Gender Assessments
Assessments and "letters of readiness"
for HRT and gender affirming surgeries.
A journey to authenticity.
I provide gender dysphoria assessments and counseling for those whose concepts of gender are expanding. The freedom in gender expression we’ve experienced in recent years is a much-welcomed shift for those who have never been fully comfortable with the gender assigned to them at birth. New language is emerging almost daily to describe the nuances of gender identity and expression. This language is key in building an open, inclusive, and responsive community for those who are gender expansive.
During this shift of cultural consciousness and awareness, many in the trans community find themselves adjusting, adapting, and evaluating “self” like no other community has been required to do.
Not only must we reconsider gender identity we must also reconsider medical transitioning, name changes, wardrobes, sexual orientation, relationships, family and community, group dynamics, work dynamics, expectations of gender presentation, voice, and body. Transitioning requires more honesty and authenticity than most non-trans people will come to know.
Together, we will explore all these things and help you arrive at the intersection of self, gender, and authenticity.

Gender is not a mental illness.
If you identify as transgender, gender non-conforming, or gender expansive and are seeking to begin hormone replacement therapy or gender affirming surgery, then counseling could be right for you. I am here to affirm your gender journey without pathologizing it.
I am here to also help you with letters of support for HRT and surgery as well as offering ongoing supportive counseling through the beginning of your transition.
Letters reflect your journey.
Assessments for gender dysphoria are affirming of your journey and any letter of support written for you will reflect you.
Assessments and letters meet the standards of care developed by the World Professional Association for Transgender Health. Letters also reflect your understanding and preparedness to begin hormone replacement therapy or surgery as well as any recommendations for ongoing therapy, personal development, and social needs.
The wait is over.

Say goodbye to the dysphoria hoodie!
Your gender assessment begins with you. Prior to your session, I’ll send you a short questionnaire to capture important dates and milestones of your transition so far.
During the live 60 minute assessment, we will talk in detail about the things you have accomplished so far and your current goals.
Shortly after the assessment is complete, I will send you a letter that indicates readiness for transition.
The assessment includes as many copies and revisions of the letter that you need.
The assessment also includes free 15 min consultation when you need a new letter for other gender affirming surgeries.
Accessibility.
Being accessible to those who need support, but find themselves in resource poor areas, is one of the greatest rewards of my work. I am able to learn about the challenges faced by queer people in various parts of the Midwest and Southeast.
Quick and effortless access to assessments and therapy is built into my practice. Utilizing a client portal and scheduler through a HIPAA compliant Telehealth provider, makes access a breeze. Clients can schedule, cancel, and reschedule sessions from their phones and computers.
If you have been transitioning for more than 6 months:
There are four steps to completing your dysphoria assessment and receiving a qualified letter for your physician and insurance carrier for all gender affirming treatments.
#1. Schedule a “90791 Gender Dysphoria Assessment” at https://troyjohnson.clientsecure.me/
#2. Once your assessment is scheduled, you will receive an email that links you to your client portal and all necessary documentation for the assessment.
#3. On the day of your assessment, you will meet with your therapist to verify your information, purpose of the assessment, and complete a live mental health evaluation.
#4. The card you put on file with Queer Talk Therapy will be charged at the time of your assessment.
#5. Your Letter of Readiness and Support will arrive within 1-3 hours after your assessment ends.
If you have been transitioning for less than 6 months:
You must meet the criteria for Gender Dysphoria for a period greater than 6 months prior to completing a GDA. Therefore, The number of sessions you will need to complete for your assessment will vary.
#1. Schedule a “90837 Psychotherapy Session” at https://troyjohnson.clientsecure.me/
#2. Once your session is scheduled, you will receive an email that links you to your client portal and all necessary documentation for the assessment.
#3. On the day of your sessions, you will meet with your therapist to discuss your history of gender dysphoria, plans for transitioning, and qualifications for the Gender Dysphoria diagnosis.
#4. The card you put on file with Queer Talk Therapy will be charged at the time of your assessment.
#5. Your Letter of Readiness and Support will arrive after you meet the full diagnostic criteria for Gender Dysphoria Disorder for a period of 6 months.
Expect to be treated with dignity for your experiences.
Questions?
The greatest determining factor for a letter of support is the preparedness of the client to begin transitioning. For those who can demonstrate reasonable expectations of the medical process for transitioning and demonstrate emotional and social stability may receive a letter in 1-3 sessions
While 95% of clients seeking GDA and Letters of Readiness with Queer Talk Therapy qualify and receive their letter, it must be noted:
Clinician’s discretion applies regarding your readiness to begin transitioning, and your qualifications for a Gender Dysphoria diagnosis; especially cases involving complex trauma, PTSD, Autism Spectrum Disorder, and Dissociative Identity Disorder.
As a Licensed Clinical Social Worker most physicians will accept a letter of support from me. Even with a letter of support, the physician may have more questions or concerns regarding your readiness for HRT. As an advocate and community educator, I have experience in helping health care providers gain the needed knowledge and resources to provide more competent care for trans and GNC patients.
For those living in the South East, QueerMed offers HRT for their patients through a similar virtual portal. QueerMed specializes exclusively in HRT for the trans and GNC community. For more information about QueerMed, please visit their website.
If you live in another area, I will help you find a qualified healthcare provider or clinic.
All assessments and therapy sessions are paid at the time of service. I work with several major insurance carriers as an “out-of-network” provider. You will want to check your benefits prior to the assessment.
You may be entitled to a reimbursement.
For those who need ongoing therapy, I am happy to offer routine Telehealth psychotherapy sessions.
Absolutely. Many surgeons like for patients to have two assessments and letters of supports from different therapists. If you are currently in counseling with another therapist and need a second letter, I’m happy to provide that service for you.
Assessments will respect your goals for HRT. Not everyone who needs medical treatment transitions to a different gender. More and more medical providers are recognizing that HRT is effective for treating dysphoria in those who identify as genderqueer, non-binary, and gender non-conforming.