Free WPATH Gender-Affirming Surgery Letter

For Queer and Trans adults located in Massachusetts or New York

I'm not here to assess your gender or question your lived experience. Trans and gender-expansive people are too often asked to defend who they are or prove their truth and that is not my goal. I believe you. I’m excited for your gender joy, and my hope is to make this part of the process as simple and affirming as possible.

I’m also deeply sorry that we live in a system where people still have to ask permission to access the care they need to feel at home in their bodies. I know from lived experience how frustrating and dehumanizing these requirements can be. My goal is to offer a process that is straightforward, respectful, and rooted in your agency and self-knowledge.

  • This service is for adults (18+) located in Massachusetts or New York.

    Unfortunately, I do not provide letters or consultations for minors and adults in other states.

  • This is a one-time consultation, not an ongoing therapy relationship. The process is collaborative, respectful, and grounded in the belief that you are the expert on your own experience.

  • Our meeting will last no longer than 30 minutes.

  • You’ll receive your letter within 48 hours of our consultation.

  • Letters are sent via email as a PDF attachment. 

    I do not fax letters or send them directly to providers.

  • Please come prepared with the following:

    • Name (legal name if required for insurance; I’ll only include it once if it differs from the name you go by)

    • Date of birth

    • Current location (must be in MA or NY during our call)

    • Pronouns you’d like included in the letter 

      • These can be different from how you’re currently identifying or presenting. If it feels more comfortable, I can also write a pronoun-free letter. This letter will be part of your medical chart.

    • Are you currently in psychotherapy?

    • Surgery location

    • Surgery date

    • Surgeon’s name

    • Are you on hormones?

    • Do you have experience with dysphoria?

  • If you need changes to a letter I’ve written, please don’t edit the PDF yourself. Since the letter is signed, all edits must be made by me. Email me with the updates, and I’ll revise the letter accordingly.

  • If you have an upcoming surgery date, please include that information in your initial contact.

  • If you haven’t heard from me within a week, feel free to send a follow-up. I do my best to respond promptly.

  • I follow the WPATH Standards of Care (SOC 8). Our conversation will focus on informed consent, medical necessity, and your post-surgical care plan.

  • Each letter is written for a specific procedure. If you're seeking a letter for an additional surgery, you’ll need to schedule a new consultation, and I’ll provide a new letter.

“Lenni’s empathy, passion, and kindness have been integral to my healing process. Their grounding, authentic presence and unwavering compassion make me feel seen and heard, no matter what I bring.”