Letter Requirements

Gender Therapist – Behavioral Health Letter Criteria
Full Gender Therapist Letter Criteria Here

One (1) or Two (2) Gender Therapist Letter(s) are ALWAYS required for:

* FTM Top Surgery – Double Incision, Keyhole & Nipple-free
* Vaginoplasty – Penile Inversion & Zero Depth
* Orchiectomy – w/ & w/o Scrotoplasty
* MTF Breast Augmentation – Implant based & Fat Grafting
* Hysterectomy & Salpingo-oophorectomy – performed as “combo” with Top Surgery

One (1) or Two (2) Gender Therapist Letter(s) are SOMETIMES required for:

* Facial Feminization
* Other Gender Affirming Plastic Surgery Procedures

Hormone Replacement Therapy (HRT) Letter Criteria
Full HRT Letter Criteria Here

One (1) HRT Letter ALWAYS Required for:

* Vaginoplasty – Penile Inversion & Zero Depth
* Orchiectomy – w/ & w/o Scrotoplasty
* MTF Breast Augmentation – Implant based & Fat Grafting
* Hysterectomy & Salpingo-oophorectomy

One (1) HRT Letter SOMETIMES Required for:

* FTM Top Surgery – Double Incision, Keyhole & Nipple-free
(Some insurance policies will require HRT completion, we will advise when applicable)
* Facial Feminization
* Other Gender Affirming Plastic Surgery Procedures