No. If you are an adult, most Texas clinics now utilize an informed consent treatment model, so you no longer need letters from mental health providers in order to receive HRT. Conservative lawmakers voted to ban gender-affirming HRT for minors; This bill was signed by the Governor and took effect September 1, 2023 and upheld by the Texas Supreme Court in June 2024.

Unfortunately, as of January 20, 2025, Texans can no longer change gender markers on Texas birth certificates, Texas driver’s licenses, state IDs, social security cards, and U.S. Passports.

During your evaluation, expect to have an open conversation about your gender journey which can include:

• Your personal experience with gender identity, including when you first became aware of it.

• Your past and current emotional well-being, and if you experience gender dysphoria.

• Your social support system.

• The specific surgical interventions you're seeking.

• Your understanding of the risks and benefits associated with surgery.

The aim of gathering this information is understand your needs and how to best support you in your journey. It is not a pass/fail test and its not questioning you about your identity. It is a supportive space to discuss your feelings and goals related to your gender identity.

Since this service is for my established adult clients, there is no additional fee regardless if you are using insurance or private pay.