How many letters of therapy clearance are needed for srs, my doctor says one

Dear Dr. Reed,

Are you at variance with the WPATH standards of care?  My primary care doctor says only one letter of therapy clearance is needed


Dear Linda,

We have been doing transsexual surgery since 2003.  I am a member of WPATH (World Professional Association or transgender Health).

At this time, version VII, released in 2012 says for genital surgery (vaginoplasty, orchiectomy) 2 letter are needed.  For hormones or breast implants one letter will suffice.  See pages 27 and 28, for more details.,%20V7%20Full%20Book.pdf

Many times in the WPATH SOC there is mention the standards are guidelines, and of course reasonable exception can be made.

We are very concerned about remorse, and to avoid this we ask for 2 letters as stated in the guidelines.  Beyond that we ask that one of the letters be written by a therapist with a doctoral degree, could be a PhD or a psychiatrist.  If your primary care doctor is not a licensed therapist, a letter from her or him would not qualify.

We hope you will consider us for affordable vaginoplasty.  You may wish to visit our web-site and view before and after pictures.

Harold M. Reed, M.D.
Transgender Surgeon – Miami
The Reed Centre – Miami



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