• Providing the insurer with diagnostic codes, an indication of medical necessity and safety for the patient and the procedure 
• Physical exam clearance letters or “pre-operative” clearance immediately before the actual surgery
• Letters of support for changing or updating your legal name in court
• Letters of support for changing your name and sex/gender on birth certificates, licenses, or passports

You don’t need to change the name on your IDs before having surgery. Of course, if you are more comfortable changing your name before surgery, go for it. Do what feels right or easiest for you.

Insurance companies, letters, and diagnostic codes

Insurance companies usually require a medical diagnostic code for " Gender Dysphoria " in order to cover transition-related care as medically necessary. You may not fit this diagnostic code exactly, but in some cases, the code is needed in order for insurers to pay for the surgery. A good example of this might be a letter for a person who identifies as nonbinary and does not have a lot of “dysphoria.” They might still need a gender dysphoria diagnostic code attached in order for insurance to cover the surgery.

Why does the World Professional Association of Transgender Health standards of care (WPATH SOC) require letters?

Letters of support for gender-affirming surgery are required by the international transgender organization WPATH in order to ensure that patients are appropriate and prepared for their upcoming gender surgery. They help surgeons prepare and get paid for these surgeries. They also help the insurance company make sure the surgery is going to be effective and safe for that patient.

WPATH updates

Updated guidelines from the WPATH standards of care ( WPATH SOC 8 ) require only one letter of assessment from a healthcare professional. This provider must be competent in caring for transgender and gender-diverse people.

Before September 2022, WPATH guidelines required those seeking bottom surgery to provide two medical letters. One had to be from a mental health provider, and the other from a medical provider, like your hormone-prescribing clinician. If your insurance company requires a letter from your hormone provider for any surgery, your FOLX clinician can provide one.

Insurance approval letters

There are usually two steps in getting insurers to cover payment for the surgery, which is what a surgeon will require before they book a time in the operating room, if you plan to use insurance to cover any part of surgery.

Step 1: Pre-certification or prior authorization. This indicates that your insurance coverage does include this in their list of benefits.

Step 2: Insurance approval.  The second important step is when the insurance company lets the surgeon know how much they will pay for the surgery and operating room or hospitalization costs.

Your surgeon will need both of these things before they can perform your surgery. It's important for you to know this, too, because it will help you figure out how much money you will need to pay for expenses that your insurance won't cover.

Letters for gender-affirming surgery

Ideally, letters for insurance approval can also provide the same information a surgeon might need to evaluate you for gender-affirming surgery. One letter can often be used for two purposes.

Some surgeons require a letter from your hormone treatment provider. Other surgeons suggest you be on hormones for a while before having some surgeries, although some people have surgeries without ever using hormones as part of their transition. Most surgeons want a letter from someone who understands your needs, your previous and current care, and your suitability for a particular surgery. For instance, letters may include a person’s history of gender affirmation care, hormone use, and whether gender dysphoria is ongoing–even with hormone therapy. These details may help establish the medical necessity for surgery.

A surgery letter may need to be provider-specific and insurance specific. This means that some providers and insurance companies may require certain language and information in these letters. Some surgeons and insurers still require two letters before agreeing to GAS (gender-affirming surgery). This complies with old WPATH standards of care ( SOC 7 ) guidelines. Only one letter is required in the updated WPATH SOC 8 guidelines, acknowledging some of the history of gatekeeping in GAS care. 

It’s quite possible the information in a letter may not be specific to you. For example, they may use a gender dysphoria diagnosis, but you really do not have dysphoria, even if you want top surgery . Even if some of the details are not as specific to you and your situation as you would like, it may be more helpful to understand some of the “whys” behind including such information for coding and or payment requirements. Be aware providers can use different versions of letter templates to meet these requirements.

Keep in mind that not all medical providers are informed on WPATH guidelines or gender-affirming care in general. That’s why it’s crucial to find a culturally competent provider who understands how to write a surgery letter.

What FOLX offers

Our team of LGBTQIA+-specialized clinicians provides surgery letters according to WPATH SOC guidelines.

What we can provide:

• We can provide medical letters for gender-affirming surgery.
• We can provide surgery referral letters for those seeking top surgery (including breast augmentation) and facial feminization surgery (FFS).
• We can provide referral letters for bottom surgery (including vaginoplasty and hysterectomies).
• We can provide medical letters to get insurance approval and coverage. 

What we can’t provide:

• We do not offer physical exam clearance letters for surgery.
• We cannot provide medical clearance for surgery.
• At present, we only offer mental health letters for surgery in select states (with more to come). (Surgeons sometimes require mental health letters before gender-affirming surgery.)

How to meet requirements for gender-affirming surgery

For folx to write a letter for gender-affirming surgery, we make sure you meet the wpath standards of care so you get the care you need. these include:.

• A desire to undergo gender-affirming surgery
• Understanding of the effect of gender-affirming surgery or procedure
• The ability to consent to the procedure
• Clearance from other mental health or medical conditions that could negatively affect the outcome of the gender-affirming surgery
• If taking hormones or other medications, an assessment that you are doing well on all your medications 

Other things to note: 

• WPATH prefers that a person is under the care of a gender-affirming expert provider for 6-12 months before surgery. This is something you can discuss with both your medical and surgical providers. 
• Many insurers require a diagnosis of Gender Dysphoria for insurance coverage and billing.

Getting referrals and surgery letters

Submit a request via the FOLX Help Center  so our Member Navigators can help you get a referral or request a surgery letter. For all FOLX and non-FOLX members seeking a gender-affirming surgeon in your area, please inquire about our referral network of over 20,000 healthcare providers and community resources nationwide.

If you’re an existing FOLX member, you can schedule an appointment with your clinician in your Athena Patient Portal to discuss surgery letters. If you're not yet a member, but you're interested in this service, book a virtual primary care appointment . Either way, your clinician needs to review your medical history and gather information so you can get your surgery letter. One of the best parts about being a FOLX member is that we’re here every step of the way to help and guide you. We make getting the gender-affirming care you need as easy and seamless as possible.

FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include expert, gender-affirming virtual primary care , gender-affirming hormone therapy (sometimes known as HRT or hormone replacement therapy), mental healthcare , sexual healthcare, and more. We offer memberships for testosterone and estrogen , sexual health products like  PrEP, and peer support groups. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQ-friendly healthcare with FOLX. FOLX Health is for everybody and every body in the LGBTQIA+ community. You deserve to feel fabulous. To become a FOLX member,  click here .

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Gender Affirming Surgery Assessments for Support Letters

Mazzoni Center recognizes everyone’s gender narrative is unique and there are many pathways to feeling whole. Those who seek gender-affirming surgery may need to present a letter from a mental health professional as requested by their surgeon and/or insurance company. Mazzoni Center continues to evaluate our process to serve our patients best, while reducing barriers, increasing access and maintaining this service at low cost. Our goal is to keep this consultation collaborative and supportive.

Our Behavioral Health Consultant (BHC) will meet with you to discuss your relevant information, goals for surgery. BHCs can also provide support with aftercare and any unmet needs, and offer resources and information. We can provide you with a letter directly or send it to your surgical coordinator. In most cases we can respond to requests for appointment fairly quickly; however, kindly allow as much notice as possible to ensure we can meet your timeline. We accept most insurances and offer a low-cost sliding scale for those without insurance. Our Behavioral Health Consultant will provide information and answer any questions you may have about the process.  

Assessments are scheduled by appointment only. Walk-ins are not available for this service.

How To Set up An Appointment

Active Medical Patients: Call us at 215-563-0658 (Option 1) to speak with our front desk staff who will be able to assist you with any of your needs. Call Hours: Monday – Friday 9 am-5 pm

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Via your medical provider: Mention it to your Mazzoni Center provider and they will link you to a Behavioral Health Consultant.

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• How to Find a Gender-Affirming Therapist for Surgery Letters

The Ultimate Guide to Getting a Therapist Support Letter for Gender-Affirming Surgery

Medically reviewed by Paul Gonzales on April 8, 2024.

Many gender-affirming surgical practices like the Gender Confirmation Center (GCC) use the informed consent model in determining who is eligible for top surgery, bottom surgery, facial feminization surgery, facial masculinization surgery and gender-affirming body contouring. However, some surgical practices and insurance companies require patients to submit support letters from one or more mental health professionals to undergo surgery and/or to cover its costs .

We go over how to get a therapist support letter for gender-affirming surgery, the requirements for the support letter(s) as well as the additional value a gender-competent mental health professional can have during the surgical journey.

If you are interested in getting gender-affirming surgery, you can schedule a free, virtual consultation with one of our board-certified surgeons today.

Why do I need a support letter for surgery?

Some gender-affirming surgeons may require at least one support letter from a mental health professional to clear a patient to be eligible for surgery. The purpose of these letters is to assess a patient’s readiness for surgery.

In the case of adolescents who are not yet legal adults, a letter of support from a licensed mental health professional and/or a medical healthcare provider (such as a physician or endocrinologist) that is part of their multidisciplinary care team will be necessary to establish their readiness for gender-affirming surgery.

Insurance Coverage

Most insurance companies that cover gender-affirming surgeries require a letter of support from a licensed mental health provider (e.g. therapist, psychiatrist) to prove that surgery is medically necessary or is part of transition-related care.

Depending on your insurance plan, your primary care provider may need to write you a referral letter to get gender-affirming surgery. Likewise, if the surgeon is outside your insurance’s list of in-network providers. For more information about which types of insurance we take and how to get coverage, you can refer to this article .

How can I find a gender-affirming therapist to write me a letter?

For some patients, it can be difficult to find a gender-competent mental health professional to support them through gender transition, or more specifically, to get a support letter for surgery.

Though it may take time, finding someone you are comfortable with is worth the effort. Patients can consult the list of WPATH members or the directory of the Gender Affirmative Letter Access Project (GALAP) to find a gender-competent, licensed mental health provider. Additionally, there are multiple online therapist directories that can filter for experience working with transgender individuals, the types of insurance they take, and their current availability.

If you have gender-affirming therapists in your area then this will help tremendously. If not, you can pick someone who is committed to learning, or look into support groups and online resources. If you cannot afford therapy, consider reaching out to health centers or local LGBTQ centers for free or low-cost options.

If you select a therapist and end up not liking them, you can always choose to stop seeing them. Some therapists provide a free consultation to assess whether they would be a good fit for you.

What questions should I ask?

When you are looking for a licensed psychiatrist or psychotherapist to write you a referral letter for surgery, these are some questions you might want to ask them:

• If you are seeking a therapist exclusively to get a referral letter for top surgery, ask if this is something they can provide and what the process is.
• How familiar are they with the WPATH Standards of Care?
• What experience do they have with clients who are transgender and/or non-binary?
• Do they take your insurance?
• If they don’t take your insurance ask: Do you offer a sliding scale? (meaning, do they offer more accessible rates for lower-income clients) 

What should a support letter contain?

According to the World Professional Association for Transgnder Health (WPATH) Standards of Care (SOC) version 8 , a support letter needs to be written by a member of a multi-disciplinary team of mental health and medical care providers involved in providing gender-affirming care to the adolescent. Since the patient is not yet a legal adult, the multi-disciplinary team needs to work with the parent(s)/guardian(s) in assessing the patient’s eligibility for surgery. Please note that top surgery is the only kind of gender-affirming procedure that adolescents are eligible for, even with parental consent and the approval of their multidisciplinary care team.

In the case of adolescent care, some surgical practices have a list of vetted mental health providers that they accept support letters from. If you have questions about the specific requirements for your adolescent’s surgery, you should contact your surgeon’s office .

According to SOC 8 , the purpose of a support letter for an adult seeking medically necessary gender-affirming medical treatments should be assessed by a licensed mental health professional with at least a master’s-level education in their clinical field (psychiatry, social work/LCSW, marriage and family therapy/LMFT, etc.). Providers should be able to assess a patient’s capacity to consent to surgical treatment, discuss mental and physical health conditions that could negatively impact the outcome of gender-affirming care, discuss the impact of the surgery on reproductive health, and more.

In the case of bottom surgery, WPATH recommends that two licensed mental health professionals provide a support letter. This can be in the form of one letter signed by two professionals or two letters provided by the professionals, separately.

According to SOC 7 , the set of WPATH standards that many providers and insurance companies still follow, letters should include the following components:

• The client’s general identifying characteristics;
• Results of the client’s psychosocial assessment, including any diagnoses;
• The duration of the mental health professional’s relationship with the client, including the type of evaluation and therapy or counseling to date;
• An explanation that the criteria for surgery have been met, and a brief description of the clinical rationale for supporting the patient’s request for surgery;
• A statement about the fact that informed consent has been obtained from the patient;
• A statement that the mental health professional is available for coordination of care and welcomes a phone call to establish this.

What are the GCC’s support letter requirements?

All surgical consultations , in-person and virtual, are free of charge to prospective and former GCC patients. Patients are not required to present support documents in order to schedule a consultation ; however, patients who do present the required support letters will be given priority in scheduling their consultations. The documentation we require is listed below:

Patients who are interested in having their insurance cover their procedure(s): 

• First, a support letter from a mental health professional should be provided so that we can move forward with requesting coverage from your insurance. Second, if Gender Confirmation Center surgeons are not considered in-network providers by your insurance plan, you will need a referral letter from your primary care provider.
• Please note that if you are interested in bottom surgery, you will need to present support letters from two licensed mental health professionals to book their consultation. This can be in the form of one joint-letter signed by two providers, or two separate letters.

‘Cash-pay’ patients who will be financing their surgery without insurance:

• Per the WPATH’s Soc 8 guidelines , patients interested in bottom surgery will need to present support letters from two licensed mental health professionals to book their consultation. This can be in the form of one joint-letter signed by two providers, or two separate letters. Supporting documents are not required for patients who are legal adults to undergo any other surgery.
• Check out our pricing & financing page for resources like trusted medical creditors and grants for gender-affirming surgery!

Mental health support before and after surgery

In many cases, requiring adults to present referral or support letters from mental health professionals in order to undergo gender-affirming surgery can be considered a form of gatekeeping . At the GCC, we simultaneously recognize and value the role of mental health professionals in supporting patients through the process of surgical gender-affirmation.

Both the process of preparing for and recovering from surgery can take an emotional toll on patients. Having an active support network of loved ones and a mental health professional can strengthen your ability to cope with challenges that may arise. Specifically, gender-competent mental health professionals can support patients through:

• Helping you figure out which procedures are right for you
• Setting realistic expectations for the results and recovery of surgery
• Figuring out how and to which people in your life you would like to reveal that you undergoing surgery 
• Organizing a support network or plan for your physical and emotional recovery from surgery
• Helping you navigate temporary feelings of post-operative depression and regret that might come up as you deal with the physical limitations and inflammation (having to wait to see the final results of your surgery)
• Celebrating your gender affirmation with you!

Conclusion:

• A support letter from a licensed mental health professional–a psychotherapist or psychiatrist–may be necessary to be eligible for surgery. Likewise, most insurance companies require a letter from a mental health procedure to justify covering the costs of gender-affirming surgery.
• You can find a gender-competent provider to write you a support letter through the Gender Affirmative Letter Access Project (GALAP) , the list of WPATH members or other online search engines like Psychology Today . Generally speaking, your provider should be a licensed clinical mental health professional (MD/DO, LCSW, LMFT, etc.), with at least a master’s-level education and a familiarity with the WPATH’s Standards of Care . 
• For adolescent surgical care, the requirements are generally stricter. Contact your surgeon to see what they require of your adolescent’s care team for them to be eligible to undergo top surgery . No other forms of gender-affirming surgeries are performed on adolescents, even with parent/guardian approval.
• Although the requirement for a therapist support letter for gender-affirming surgery is often a form of gatekeeping , we recognize that mental health professionals often provide an invaluable role in supporting patients through surgery.

More Articles

Estrogen: for trans women, transfeminine, non-binary, and gender-expansive folks, after surgery low-sodium diet to reduce inflammation, top surgery myths, sign up for instructions to get a virtual consultation.

The virtual consultation will be billed to your insurance company. We will accept the insurance reimbursement as payment in full.

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Transgender Health Program

Transgender health program: for health care professionals, refer a patient.

The Transgender Health Program offers resources, training and help with referrals to health care professionals in the community. You’ll find our providers and their clinics below.

Contact us at 503-494-7970 or [email protected]   with questions.

• Please complete our Request for Transgender Health Services referral form .
• Some services have specific prerequisites for patients to be seen. Please make sure all fields on the form are complete.
• Fax the referral form to 503-346-6854 .

Grand rounds: You're invited

Please join our quarterly series on issues generated by and important to the transgender and gender-diverse community. These learning opportunities aim to educate providers to:

• Eliminate disparities in health care
• Promote equity, healing and visibility

All sessions are online, noon to 1 p.m.

Upcoming events

Watch previous grand rounds .

* TGD = transgender and gender diverse

Continuing medical education

Accreditation: Oregon Health & Science University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit: OHSU School of Medicine designates this live activity for a maximum of 1 AMA PRA Category 1 Credit TM .  Physicians should only claim credit commensurate with the extent of their participation in the activity.

Mental health providers: Write a letter of support

OHSU providers follow World Professional Association for Transgender Health (WPATH)  Standards of Care, Version 8 . This means some surgical referrals require a mental health letter of support. The letter should be written by a licensed mental health provider. If written by an unlicensed provider, the letter should be attested to and co-signed by a licensed supervisor.

• Please use this fillable mental health letter of support template to complete the letter.
• Fax the letter to 503-346-8310 .

Transgender Health Program training

The Transgender Health Program provides training and classes to health care professionals and offices. We can help you provide hormone therapy and other forms of gender-affirming care in a welcoming environment. Learn more:

• Education and consultation request
• Recommended rates and fees
• Four-part training: “Introduction to Gender Diversity: Care and Treatment of Transgender and Gender Nonconforming (TGNC) People Across the Lifespan”

Find an OHSU provider

Pediatric care.

Pubertal suppression and hormone therapy

• Hayley Baines, M.D.
• Kara J. Connelly, M.D.
• Charlene Lai, M.D.
• Stephanie Tarlow, PA-C, CDCES

Mental health care

• Danielle Moyer, Ph.D.

Endocrinology

• Winnie Liu, M.D.
• Sarah C. Soltman, M.D.
• Leah Wilson, M.D.
• Paula Amato, M.D.
• Jason Hedges, M.D., Ph.D.
• David M. Lee, M.D.

Hair removal

Electrolysis

• Michelle Cappadona , licensed electrologist

Laser hair removal

• Heather Onoday, RN, M.N., FNP

Hormone therapy

The Transgender Health Program encourages primary care providers to manage hormone therapy whenever possible. This avoids disruptions in care and reduces travel time for patients who live outside the Portland area. The THP can provide resources, technical assistance and advice if you need.

Specialty care: See Endocrinology (above) for patients who need specialty hormone therapy care because of diabetes, thyroid disease or other conditions.

• Asha Jetmalani, D.O.
• Mary Marsiglio, Ph.D.

Surgical services

Top surgery.

Gender-affirming mastectomy and gender-affirming breast augmentation

• Jens U. Berli, M.D.
• Juliana Hansen, M.D.
• Blair Peters, M.D.

Bottom surgery

Hysterectomy and oophorectomy

• Lishiana Shaffer, M.D.

Metoidioplasty

• Daniel Dugi III, M.D., FACS
• Geolani Dy, M.D.

Orchiectomy

• Jyoti Chouhan, D.O., Pharm.D.

Phalloplasty

• Erectile implants: Geolani W. Dy, M.D.

Vaginectomy

• Kamran Sajadi, M.D.

Vaginoplasty/vulvoplasty

• Geolani W. Dy, M.D.

Facial surgery and body contouring

Laryngochrondoplasty and vocal surgery.

Laryngochrondoplasty (Adam’s apple reduction; also called a tracheal shave)

• Joshua S. Schindler, M.D.

Vocal surgery to raise pitch 

OHSU research

OHSU providers have done extensive research on topics related to caring for gender-diverse patients. Here is a selection of papers:

Chest surgery

• Differences in Chest Measurements between the Cis-female and Trans-female Chest Exposed to Estrogen and Its Implications for Breast Augmentation , Plastic and Reconstructive Surgery, March 2019
• Top Surgery in Transgender Men: How Far Can You Push the Envelope? Plastic and Reconstructive Surgery, April 2017
• What is ‘Nonbinary’ and What Do I Need to Know? A Primer for Surgeons Providing Chest Surgery for Transgender Patients , Aesthetic Surgery Journal, July 2018

Facial surgery

• Facial Gender Confirmation Surgery: A New Nomenclature , Plastic and Reconstructive Surgery, November 2017

Pediatric patients

• Using the PHQ-9 and GAD-7 to screen for acute distress in transgender youth: findings from a pediatric endocrinology clinic , Journal of Pediatric Endocrinology and Metabolism, January 2019
• Phalloplasty: techniques and outcomes , Translational Andrology and Urology, June 2019
• Phalloplasty Flap-Related Complication , Clinics in Plastic Surgery, July 2018
• Implementation of a Pelvic Floor Physical Therapy Program for Transgender Women Undergoing Gender-Affirming Vaginoplasty , Obstetrics and Gynecology, May 2019
• Does Depth Matter? Factors Affecting Choice of Vulvoplasty Over Vaginoplasty as Gender-Affirming Genital Surgery for Transgender Women , The Journal of Sexual Medicine, June 2018

More information for surgeons

• Injury in the transgender population: What the trauma surgeon needs to know , Journal of Trauma and Acute Care Surgery, October 2018
• What Surgeons Need to Know About Gender Confirmation Surgery When Providing Care for Transgender Individuals , JAMA Surgery, April 2017

OHSU presentations

Suicide Risk and Resilience Among TGD People Across the Lifespan

June 17, 2021:  Beyond “Born in the Wrong Body”: Challenging out Biases to Provide Inclusive Care for Nonbinary Youth | Dr. Kara Connelly, Dr. Danielle Moyer, and Jess Guerriero, MSW

June 2, 2021:  Beyond Medicine: The Healing Power of Gender Affirming Care

June 4, 2020:  More than Medicine: Creating Safety Nets for Gender Diverse Youth | Dr. Kara Connelly, Dr. Danielle Moyer, and Jess Guerriero, MSW

May 3, 2016: Gender Reassignment Surgery: Experience From Belgrade  |  Miroslav L. Djordjevic, M.D., professor of pediatric surgery/urology, University Children’s Hospital in Belgrade Serbia

March 22, 2016:  Medical and Surgical Transition for Transgender People  |  Daniel D. Dugi III, M.D., FACS, assistant professor of urology, OHSU; and Amy Penkin, LCSW, clinical program manager, OHSU Transgender Health Program

March 15, 2016:  Building Trans Awareness and Responsiveness (Part 2) | Amy Penkin, LCSW, clinical program manager , OHSU Transgender Health Program

March 1, 2016: Transgender Health Program Community Forum: Vaginoplasty  |  Daniel D. Dugi III, M.D., FACS, assistant professor of urology, OHSU

June 5, 2015:  Building Trans Awareness and Responsiveness (Part 1) | Amy Penkin, LCSW, clinical program manager , OHSU Transgender Health Program

March 22, 2015:  Assessing Sexual Orientation and Gender Identity in Clinical Encounters  |  Juno Obedin-Maliver, M.D., M.P.H., and Mitchell R. Lunn, M.D., University of California-San Francisco

Publications

• Standards of Care Version 7 , World Professional Association for Transgender Health
• The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health , 2nd Edition, and other publications, National LGBT Health Education Center, Fenway Institute
• Creating a Safe and Welcoming Clinic Environment , Center of Excellence for Transgender Health
• Transgender Sexual and Reproductive Health: Unmet Needs and Barriers to Care , National Center for Transgender Equality
• Organizing for Transgender Health Care: A Guide for Community Clinic Organizing and Advocacy , Transgender Law Center
• 503-494-7970
• [email protected]

Continue your education

• Visit our Patient Education and Events page and Continuing Professional Development  page to look for CME opportunities in transgender care.
• Read a course outline of our “ Introduction to Gender Diversity: Care and Treatment of Transgender and Gender Diverse (TGD) People Across the Lifespan ” training.
• Fill out the Education and Consultation Request form

Stay connected

• Track your patient’s care: OHSU Connect gives you easy online access to your patient's shared electronic medical records.
• Provider relations: OHSU’s Provider Relations Team can help you resolve issues, enroll in or learn how to use OHSU Connect, and access continuing education opportunities.
• Newsletter: Connections , our quarterly newsletter for primary care providers, reports on the latest medical developments at OHSU.

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People Who Undergo Gender-Reassignment Surgery Have a 12x Increased Risk of Suicide

People who undergo gender-reassignment surgery have a 12x increased risk of attempting to commit suicide, according to a new study, as well as suffering other mental-health problems like PTSD and self-harm. The study, published in the journal Cureus, clearly shows that undergoing gender-reassignment, where the patient’s genitals are surgically rearranged and they also embark on a regimen of hormonal therapy, carries significant, potentially deadly, risks. The researchers note, “There is ongoing controversy surrounding the benefits of gender-affirmation surgery on mental health.” Their aim was to explore the risk of “adverse...

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