A support letter for your surgery, written with you.
Psychosocial readiness assessment letters for top surgery and gender-affirming surgery, in Nedlands and online across WA. No gatekeeping, no proving yourself — just a warm, careful process by a clinician who gets it.
Now welcoming new clients
You lead. We won’t gatekeep, question who you are, or ask you to prove your gender. The letter is written with you, not about you.
A letter that reflects you, in your own words.
Many surgeons ask for a letter from a mental health professional before top surgery or gender-affirming surgery — you may have heard it called a ‘WPATH letter’. What that letter really is: a psychosocial readiness assessment — a considered note that you understand the surgery, have thought it through in your own time, and have support around you. That’s it. It isn’t a test, and it isn’t a verdict on who you are.
My assessment is informed by the WPATH Standards of Care (SOC-8) and AusPATH, and grounded in Australia’s informed-consent model. That approach — affirming, informed-consent, no gatekeeping — isn’t only how I work; it’s where Australian best practice now sits. In practice that usually means one letter for chest or top surgery — but your surgeon’s requirements are the ones we follow. Bring what they’ve asked for, and we’ll match it exactly.
You’re believed here
I’m a queer woman and a proud Yorta Yorta woman, and I’ve spent years in gender-affirming services and advocacy. So you’re not teaching the basics or translating yourself before the real work can start. This part of your journey should feel warm and human, not clinical and rushed — and that’s exactly how I’ll hold it.
You might be in exactly the right place.
- You’re booked for, or considering, top surgery or gender-affirming surgery, and your surgeon needs a letter.
- You want an assessor who won’t gatekeep, or make you prove your gender to earn it.
- You’d rather this felt like a real conversation than a box being ticked.
- You’re neurodivergent, and you want each step explained clearly, with no surprises.
- You want someone who understands that this is joyful, not just clinical.
Any of these? You’re welcome exactly as you are, and we can start whenever you’re ready.
The whole path, no surprises.
Four gentle steps, at a pace you set. Nothing has to be figured out before you begin.
A free welcome session
We meet first, with no pressure and no cost. I hear what you’re holding, we map out how to approach the letter, and you get a sense of whether working together feels right. If you have your surgeon’s requirements or letter template, bring them — we’ll match them exactly. Video or phone, camera never required.
The assessment
A single, unhurried 90-minute session to get to know you and your story, in your own words — with a short follow-up only if your situation needs it. We’ll go through informed consent together, so you always know what’s happening and why.
Your letter, written with you
I write the psychosocial readiness letter to your surgeon’s requirements. You see it before it goes anywhere — it should sound like you, and feel true. Many surgeons want the letter dated within about three months of surgery, so we’ll time it to suit yours.
Ongoing support, if you want it
Some people just need the letter. Others want a steady room for the whole journey — body, identity, family, the lot. Either is right. Ongoing therapy can attract Medicare rebates.
What the letter is, and what it isn’t.
Being honest with you up front is part of being safe:
- It’s a readiness assessment, not a medical clearance. Your medical, anaesthetic and nutritional fitness for surgery are for your surgical and medical team — the letter doesn’t speak to those.
- Your surgeon’s rules govern. SOC-8 generally points to one letter for chest or top surgery, but requirements vary by surgeon and procedure. Bring theirs and we’ll follow them.
- It’s not a gate. I write with you, reflecting you. No proving your gender, no hoops.
- A couple of things I don’t do. A statement to change the sex or gender marker on a WA birth certificate must come from a doctor or psychologist registered with AHPRA, so I’ll point you to the right person. And hormone-therapy letters usually aren’t required under Australia’s informed-consent model.
- No promises in advance. The assessment is genuine, so I can’t promise a letter or a timeline before we’ve met. What I can promise is honesty, warmth, and no surprises.
What it costs.
The welcome session is free. The assessment and letter are a private service and aren’t covered by Medicare. It’s a single 90-minute session for $450, letter included, with concessions available — occasionally a short follow-up where your situation needs it. I’ll go through it all with you at the welcome session, so nothing catches you by surprise. If you’d like ongoing therapy, that’s $200 a session, with Medicare rebates for eligible clients who have a valid GP plan.
Questions, answered.
Do you gatekeep?
No. The letter is written with you and in your own words, not about you. You don’t have to prove your gender or perform anything. My role is to understand you and support you, not to stand between you and your surgery.
How many sessions before the letter?
Usually just one: a single, unhurried 90-minute assessment after the free welcome session, with the letter written to match what your surgeon requires. Occasionally a short follow-up where your situation needs it, and we decide that together.
Is the letter guaranteed?
I can’t promise a letter, an outcome or a timeline in advance, because the assessment is genuine. In practice, most people who come for this are ready. If anything suggests a different next step would serve you better, I’ll be honest and help you find the way forward.
Which surgeons and requirements do you follow?
Your surgeon’s requirements are the ones we follow — bring what they’ve asked for and we’ll match it. My assessment is informed by WPATH Standards of Care (SOC-8) and AusPATH, which generally point to one psychosocial readiness letter for chest or top surgery, but the surgeon’s rules govern.
How much does it cost, and can I use Medicare?
The welcome session is free. The assessment and letter are a private service (no Medicare rebate). It is a single 90-minute session for $450, letter included, with concessions available; occasionally a short follow-up where your situation needs it. Ongoing therapy, if you’d like it, is $200 a session, with Medicare rebates for eligible clients who have a valid GP plan.
Do you write hormone-therapy letters?
Under Australia’s informed-consent model, a mental health letter for hormone therapy usually isn’t required. If your prescriber asks for one, we can talk it through.
Do you write birth-certificate letters?
No. A statement to change the sex or gender marker on a WA birth certificate must come from a doctor or psychologist registered with AHPRA, so that isn’t something I provide — but I’ll happily point you toward the right person.
In person or online?
Telehealth from anywhere in Western Australia and across Australia, with in-person sessions at the rooms in Nedlands from November 2026.
Accredited, credentialed & in good company
Let’s start with a conversation.
we kept one for you.A free, no-pressure welcome session, then we take it from there. If you’d also like a steady room for the wider journey, you’re warmly welcome in LGBTQIA+ affirming therapy.
Other rooms you might need.
LGBTQIA+ affirming therapy → Eating & body image → See all pathways → Get in touch →
This is not a crisis service.
Body Belonging Clinic is not an emergency or crisis service. If you or someone else is in immediate danger, call 000. For 24/7 support: Lifeline 13 11 14, 13YARN 13 92 76, QLife 1800 184 527 (LGBTQIA+ peer support), Kids Helpline 1800 55 1800, or the Butterfly Foundation 1800 33 4673.