Gender Identity-Related Assessment for Adults

What an Assessment Involves

Adults Applying for OHIP-Funded Sex Re-Assignment Surgery (SRS) / Gender Confirming Surgery

What’s involved?

For letters for gender confirming surgery, it’s recommended we meet at least 2 or 3 times. The purpose of these sessions is to better understand your personal history, any clinical conditions, and to explore informed consent, preparedness, etc.

On average, these assessments take anywhere from 2.0 hours to 5.0 hours to complete in total, including time for writing the letter and completing the forms.

Who does the assessment?

All assessments supporting gender confirming surgery are completed by either Dr. Miller, Dr. Hendry, or Dr. Dennis, or by an advanced therapist or graduate student under their supervision.


Fees for psychology services are not covered by OHIP. However, you may have coverage for services through your extended health plan (for example, Manulife, Sunlife, Greenshield, Blue Cross, etc.). Fees are charged on a per-hour basis for all services, including face-to-face time with the clinician and time spent completing relevant documents (supporting letter, forms, etc.).

Please note – If finances are an issue preventing you from coming in, please contact us to inquire about the possibility of reduced fees. We don’t want finances to be a barrier to trans clients accessing services.


What to expect when you come in:

LGBTQ-Positive Space:

Our office is an LGBTQ-positive space. Our clinicians, including our reception and administrative staff, have undergone training in provision of LGBTQ-positive services.

You can expect to be asked by reception what your preferred name and preferred gender pronouns are, and we aim to use these during all interactions.

Being an LGBTQ positive space, you are welcome to dress in a manner to express your preferred gender.



Unfortunately, at this time, our Burlington office is in a building where no gender neutral washrooms are yet available. This is a work in progress. There are keys on the receptionist’s desk for the washrooms. All keys open both the women’s and men’s washrooms. Both washrooms are located across from the elevators. You are invited to use whichever washroom is most consistent with your experienced gender. (The washrooms tend not to be busy, so you are unlikely to encounter others in there.)

St. Catharines:

Our washroom is gender neutral at our St. Catharines office.

Assessment Process

Assessment appointments are typically about 1 to 1½ hours in length. The whole assessment is typically completed in about 2 to 5 sessions.

Over these sessions, you are invited to talk about your goals for coming to see someone at the practice.

You are welcome to talk about anything that is important to you in your sessions. You are also invited to clarify to your clinician what you want, and what you don’t want, from the assessment process.

The aims of the sessions are to help you to be both psychologically and practically prepared for transition, whether you are taking the route of hormone treatment alone, or are preparing for transition-related surgeries.

For example, your clinician will work with you to ensure that:

  • you have made a fully-informed decision about your treatment options with clear and realistic expectations of potential outcomes,
  • that you are aware of potential risks and benefits,
  • that you are ready to engage in the treatment process you have chosen,
  • that you have included family and/or community supports as needed, and that you are practically prepared (for example, for surgeries – that you have made an informed choice about a surgeon to perform the procedure; that you have arranged aftercare, etc.).

Reproductive options after hormone treatment or surgery may also be explored if relevant to you.

Mental health history, personal history, and your experience of gender are explored with care and respect in these sessions; one of the primary purposes of this discussion is to ensure that if significant medical or mental health concerns are present, they are reasonably well controlled.

Although not an explicit criteria in the World Professional Association for Transgender Health (WPATH) Standards of Care (SOC), the SOC recommends that clients who plan to under gender affirming surgeries (GAS) have regular visits with a mental health or other medical professional.


Supporting letters and form completion:

When the assessment is completed, your clinician will draft a letter addressed to your family physician (or to you directly if you prefer).

Your clinician will send you or show you a draft of the letter before it is finalized, so that you can review it and make sure it accurately reflects your experience and situation. If there are any important changes that need to be made, be sure to let your clinician know.

Once the letter is finalized, it will be sent to your family physician and/or whomever you specify. You are welcome to have a copy of the letter as well.

The supporting letter will include the following (consistent with WPATH SOC recommendations):

  1. Your general identifying characteristics (for example, age, where you are residing, relationship status, etc.)
  2. Results of your psychosocial assessment, including any diagnoses;
  3. The duration and nature of your relationship with your clinician at the practice (in other words, when you first met, how frequently or how many times you have met; whether this was for assessment or for treatment);
  4. An explanation that the criteria for surgery have been met, and a brief description of the clinical rationale for supporting your request for surgery;
  5. A statement regarding the degree to which you have been informed about the risks and benefits of surgery and have consented to go forward in full knowledge of these risks and benefits; and
  6. A statement that the clinician is available for coordination of care and welcomes a phone call from your primary care provider (such as your family physician) or surgeon to establish this.


We hope to make this process as quick and easy as possible for you. Please let us know if there is anything that would make your experience more comfortable!