UCSF Transgender Care adheres to the guidelines for surgical assessment as described in the World Professional Association for Transgender Health Standards of Care, 7th Version. Most insurance companies also adhere to these guidelines. The guidelines are focused on undergoing an assessment by a licensed mental health provider, who then generates a referral letter (two providers, assessments, and letters required in the case of genital procedures).
We recognize that this model "medicalizes" the concept of being transgender, and we aim to minimize the impact of this model on individuals seeking treatment. The guidelines do not specify a particular process or minimum number of sessions or length of time a patient should have with a mental health provider. Our assessment process begins with a single meeting with our program social worker. During that session, any additional needs or areas for support will be identified.
Beyond the specific criteria set forth by the WPATH Standards of Care, there are two other important areas for assessment of anyone undergoing major surgery for any reason, including hip replacements, organ transplants, open heart surgery, etc....
1) Insuring realistic expectations of what surgery can and can not do, being emotionally prepared for the realities of potential complications or less-than-satisfactory outcomes.
2) Insuring adequate support during the pre- and post-surgery period. This includes having someone to take you to and from surgery, and be with you after surgery to assist with recovery needs. This could include anything from obtaining supplies at the pharmacy, to preparing meals and assisting with domestic needs. For those who do not have someone to fill these roles, arrangements can be made for home health assistance or even short term placement in a skilled nursing facility.
All patients seeking gender affirming surgery at UCSF will undergo this assessment by our team prior to consultation with the surgeon. For those who provide referral letters from outside mental health providers, these letters will be reviewed and taken into consideration when conducting the overall pre-operative assessment.
In all, our goal is to get you to surgery, with a minimum of barriers or gatekeeping, and support a positive and satisfactory surgical outcome.
Learn more about Ida Hammer, MSW, who oversees the assessment process.