EXPRESS YOURSELF THERAPY
GENDER AFFIRMING LETTERS
If you need a letter supporting gender-affirming hormone therapy or surgery, you shouldn’t have to spend months in therapy proving something you already know about yourself. At Express Yourself Therapy, we believe that trans and non-binary people are the experts on their own gender — and our role is to support your care, not to stand between you and it.
We provide gender-affirming letters for clients in New York State. Our process is straightforward, our clinicians are genuinely affirming, and we work at a pace that fits your timeline and your needs — not a bureaucratic checklist.
Letters are typically completed within a few sessions. If you’re primarily here for a letter and don’t need ongoing therapy, we can accommodate that.
WE WRITE LETTERS SUPPORTING
-
Hormone therapy (HRT)
Letters supporting estrogen, testosterone, or other hormone therapy for trans, non-binary, and gender-expansive individuals. We work within your prescribing provider’s requirements and can tailor the letter format to their request.
-
Gender-affirming surgeries
Letters for a wide range of gender-affirming surgical procedures, including but not limited to:
-
Top surgery (chest masculinization or breast augmentation)
-
Bottom surgery (vaginoplasty, phalloplasty, metoidioplasty)
-
Orchiectomy and hysterectomy
-
Facial feminization or masculinization surgery (FFS / FMS)
-
Tracheal shave
-
Voice surgery
If your procedure isn’t listed here, reach out — we can discuss whether we can help.
-
Legal name & gender marker changes
Some clients need a supporting letter for changes to their legal name or gender marker on identity documents. We can provide documentation to support this process where a mental health letter is required.
-
Insurance pre-authorization
If your insurance requires a letter from a mental health provider as part of the pre-authorization process for gender-affirming care, we can write to meet those specific requirements. We’re familiar with the documentation most major insurers require and will work directly with your care team if needed.
HOW IT WORKS:
STEP 1
Book a free virtual consultation
Tell us what you need and ask any questions. There’s no commitment required.
STEP 2
Meet with your therapist
We’ll typically need one to three sessions to complete the clinical assessment required for a letter. The number of sessions depends on your situation and what your provider or insurer requires.
STEP 3
Receive your letter
We’ll send it directly to you, your surgical team, or your prescribing provider — wherever it needs to go. We can provide letters in whatever format is required.
STEP 4
Continue or close
If you’d like to continue with ongoing therapy after your letter is complete, you’re welcome to. If your only goal was the letter, that’s completely fine too. No pressure either way.
For additional questions, see our F.A.Q's page.
OUR APPROACH: NO GATEKEEPING
We want to be transparent about what “no gatekeeping” actually means in practice, because we know the phrase gets used loosely. We will document clinically relevant information as required by the World Professional Association for Transgender Health (WPATH) Standards of Care or your provider’s specific requirements. It's a conversation — typically across one to three sessions — that allows us to document your gender history and affirm that you understand the nature of the procedure or treatment you’re seeking. This is the minimum necessary to write a letter that will hold up with your surgical team or prescriber, and we work through it efficiently and without judgment. If you have questions about our specific approach before booking, please reach out.