Surgery readiness assessments.

We work to the World Professional Association for Transgender Health's Standards of Care, version 8 (SOC8, 2022). For adults, SOC8 supports surgery when:

• your gender incongruence is marked and has lasted over time
• you meet the diagnostic criteria, where a diagnosis is needed to access care
• you have capacity to consent to the specific surgery
• other health conditions that could affect surgery or recovery are being managed well enough
• for gonadectomy (removal of the testes or ovaries) or genital surgery only, you have had at least six months of hormones that suit your goals, unless hormones are not wanted or not medically suitable

SOC8 is clear that therapy should not be a requirement for surgery.

Is a Registered Psychologist enough?

The standards describe skills and training, not a job title. Many surgeons accept letters from Registered Psychologists. A few prefer a Clinical Psychologist or psychiatrist, so please check with your surgeon before you start.

Hormones usually do not need a letter

Many adults in Australia can start hormones through a GP or sexual health clinic using an informed consent model, set out in AusPATH's standards (updated April 2026). Some prescribers still ask for a letter, and we can help if yours does. If you are not sure what you need, ask us first. We would rather save you the sessions.

Two diagnostic words

Gender incongruence is the World Health Organization's term (ICD-11), in a chapter on sexual health, because being trans is not a mental illness. Gender dysphoria is the DSM-5-TR term, about distress. SOC8 only needs gender incongruence, but some surgeons and insurers still ask for gender dysphoria. We talk with you about the wording before we use it.

Our care is gender affirming and neurodiversity affirming, trauma informed and identity inclusive. We walk alongside people as they navigate liminal spaces. We are not gatekeepers.

Medium to long-term support

Getting to surgery often takes months, sometimes more than a year. Private health insurance hospital cover can have a waiting period of up to 12 months, and surgeons have their own waitlists. It helps to know your procedure, surgeon, likely date and insurance waiting period. It also helps to know whether your surgeon needs the letter from a Clinical or Registered Psychologist. With that, we can map out the steps towards your goals together. Along the way, we can support you with:

• practical planning before and after treatment
• social, legal and other affirmation steps
• mood, sleep, and eating and body image
• neurodivergence, paperwork and systems
• trauma, including identity-based trauma that hormones or surgery don't resolve on their own
• fears about needles, hospitals, anaesthesia or flying
• OCD and other anxiety

None of this is ever a requirement for gender-affirming treatment.

Screening for everyone

We offer every new client screening for trauma, neurodivergence, and eating and body image, whatever brings them to us. These are more common for trans and gender diverse people, and often masked. 81.5% of gender diverse Australians have experienced child maltreatment, compared with 62% overall. Trans and gender diverse people are 3 to 6 times more likely to be autistic. In Australia, 15% of trans adults report an autism diagnosis and 11% report ADHD. About 1 in 4 trans young people have had an eating disorder diagnosis. Masking, and screening tools built around cisgender people, make these easy to miss, so we ask in affirming ways and read results with gender and neurotype in mind.

Medicare

A Mental Health Treatment Plan needs your GP to confirm an eligible mental health condition. Being trans is not one on its own. If eating or body image is part of what you are navigating, an Eating Disorder Plan may help. It gives up to 40 psychology sessions in 12 months for people who meet eating disorder criteria. Some people are eligible for a GP chronic condition management plan, and the Extended Medicare Safety Net helps once out-of-pocket costs pass a yearly threshold. Current details are on our fees and funding pages.

For carers and the people around you

If you are caring for someone else while navigating your own affirmation, Carer Gateway (1800 422 737) and Tandem can help. Partners, family and friends supporting you can find help through TransHub, Rainbow Door and Queerspace.

We give you a written quote for the whole assessment before it starts. Therapy fees are on our fees page.

• Sessions may attract a Medicare rebate with a GP referral and a Mental Health Treatment Plan, where the Better Access rules are met. Your GP must confirm an eligible mental health condition, and being trans is not one on its own.
• The report is billed privately. Medicare does not cover it.
• Medicare sessions are limited to 10 a calendar year, so using some for this assessment leaves fewer for therapy.
• Reports are usually accepted for 12 months, sometimes only three. Updating one usually takes one review session and about an hour of writing.