Information and Resources to address your gender dysphoria

I am currently NOT accepting new clients.

What gender services do you provide?

The following gender services are available:

> Individual and Relationship Counseling (more information)

> Gender clarification, diagnosis (if applicable), and exploration of options for making peace with your gender

> Assessment and Letter of referral for Hormone Replacement Therapy (HRT) based on WPATH Standards of Care (more information)

> Letter of referral for Sex Reassignment Surgery (SRS) also known as Gender Reassignment Surgery (GRS) based on WPATH SOC’s

> Support through Real Life Experience (RLE) also known as Real Life Test (RLT)

> Emotional and psychological support and assistance through the steps necessary for a gender transition
Workshops and Training

> ONLINE TRANSGENDER FORUM – a place to ask questions and engage in written communication with other people experiencing what you are (more information)

> ONLINE TRANSGENDER SUPPORT SYSTEM – this is a unique opportunity to connect face-to-face real-time with other transgender-identified people, or their spouses through a video meeting hosted weekly by Michele O’Mara (more information)

How many sessions does it take to get a referral letter for HRT?

Usually, it is a quick process and the number of sessions required varies according to where you are in your transition process already.

Typically the process takes one to three sessions. A combination of variables affects how quickly this process goes. If you would like to get a reliable estimate of how many sessions you will need to get a letter of referral for the letter of referral for hormone replacement therapy (HRT), you can complete this form here.

What is the same-day "Quick Assess" option for letters of referral?

The Quick Assess is a 60-minute session, after which I will complete the documentation for your referral and provide you a letter the SAME DAY. For many people who have already been living in their preferred gender (not their gender assigned at birth), there is very little to assess, though both the surgeon or MD, along with the insurance company (if applicable), will require documentation to be sure you meet the requirements set forth by the World Professional Association of Transgender Health (WPATH) in the Standards of Care (SOC).

To see if you qualify, simply complete this gender inquiry form. Once I receive this information, I will personally reply to you by email with the estimated number of sessions that I predict it will take for you to get your referral letter.

What are the requirements for a Quick Assess option for Hormone Replacement Therapy (HRT)?

The following is a general overview what qualifies someone for the Quick Assess option for HRT.

1. You meet at least two of the following criteria set forth in the DSM-V for Gender Dysphoria which states that for the last 6 months (at least)

* A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics

* A strong desire to be rid of one’s primary and/or secondary sex characteristics

* A strong desire for the primary and/or secondary sex characteristics of the other gender

* A strong desire to be of the other gender

* A strong desire to be treated as the other gender

* A strong conviction that one has the typical feelings and reactions of the other gender

2. You are financially independent (with no dependency on parents or guardians for insurance, cell phone, school, car payment or car insurance, etc.) UNLESS they are supportive of your transition and will not withhold their support if you start HRT.

3. If you are married, your spouse is aware of and supportive of your decision to pursue HRT.

4. You have a strong sense of confidence about your gender and your desire to begin this irreversible process of hormonally influencing your secondary sex characteristics to achieve a greater external alignment with your internal sense of gender.

What are the requirements to be eligible for a letter of referral for Gender Confirmation Surgery?

In addition to the requirements for HRT as described above, the following requirements are.suggested by most surgeons and insurance companies for a letter of referral for Gender Confirmation Surgery:

- > Age 18 or older
- > Typically 12 months of continuous hormonal therapy (unless medically contraindicated)
- > 12 months of successful uninterrupted full-time real-life experience living as the preferred gender
- > Demonstrable knowledge of the cost required lengths of hospitalizations, likely complications, and post-surgical rehabilitation requirements of various surgical approaches
- > Awareness of different competent surgeons
- > Verifiable progress in consolidating one’s gender identity
- > Demonstrable progress in dealing with work, family and interpersonal issues resulting in a satisfactory control of any stressors, diagnoses or other issues, including substance abuse, psychosis, suicidality, as examples
- > Both the Standards of Care and most insurance companies require two letters of approval (often one from a Ph.D. therapist, which I am)

Can I go to any mental health therapist for a Letter of Referral?

Most therapists are not trained in gender care. Those who are have sought additional education and training beyond their schooling. Most clinical training programs will provide an overview of gender dysphoria and related issues, but there is not adequate training provided to the typical mental health therapist or psychotherapist unless they pursue specialized training, workshops, related reading and involvement with the professional association called the World Professional Association of Transgender Health.

Here is more information about how to select a gender therapist.

What will happen to me if I take HRT (estrogen) for a M-t-F transition?

The goal of HRT is to reduce the level of discomfort you feel about the incongruence between how you feel and what your body reflects when it comes to gender identity. When you take feminizing hormones your body will experience many new things, as well as stop experiencing other things you’ve come to expect. For more details about exactly what to expect, visit this page.

How can I improve my voice if I am transitioning from male-to-female?

The voice is one of the harder aspects of the physical transition for those who are transitioning from male-to-female. Many people will find inspiration on youtube.com, following others who have created resources to assist those wanting to adjust their voice on their own. Others will purchase programs that are available online, such as

Here is a link to professional voice/speech therapists in Indiana who provide services to transgender men and women.

What resources do you recommend for parents with children who are questioning their gender?

While I do not work with people under the age of 18, there are many resources available. For a list of resources visit here.

Can you give me a basic overview of gender dysphoria?

For a good overview and basic introduction to what is gender identity, gender dysphoria and other related questions, here is a good place to learn more.