Gender-Affirming Letters
Respectful, clinically grounded evaluations and professional documentation for adults pursuing gender-affirming medical care.
Elevated Horizons Mental Health provides secure telehealth evaluations for adults age 18 and older who are physically located in Texas, New Mexico, Arizona, or Colorado at the time of service.
Supportive and Respectful Evaluations
Some surgeons, medical providers, and health plans require a letter from a licensed mental health professional before certain gender-affirming procedures.
Elevated Horizons Mental Health offers a confidential and affirming evaluation process focused on understanding the individual, their treatment goals, mental health history, support system, and preparation for the requested medical care.
Our role is to provide an independent clinical evaluation and, when clinically appropriate, prepare professional documentation addressing the requirements supplied by the client’s medical provider.
Who This Service Is For
This service may be appropriate for individuals who:
Are 18 years of age or older
Are physically located in Texas, New Mexico, Arizona, or Colorado
Are pursuing gender-affirming surgery or another qualifying medical procedure
Have been asked to obtain a letter from a licensed mental health professional
Can provide the documentation requirements from their surgeon, medical provider, or health plan
Understand that completing an evaluation does not guarantee that a letter will be issued or accepted
The Evaluation Process
1. Initial Consultation
The process begins with a 30-minute consultation to discuss the requested procedure, the client’s physical location, documentation requirements, relevant deadlines, and whether EHMH is an appropriate provider.
2. Documentation Review
Before the evaluation, the client should provide any written letter requirements received from the surgeon, medical provider, treatment program, or health plan. Relevant medical or mental health records may also be requested.
3. Clinical Evaluation
The client attends a secure telehealth evaluation with a licensed mental health professional. The evaluation may address the client’s gender history, treatment goals, mental health history, understanding of the requested procedure, support system, informed decision-making, and plans for recovery and follow-up care.
4. Clinical Determination
The evaluator reviews the information collected and determines whether the requested documentation is clinically appropriate. A specific recommendation or letter is not guaranteed.
5. Letter Preparation
When clinically supported, a professional letter is prepared based on the evaluation and the requirements provided by the client’s medical provider. With the client’s written authorization, the letter may be furnished directly to the surgeon or treatment provider.
Fees and Payment
Initial consultation: $95 for 30 minutes
Clinical evaluation: $250
Professional letter, when clinically appropriate: $155
The consultation, clinical evaluation, and letter are separate services. Payment for an evaluation or letter does not guarantee a particular clinical recommendation, acceptance by a medical provider, insurance authorization, or approval for a procedure.
These services are self-pay and are not billed to health insurance.
Before Scheduling
Clients should obtain the current written letter requirements from their surgeon, medical provider, treatment program, or health plan before scheduling the evaluation.
Requirements vary among providers and health plans. Elevated Horizons Mental Health cannot guarantee that a letter will be accepted or that a procedure will be authorized.
Additional interviews, record review, consultation with other providers, or updated documentation may be required depending on the request. Additional services outside the original scope may involve separate fees.
Important Information
Services are available to adults age 18 and older.
Clients must be physically located in Texas, New Mexico, Arizona, or Colorado during clinical appointments.
Evaluations are conducted through secure telehealth.
Letters are issued only when supported by the clinical evaluation.
EHMH does not guarantee insurance authorization, provider acceptance, or a particular medical outcome.
EHMH does not make surgical decisions or replace medical informed-consent discussions with the client’s treatment team.
Schedule a Gender-Affirming Letter Consultation
Begin with a confidential consultation to discuss the requested documentation, provider requirements, client location, and anticipated timeline.