Gender-Affirming Procedure Evaluation/Letter
You deserve to experience harmony between your physical being and your gender identity
The associates of Arbor Sana offer evaluations, culminating with a letter of support, to establish or corroborate clients’ readiness to undergo gender-affirming medical and/or surgical procedures.
When to Come for A Gender-Affirming Procedure Evaluation/Letter
Transgender, or trans, is a term encompassing many identities (e.g., non-binary, genderfluid, gender expansive, etc.), all of which challenge societal gender norms (i.e., the gender binary of boy/girl and man/woman). Many folks who are trans experience distress and discomfort related to an experience of disharmony between their gender identity (i.e., man, woman, trans, etc.) and designated sex at birth (i.e., male, female, or intersex). This is known as gender dysphoria. Trans and gender-expansive folks will typically reach out to Arbor Sana seeking an evaluation/letter to establish or corroborate their readiness to undergo gender-affirming procedures (i.e., medical and/or surgical interventions for the treatment of gender dysphoria).
How Can a Gender-Affirming Procedure Evaluation/Letter Help?
For better or worse, gender dysphoria is the gatekeeper to affirmation
Gender dysphoria is related to a well-documented history of endorsing an experienced disharmony between one’s gender identity and designated sex at birth, and/or that one has the typical feelings/reactions of another gender. This experience includes strong and persistent desires as well. These desires can include: wanting to be another gender, wanting to be treated as another gender by others, and wanting to have sex characteristics of another gender other than those of one’s designated sex at birth.
Unfortunately, most major insurance companies require a formal diagnosis of gender dysphoria, among other things, to reimburse for medical and/or surgical gender-affirming procedures.
Arbor Sana values autonomy and the right of persons to make informed decisions about their physical being and gender. While Arbor Sana acknowledges the pathologization of gender expansiveness that is pervasive within our healthcare system, we continue to uphold our ethical, legal, and professional responsibility to operate within the bounds of our current system, flaws and all.

Not all trans and gender-expansive folks pursue every form of affirmation
There are two primary paths of gender affirmation. For some, the exploration and pursuit of one path is desirable. Whereas for others, both paths resonate:
- Social affirmation
- Involves experiences such as coming out, expressing one’s identified gender through clothing, accessories, demeanor, etc., and/or changing legal documents to be consistent with one’s gender identity, etc.
- Medical affirmation
- Involves the pursuit of feminizing or masculinizing hormone replacement therapy (HRT), hair removal, speech modification therapy, and/or gender-affirming "top" and/or "bottom" surgeries, etc.
Our Gender-Affirming Procedure Evaluation/Letter Process
Your first step is to call us to schedule your initial appointment. Arbor Sana’s gender-affirming procedure evaluation/letter process typically consists of one appointment. However, the evaluation may take 2-3 sessions dependent upon the amount of information needed to satisfy the criteria for the desired medical and/or surgical affirmation procedure in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care.
Your evaluation session will consist of providing your evaluator with some background about yourself and the reasons you are seeking a gender-affirming procedure evaluation/letter. In addition, your evaluator will be able to answer your questions regarding services, confidentiality, and what to expect during the evaluation process.
At the conclusion of the process and dependent upon the findings of the evaluation, your evaluator may write a letter of support to establish or corroborate your readiness to undergo your desired medical and/or surgical affirmation procedure. Additionally, you will be asked to complete a release of information authorization form if your evaluator must email, fax, or mail the letter of support directly to your surgeon/physician.
Call (440) 895-0366 or email info@arborsana.com to learn more or schedule an appointment.
Benefits of Gender-Affirming Procedure Evaluation/Letter Include:
- Access to otherwise inaccessible treatments
- Validating one's lived experience
- Improved self-esteem

If you are interested in an evaluation, give us a call:
(440) 895-0366