Evaluations for

Letters of Support

I offer independent evaluations and letters of support for gender-affirming care in a way that is respectful, collaborative, and grounded in your autonomy.

As a member of the World Professional Association for Transgender Health (WPATH), my approach aligns with current standards of care while also acknowledging the very real systemic barriers that can make access to gender-affirming services difficult. My intention is not to gatekeep, but to support you in moving forward with care that reflects who you are.

Jessica Fletcher, Jess Fletcher, LPC, trauma therapist, LGBTQ+ therapist, OCD therapist, Anxiety Therapist, Dissociation

What to Expect

This process is designed to feel straightforward and affirming:

  • A 90-minute evaluation session focused on your goals, lived experience, and readiness for care

  • A collaborative conversation, not an interrogation

  • Space to ask questions, clarify next steps, and feel informed

  • A formal letter of support, when appropriate, for medical or surgical care

If you’re feeling nervous about being “evaluated,” that makes sense. Many people come in with that concern. You can expect to be met with respect, transparency, and care throughout the process.

Independent Evaluation

This service is intentionally structured as an independent evaluation, which means:

  • It is separate from ongoing therapy

  • No therapeutic relationship is required or established

  • You are not expected to continue services beyond this appointment

  • Per board requirements, I may refer out for evaluations for ongoing therapy patients

Cost

  • $50 flat fee

This rate is intentionally set to be comparable to a typical co-pay, with the goal of increasing access for those who may otherwise face financial barriers.

Turnaround Time

  • Letters are typically completed within 7-10 business days following your appointment

Eligibility

  • Adults (18+) only

FAQ

  • This process is not about proving yourself—it’s about having a conversation that ensures your care is supported and documented in a way that meets medical requirements.

  • My approach is not to gatekeep. In the rare case that a letter cannot be provided immediately, we will talk openly about why and what next steps would support you in getting there.

  • No. This is an independent evaluation, and you are not expected to begin or continue therapy with me. I am happy to also provide referrals.

  • Please send specific requirements from a provider or surgeon in advance of the evaluation by email or portal.

  • Letters are typically provided electronically via a secure patient portal. If you need another format, we can discuss options. The timeline to process a letter after an evaluation is 7 to 10 business days.

Schedule an Evaluation