06/08/2026
The successful completion of letters of assessment and approval requests for gender-affirming surgeries are a hugely significant milestone in the lives of many clients and members of our community. Although worthwhile, it can be a confusing and deeply vulnerable experience. It’s important to have a qualified and passionate professional in your corner.
Let’s talk about letters of assessment (thanks Nat for the handy summary)👇🏻
🔴 Letters of Assessment are required as part of the process for Gender Affirming Surgery (GAS) and sometimes required for Hormone Replacement Therapy (HRT).
🟠 The role of a therapist is to assess your psychosocial readiness, document the therapeutic relationship, and confirm that you understand and have consented to the treatment you are requesting. This is not a medical assessment, but a clinical one focused on your mental health, wellbeing, consent, and decision-making.
🟡 For surgeries performed at public hospitals in New Brunswick, Medicare billing rules require that a formal referral to the surgeon be sent by a doctor or nurse practitioner (MD/NP). In practice, a therapist can complete your Letter of Assessment and work together with you and/or an MD/NP, who adds their own referral note to the surgeon.
🟢 When it comes to the medical side of things, such as hormone prescribing, surgical decisions, or post-operative care, those questions belong to your prescriber and surgical team. Our role is to support you through the psychosocial and emotional aspects of your journey, and to advocate for you during the documentation process.
🔵 The time commitment to complete these tasks really depends on a lot of factors. It’s not a one size fits all, we are all different! We want to make sure we have a thorough understanding of your circumstances.
🟣 Remember - if you have questions/concerns about time commitments, finances, the therapeutic process, or anything else, free 15-minute consults are an option!
For bookings & inquiries:
📞 (506) 454-137
📧 [email protected] [admin]
📧 [email protected]
www.prismfredericton.com
