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Forest Grass

Gender-Affirming Care

Supporting access to care in an oppressive system.

Katie is formally trained to provide WPATH letters/assessments for adults. You will not be denied access to this service due to financial barriers.

For as long as we have had written historical documentation, transgender people have always existed. I'm not here to gatekeep as part of an oppressive system. Whether you have insurance you would like to use to fund your assessment session, you prefer to keep insurance out of it, or you are uninsured and have a financial barrier, I will never gatekeep your access to healthcare based on your inability to pay for a letter-writing assessment. In addition to letters of support for hormone therapy or surgery, upon request I also provide support letters for gender marker change/legal name change

I am here because I see you, no matter what part of your path you are on, and I believe you. You don't have to prove your queerness to me. We do, however, have to follow the laws and standards that are in place to honor and protect all parties, as outlined below. I follow the informed consent model as a best practice and standard of care.

Hormone Readiness Assessments

Many insurance providers and physicians require a diagnosis of Gender Dysphoria from a licensed mental health professional to cover hormone therapy. This is not the same as gender nonconformity, although those who are gender nonconforming can also have gender dysphoria. The hormone therapy assessment is intended to assess and confirm diagnosis and refer to a physician for hormone therapy if applicable. 

It is your responsibility as an adult human with self-determination and self-awareness to have done your research for informed consent before your assessment session. All decisions regarding your healthcare, including hormone use, are yours alone to make.  

As part of your letter, I will need to assess that you are psychologically, emotionally, and logistically prepared and have appraised  the full risks, benefits, limitations, and implications of seeking hormone therapy. 

Counseling is not required to obtain a prescription for hormones although it can be helpful for those who are unsure if hormone therapy is right for them, don't have a plan in place to live as their authentic selves with support, or have significant mental health or substance use concerns.

You do not need to first identify a physician/provider. However, below are some online providers that offer informed consent hormone therapy and gender-affirming medical care:

Folx Health

- follows a membership model (starting at $25 per month)

- insurance is accepted in all 50 states


- insurance is not accepted but a sliding scale is available

Trans Clinique

- Subscription plan model based on needs


- Some insurances accepted

- offers a monthly membership option or self-pay per visit model

Surgery Assessment/Letters of Support

Insurance companies and surgeons require a capacity evaluation by a mental health professional for TGNC surgical procedures. This evaluation involves assessing your understanding of the risks, benefits, limitations, and implications of the surgery; ability to retain information long enough to make a decision; that you weigh all information in making the decision; and you have the ability to communicate your decision in a clear, consistent manner. 

It is your responsibility to have done your informed consent research regarding the desired intervention and surgeon before your assessment appointment. 

For chest surgery ("top surgery" - removal or augmentation) or gonadectomy ("bottom surgery" - hysterectomy or orchiectomy) you MUST have an identified surgeon before your assessment. It is preferred that you have also had an initial consultation with your surgeon, but it is not required. 

For facial surgery or genital reconstruction (vaginectomy, metoidioplasty, phalloplasty, scrotoplasty, vulvoplasty, penile inversion vaginoplasty, peritoneal vaginoplasty, and rectosigmoid vaginoplasty) you MUST have an identified surgeon AND have already had an initial surgical consultation prior to the letter-writing assessment appointment. 

A Note About Youth/Minors

Due to the passing of Florida SB254, I am not able to assess or write letters for minors under the age of 18. Gender-affirming care for youth has been shown to reduce rates of suicidal ideation and death by suicide.

My goal is to assist youth and parents with supportive counseling around discrimination, stigma, threats to safety, and harm reduction while supporting your most authentic self.

Resources for Parents/Caregivers:

LGBTQ+ Support for young people

Mental health outcomes

Life-saving science behind gender-affirming care for youth

Gender-affirming care saves lives

Get the facts on gender-affirming care

The danger of prohibiting gender-affirming medical care for youth

Financial Resources

Point of Pride Trans Surgery Fund

Trans United with Family and Friends

Genderbands - Free chest binders and grants

The Jim Collins Foundation

Black Trans Men Top Surgery Grant

How to Get Started

If you have read the above and would like to schedule your assessment, email Katie ( or complete this form. You will be emailed a pre-screening form that must be sent back before your appointment is confirmed.

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