Sample surgical referral letter for gender-affirming …
Re: Last name, first nameLegal name (if different):DOB: Dear Dr. ____,Thanks for seeing this __ year old trans man (or trans woman or non-binary trans person) for consideration of gender-affirming chest surgery (or breast surgery, hysterectomy and bilateral salpingo-oophorectomy, orchiectomy, phalloplasty, metoidioplasty, vaginoplasty).The assessment documentation is attached and there are no updates to the clinical information provided. (or include any updates, changes to medication, changes to mental or physical health since the assessment was completed or addition of any missing information, for example BMI)Your assessment and treatment recommendations are much appreciated.Sincerely,Your name and contact information ................
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