What the assessment involves
Our mission is to reduce barriers to obtaining letters for hormone therapy and gender-affirming care. Although therapy is highly recommended while transitioning, we do not require counseling as part of this process. Transitioning, especially socially and with hormones, can often bring about unexpected experiences where talking with an experienced therapist could be helpful.
The assessment is a collaborative, interview style discussion, conducted over 2-3 appointments. Generally, the first appointment will be a collaborative interview about your history. A second appointment may be needed to obtain additional information. If not, the second appointment time is used to review the letter and make any changes before sending it off to the primary care provider and/or surgeon. You may also have the opportunity to setup ongoing therapy.
Preparation for the assessment is an imperfect process. While we use gender-affirming language during the interview, some questions have to be asked in a specific manner, which may feel uncomfortable. You are encouraged to let your therapist know when things feel overwhelming. We are here to support you. You will be asked to complete questionnaires and discuss your experiences of gender, including your gender identity, gender development, gender incongruence, and gender dysphoria*, if any. You will also be asked about your overall psychosocial history and about your mental health across your lifespan. The assessment is conducted in line with the standards of care set out by the World Professional Association for Transgender Health (WPATH) and differs depending on the type of affirmation being sought (e.g., hormones or surgery). The WPATH standards of care are available here: https://www.wpath.org/publications/soc
The assessment does not "decide" your gender identity, and your therapist will not decide what your gender identity is for you. Your gender identity is always your personal journey and understanding to reach. In general, the assessment is designed to explore the impact of gender in your life, the impact of other challenges, psychological and otherwise, that might negatively impact outcomes of affirmation/transition, and the presence of any obstacles that might present with gender variance (please see the WPATH standards of care above for a full overview). This does not mean that if you have a mental health condition or are experiencing psychological distress that you would not meet the criteria for affirmation. It may just mean that your therapist will work with you to ensure these challenges are well managed to decrease the chance they will negatively impact your affirmation.
The assessment also explores readiness for affirmation, expectations, and supports. If required, there may also be elements of therapy included in the assessment process as deemed necessary. As part of the assessment, and with your permission, the assessing therapist may need to speak to other healthcare professionals involved in your care. Once the assessment is complete, the therapist will be required to write a report to whichever medical professional is supporting you in your affirmation.
Availability and access
Assessment sessions can be done face to face at the office (dependant on COVID restrictions) or via TeleHealth. You should be aware that the state of Oregon still mandates that face coverings are required in all healthcare settings, which includes mental health offices. Please contact us at (503) 583-2121 or firstname.lastname@example.org to check availability.
*Gender dysphoria is the feeling of discomfort or distress that can occur in people whose gender identity differs from their sex assigned at birth, or sex-related physical characteristics. It is important to note that not everyone experiences dysphoria about their gender.