What is GALAP?
GALAP stands for the Gender Affirming Letter Access Project
Providers agree to write at least one free surgery letter each month for transgender and nonbinary people who are required to have a letter from a mental health provider as a condition for the surgery.
The GALAP was founded to address the high cost of surgery letters which creates an additional barrier to access to gender-affirming support. It is a network for people seeking surgery letters to help them connect with a list of providers who have pledged to provide at least one free letter per month. People who have insurance or who are financially able to pay may choose to donate to cover the cost of the letter so more people have access to this support, but this is completely optional.
Who can get a free letter?
As a provider licensed in California, I am able to provide free letters to anyone located in California at the time of the letter session.
Letter writing sessions take between 15-20 minutes and are written using a standardized template that is generally accepted by most insurances and surgeons. We will go through the letter together and you will receive an unsigned draft to review. After you approve the draft, I will send you a finalized, signed copy and ensure you receive it before we end the call.
If your surgeon has a particular template they want me to use, please let me know at the time we schedule the session.
There are a few restrictions:
I am a master’s level therapist, so please make sure this is acceptable for your surgeon. Top surgery and FFS typically accept a MA clinician’s letter. Bottom surgery often requires two letters, only one of which can come from a MA clinician.
Most insurance companies require a diagnosis of Gender Dysphoria. If you do not want a diagnosis, let me know and I will remove that section. Your letter can be denied by insurance without a diagnosis. If your letter is denied, I can rewrite the letter to include a diagnosis without having to have another letter writing session.
Letters are typically written and addressed to the surgeon, so I do not write letters ahead of time without a current surgery plan.
Your letter may need to acknowledge your legal name as it appears on your insurance card. If you have not changed your name, I will need to know any name you use legally to include that name at the start of the letter.
The letter will affirm that you meet WPATH criteria: that you are of the age of majority, that you understand informed consent, that you do not have any mental health concerns that would impact the surgery or recovery, and that you meet criteria for gender dysphoria.