I really just need a letter! Can you help?

Most likely yes! Jessie writes letters for gender-affirming care at no charge. Please read the information below and use the link at the bottom of the page to schedule. I do occasionally pause offering letter-writing sessions when I am teaching other providers how to write them.

If you can’t find a time that works, you can use this link to find other providers who offer letters at no charge: https://thegalap.org/ or this one for providers who only require one meeting for letters: Mental Health Professionals Who Will Provide Letters on First Session.

(Are you a mental health professional wanting support writing letters? Email me!)

Here are some questions you might have about the process:

Do I need a letter to start hormones as an adult?

Many providers in Denver and Colorado do not require letters from a mental health professional for adults to begin gender-affirming hormone care. They use what is called the “informed consent” model, which means they do not require a letter or mental health therapy. You should always check with the doctor and your insurance company to see what they will require, as there are definitely still providers requiring evaluations and letters for adult hormone care despite updated standards honoring patient autonomy.

Do I need a letter for my child to start puberty blockers?

Maybe. This will depend on the doctor and the insurance company and currently has more variability than hormone care for adults. This is because, unlike hormones and surgeries, puberty blockers are a totally reversible medical intervention. Most doctors will require involvement with a mental health professional and will want to communicate with them in some way, which could be a letter or a phone call.

Do I need a letter for gender-affirming surgery?

Most likely yes. Check with your surgeon and your insurance for specific requirements.

I’m a teenager under 18. What does that change about this process?

This will depend on what is going on in your life, what medical things you are wanting, and whether or not your parents/legal guardians are on board. You are welcome to send me an email about your situation and we can talk through what it might look like!

Shouldn’t I just go ahead and get a letter just in case?

No! You might not need one OR your provider might have a specific time frame in which it must be written, so make sure to check with the doctor providing care AND insurance before you get a letter.

How much do you charge for letters?

I am a pledge-signer of the Gender Affirming Letter Access Project (GALAP) and I do not charge you for letters. I am a firm believer in the agency of individuals when accessing their healthcare and I do not support the current gatekeeping system. Because of that, I do not charge you for letters or for the time we spend working on them. If you are a current client, I just charge your regular session fee but there will be no additional charges.

If you have insurance that would cover a session and you give me permission, I can receive payment through insurers. In that situation, you will have no out-of-pocket costs regardless of your coverage specifics. If you feel strongly about paying me yourself AND are financially stable AND do not have Medicaid, I will accept payment. My standard session rate is $170.

Can you guarantee I’ll get my care covered with your letter?

Nope, I can’t. I have a rigorously developed template and integrate all provided requirements from your insurance company and medical provider. However, requirements are always changing and I cannot make any guarantees. The more information you can give me from your healthcare provider and insurance company, the better our chances are of the letter being accepted. I have had letters sent back because they needed more information the client and/or I did not know at the time of writing. I have not had a letter denied after a revision (yet).

What is the process like?

I use a collaborative letter writing process with two main goals: 1) meet the requirements from doctors and insurance; and 2) honor your dignity and humanity. This process involves a thorough intake form followed by one meeting at minimum that happens through Zoom. Depending on your specific needs, we may need to meet more than once. When we meet, we will review some paperwork, I’ll ask you some questions, and we can talk through anything that might be coming up for you about the care you’re seeking and the letter-writing process itself. After the meeting, I send you a copy for approval, make any edits as necessary, and upload a final signed copy for you to send where it needs to go. Please complete all paperwork in the client portal before your session or we will have to reschedule.

Are you going to deny my letter if I don’t have a binary gender?

Heck no! I think it’s ridiculous that you even need a letter from a mental health professional to get healthcare, and even more ridiculous to deny someone healthcare based on their uniqueness. Gender is incredibly complex and nuanced and I am here for all of it. I’ve written many letters for folks of a wide variety of identities, including genderqueer, nonbinary, woman, transgender male, agender, and more.

How long will it take for me to get my letter after we meet?

It typically takes between one and three weeks for me to finish the letter. I am not able to fax letters. The quickest method for getting your letter is for me to upload it into your portal and for you to email it directly to your provider.

Why does this process exist?

I could talk about this for hours, but the short and honest answer is transphobia and colonization. You can learn more about the history by reading decolonizing trans/gender 101 by b. binaohan, Transgender History by Susan Stryker, and the current and past Standards of Care documents on the website of the World Professional Association for Transgender Health (WPATH).

Ready to schedule?

Click here to find a time.

PLEASE NOTE:

***I occasionally pause letter-writing when I am teaching other providers how to write them. If you don’t see the option for a “GAHC Letter Session,” that means I’ve paused. Please don’t request a “New Client Meeting” or “Initial Session” for a letter - it will get declined.***

While the system does allow you to schedule 12 hours ahead of an appointment time, please schedule letter sessions at least one week in advance to allow time for paperwork. All paperwork must be completed before your session or it will be canceled.