Transgender FAQ

What is "Transgender"?

"Transgender" means a person's brain doesn't match their body, gender-wise. Most people assume penis = boy and vagina = girl. Unfortunately It's not that simple. 

Gender encompasses more than the shape of the flesh between a person's legs. It's also about IDENTITY (who I know myself to be), and EXPRESSION (how I show myself to the world in dress, speech, movement, attitudes). 

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Don't look for society to give you permission to be yourself.


~Dr. Steve Maraboli


Is there a test to tell for sure?

For now, there's no "test," but there is an answer key: It's all there, inside the person who wonders if - or simply knows - that they are trans. 

If it's you that's wondering, let yourself listen to those thoughts. The more you try to dodge them, the more they will dominate your thinking. 

If it's someone you love, follow their lead. You don't have to understand. Just be unconditionally supportive. 

How do you know that it's not just a phase?

The rule of thumb is, if the person expresses these feelings consistently, persistently and insistently, it's probably not a phase.

The feeling that something isn't quite right can begin in early childhood. Even if the gender confusion doesn't appear until puberty or the teen years or even later,  that doesn't mean it isn't real. 

Some parents worry that their child is being influenced by friends in the LGBTQ community, or that social media and websites are brainwashing them. 

Generally speaking, it's safe to say that people aren't "recruiting" others to be trans. Whether that's true or not, there are some people who experience gender confusion who later decide they are not trans.

Either way, the best course of action if someone you love is struggling with gender confusion is don't try to talk them out of it. Don't judge. Be unconditionally loving. Listen. Allow them to experiment with expressing themselves through what they wear, how they move and speak, which pronouns they choose. If it is "just a phase," you will have given them the space to discover that is the case.

Can a Transgender person be gay? 

It gets confusing because we often use the terms "gender" and "sex" interchangeably.


Think of it this way:

"Gender" is who I am. "Sexual Orientation" is who I like.

Having said all that, the answer is "Yes," a trans individual can be gay.


As an example: A transgender male - that is, a person who identifies as male but was born with a female body - would be considered gay if he were attracted to other males.

A trans male who is attracted to females would be considered heterosexual. 

A transgender person can be anywhere on the continuum of sexual orientation, from heterosexual, to homosexual, to pansexual, to asexual. Just like anyone else.

"Letters" FAQ

What is a "Letter"?

When a transgender individual decides they are ready to change their body so that its appearance matches their gender identity, they're going to need a "Letter." 

Doctors who offer gender affirmative procedures (such as HRT, "top surgery", genital reconstruction, facial feminization) will require mental health clearance from a qualified professional. In other words, a "Letter."

As a certified Transgender Care Therapist, I am qualified to evaluate whether an individual is mentally and emotionally prepared  to undergo medical interventions.

How many sessions are required?

It depends. Realistically we are looking at about three sessions, sometimes more. Full disclosure: Leaving with a Letter is not a sure thing. It is my goal and my responsibility to do everything I can to ensure that you have no regrets.

The reason your docs require mental health clearance is to safeguard you, the patient, from making a rash decision, or an ill-informed one.

If we discover during your evaluation you are facing any obstacles to the best possible outcome, all is not lost. In that case, I would make recommendations to help you resolve whatever is in your way. That could mean more therapy, or maybe you just need to educate yourself to be fully informed about the risks and benefits of medical or surgical treatments you are considering. 

How much does it cost?

My standard fee is $125 for a full hour session. If my eval indicates your're ready to proceed, there is no additional fee charged for "The Letter."


Can I continue therapy with you even after you've written my "Letter"? Or, if you don't think I'm ready to get a "Letter"?

Of course you can!


Unless I determine that I am not the one best qualified to help you work through whatever it is that comes up for you.


In that case I would refer you to other resources. 

There's always the possibility that we figure out you're not quite ready and I won't be writing a letter, at least not for now.


In that situation, I would offer specific recommendations. Maybe you would continue therapy with me - or another qualified mental health professional - to get you where you need to be.