Affirming Support, Without Gatekeeping

If you're here, you're likely navigating a process that already asks a lot of you—emotionally, logistically, and sometimes financially. Whether you're seeking a letter to support gender-affirming surgery or to verify the need for an emotional support animal, you deserve to feel respected and affirmed every step of the way.

I offer professional evaluations and documentation that meet clinical and legal requirements, but more importantly, I offer a compassionate, judgment-free space rooted in trauma-informed care and a deep respect for your autonomy.

Gender-Affirming Surgery Letters

Most insurance companies and surgical providers require a letter from a licensed mental health provider confirming that you meet the criteria for gender-affirming surgery. This can feel invasive—but it doesn’t have to be.

I follow WPATH guidelines, and my goal is to provide this documentation with care, clarity, and as little stress as possible.

Here’s what to expect:

In the state of Washington, a letter for gender-affirming surgery must come from a licensed mental health provider with whom you have an established therapeutic relationship. This means that I can only provide a letter if you are currently engaged in ongoing therapy with me.

Together, we’ll explore your goals, support your mental health, and ensure you feel informed, empowered, and ready for the next steps in your gender journey. When the time is right, I’ll provide a letter that meets WPATH standards and satisfies the documentation requirements of your surgical team and insurance provider.

🌈 This is a collaborative process, not an interrogation. You are the expert of your experience. My role is to support you, not to stand in your way.

Emotional Support Animal (ESA) Letters

In some housing or travel situations, you may be asked to provide documentation showing your need for an emotional support animal. I offer ESA letters that meet Fair Housing Act (FHA) requirements and reflect a genuine assessment of your mental health needs.

What you can expect:

If you're currently working with me in therapy and have a qualifying mental health condition, I can provide a professional letter of support for an Emotional Support Animal (ESA) in alignment with Washington state and federal Fair Housing Act (FHA) standards.

ESA letters can help you:

Bypass “no pets” housing restrictions

Avoid pet fees, deposits, and breed/size limitations

Secure housing accommodations that support your mental health

What to Know:

You must be an active therapy client of mine in Washington state

ESA letters are based on a documented mental health need such as anxiety, depression, PTSD, or ADHD

Your animal must be well-behaved and not cause property damage or health risks

ESA letters do not provide access to public spaces or workplace accommodations (they are not protected under the ADA)