WPATH Letters

WPATH letters are letters required by surgeons and insurance companies to approve and cover gender affirming medical interventions. These letters assess readiness for gender affirming medical interventions.

For adults, these letters are required for a double mastectomy, breast augmentation, hysterectomy, orchiectomy, metoidioplasty, phalloplasty, vaginoplasty, facial feminization surgery, facial masculanization surgery, and depending on insurance coverage, body masculanization surgery.

For minors, these letters are required to start hormone replacement therapy, have a double mastectomy, and sometimes for starting puberty blockers.