Letters for Gender Affirming Medical and Surgical Treatment
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We are here to support you. Not to gatekeep you.
If your surgeon has asked you to get a psychological evaluation before your gender-affirming procedure or surgery, you are in the right place. We know the process of getting here hasn’t always been easy. We know you’ve probably navigated systems that weren’t built with you in mind. At The CBT Center, we do things differently.
We offer Letters for Gender Affirming Medical and Surgical Treatment for transgender and non-binary adults, conducted by Dr. Christina Goodwin, Ph.D., a licensed clinical psychologist and committed gender-affirming provider. Dr. Goodwin has worked with many adults who identify as transgender, non-binary, genderqueer, genderfluid, and gender diverse throughout her career. She understands the medical and emotional landscape of gender-affirming care, and she approaches every evaluation with respect, competence, and zero judgment.
All assessments are conducted in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care – the gold standard for gender-affirming healthcare worldwide.
What Is a Letter of Psychological Assessment for Gender Affirming Medical and Surgical Treatment?
Your surgeon may have called this a “psych evaluation” or asked you to get a “mental health letter of support.” Here is what it actually involves – and what it doesn’t.
Dr. Goodwin’s role is to confirm a gender dysphoria diagnosis (often required for insurance purposes) and to identify any additional logistical or emotional support that might help you before and after surgery. That is it. She is not here to question the validity of your identity. She is not here to decide whether you deserve care. Her job is to support your surgical journey and help you have the best possible outcome.
What the Assessment Includes
Before your appointment: You will complete several self-report measures and sign a release of information allowing Dr. Goodwin to share the report with your surgical team. If you are currently working with a therapist or psychiatrist, you will also sign a release allowing her to confirm relevant information with them.
Your telehealth appointment: Most assessments are completed in a single visit. Dr. Goodwin will discuss your history, your experience with gender dysphoria, and any relevant mental health factors. The conversation is straightforward, affirming, and respectful.
Your report and letter: After your appointment, Dr. Goodwin will prepare a full assessment report and the Letter of Psychological Assessment for Gender Affirming Medical and Surgical Treatment your surgical team requires. She will send the letter directly to your surgical team.
Who This Is For
This assessment is for transgender and non-binary adults (18+) preparing for gender-affirming procedures or surgeries, including top surgery, bottom surgery, facial feminization surgery (FFS), orchiectomy, vaginoplasty, phalloplasty, metoidioplasty, and other gender-affirming procedures requiring a mental health clearance letter.
Many surgical practices will not schedule a consultation until the patient already has their clearance letter – which means getting your evaluation done promptly can directly impact your surgery timeline.
A Note for Patients in the New York Area
Dr. Goodwin sees patients via telehealth only and is licensed in New Jersey and 40+ states through PsyPACT. She is not currently licensed in New York. If you are located in New York, you are welcome to complete the telehealth session from a location in New Jersey.
Not sure if this is the right evaluation for you? Contact us and we’ll help you figure it out. Ready to get started? Complete our New Patient Interest Form.
Related Services
Assessments
Not sure which evaluation is right for you? Visit our Assessments page for a full overview of our psychological evaluation services, including adult ADHD evaluations and gender-affirming readiness assessments.
Adult ADHD Evaluation
A comprehensive evaluation to determine whether ADHD - or something else - is behind the symptoms you're experiencing. You'll receive a full diagnostic report and personalized recommendations, regardless of outcome.
Trauma and PTSD Therapy
What happened to you matters — and so does what comes next. We use evidence-based approaches to help you process the past and move forward.
Cognitive Behavioral Therapy (CBT)
CBT is the most researched, most effective talk therapy available. We don't just use CBT — we're board-certified in it. This is what we do, and we're really good at it.
Virtual Therapy
Great care shouldn't depend on where you live. We're licensed in NJ, NY, and 40+ states — so wherever you are, we can likely work together.
OCD Therapy
You don’t have to stay stuck in the pattern. With the right support and strategies, it’s possible to regain control, build resilience, and move toward a calmer, more balanced mind.
Frequently Asked Questions
An adult ADHD evaluation is a comprehensive psychological assessment designed to determine whether Attention-Deficit/Hyperactivity Disorder (ADHD) explains the symptoms you are experiencing. ADHD is a neurodevelopmental condition that affects attention, focus, impulse control, and executive functioning – the mental skills that help you plan, organize, and follow through on tasks.
A gender-affirming readiness assessment is a psychological evaluation required by many surgical practices before gender-affirming procedures or surgeries. It is conducted in accordance with the World Professional Association for Transgender Health (WPATH) Standards of Care. The assessment confirms a gender dysphoria diagnosis – often required for insurance purposes – and identifies any additional support that may help you before or after surgery. The result is a written report and a letter of support sent directly to your surgical team. Dr. Goodwin’s role is to support your care, not to gatekeep it.
The evaluation includes a thorough clinical interview, validated psychological questionnaires completed before your appointment, and a careful review of your personal, academic, and work history. Dr. Goodwin will also screen for anxiety, depression, trauma, and other conditions that frequently overlap with or mimic ADHD – because accurate diagnosis means looking at the full picture, not just checking a box.
Regardless of the outcome, you will receive a full written diagnostic report with clear findings and practical, personalized recommendations. Whether the answer is ADHD or something else entirely, you will leave with clarity and a path forward.
The CBT Center charges a flat fee of $450 for the complete gender-affirming readiness assessment. This includes the evaluation appointment, the full written report, and the letter of support sent directly to your surgical team. The CBT Center is an out-of-network practice and a superbill will be provided so you can submit for potential reimbursement through your out-of-network insurance benefits.
No referral is needed. Simply complete The CBT Center’s New Patient Interest Form and indicate that you are inquiring about a gender-affirming readiness assessment. Dr. Goodwin will follow up directly to schedule your appointment.
Most assessments are completed in a single visit. Dr. Goodwin prepares the report and letter promptly after your appointment. If your surgical practice has specific requirements for the letter, let us know when you reach out so Dr. Goodwin can make sure everything is in order.
The assessment is conducted entirely via telehealth. Dr. Goodwin sees patients by video only, with availability Monday through Thursday evenings and Friday through Sunday mornings. As a PsyPACT member psychologist, she is licensed to provide services to adults in New Jersey and 40+ states. Please note she is not currently licensed in New York. Patients in New York are welcome to complete the telehealth session from a location in New Jersey.
Many gender-affirming surgical practices require a psychological evaluation and letter of support before scheduling a consultation or procedure. This commonly includes top surgery, bottom surgery, facial feminization surgery (FFS), orchiectomy, vaginoplasty, phalloplasty, metoidioplasty, and other gender-affirming procedures. Requirements vary by surgeon and practice – check with your surgical team about their specific requirements.
Dr. Goodwin is a gender-affirming provider. She does not question the validity of your identity or treat this evaluation as an obstacle to your care. She has worked with many transgender and non-binary adults throughout her career and understands the importance of affirming, respectful care. Her role is to support your surgical journey, period.
Yes. All clinical information is fully confidential under standard privacy laws. The only information shared with your surgical team is what is included in the assessment report, which you authorize with a signed release before your appointment.
Yes. Dr. Goodwin can send your assessment report and letter to any surgical practice regardless of location. She regularly provides letters to practices in the New York metropolitan area including Gender Affirming Medical and Microsurgical Associates (GAMMA) and ECA Plastic Surgery. The only restriction is that the telehealth session itself must be conducted while you are physically located in a PsyPACT state.
Reference virtual as an option