Dear Dr. XXXXXX
The following is in response to your letter requesting a recommendation for [female name]. It is my understanding that Ms. [female name] is electing to undergo Sex Reassignment Surgery. Ms [female name] has been a patient at the Center on and off since [date]. Approximately [time period] ago Ms [female name] disclosed the turmoil that she has been struggling with for most of her life. She disclosed the feelings and desire to live as a female to her family and then in counseling. In the past year, Ms [female name] has indicated that she feels she is ready to undergo Sex Reassignment Surgery. Ms [female name] appears to be living a fully transgendered lifestyle. Currently she indicates that she has changed her name at work, she is dressing 100% as a female and presents herself in new situations as a female. She indicates that here is no aspect of her life that she presents as a male or needs to refer to herself as a male and before that was aware that she didn't feel "normal" in the biological body of a male.
It appears from all that Ms [female name] presents that she is prepared to live the life of a female. Sex Reassignment Surgery appears to be the final step she needs to take in her transition.
############ MA, CSW, LLP
Dear Dr. WWWWWWWW
This letter is written at the request of [female name]. I evaluated her on [date]. Based on my evaluation she appeared to be mentally stable. Psychologically and emotionally I see no reason for her not to proceed with the sexual reassignment surgery. Given that she has started the process of her physical presentation as a female almost [date] years ago, it seems that the SRS would be a natural progression towards her no longer feeling that she is in the wrong body. She has integrated into society and is perceived throughout as a female. She has been in therapy with ######### MSW for approximately four years. If you have any questions please feel free to call me.
RE: Xxxxxxxx Xxxxxx
Driver's License: Xnnn-nnn-nn-nnn-n
To Whom It May Concern:
Xxxxxxxx Xxxxxx has been identified with Gender Dysphoria and has been receiving counseling, hormone therapy, and other treatments for Gender Reassignment from male to female. She has successfully made the transition to living as a female full-time since October 1999, as is required for her medical treatment as part of the Real Life Test (RLT) and transition process.
She is required to live as a female 24 hours a day for a minimum of 1 year under the Harry Benjamin Standards of Care, to which she has willingly complied with as of this time. She is successfully living full-time in the female role and should be treated accordingly. Her driver's license, and other forms of identification, gender marker's should be changed to read "F" for Female to assist with her gender role presentation.
Since coming under my care November 29th, 1999, she has displayed mental stability, a good foreknowledge of procedures and what is required of her, and has followed medical advice and treatments explicitly. She is quite capable of making an informed decision in regards to ehr gender reassignment and ongoing medical treatments.
Should you have an questions, please contact me.
Xxxxx X. XXXXXXXX