How many mental health letters you need for gender affirming surgery, what the current standards say, and why some surgeons still ask for two.

Whether you need a formal diagnosis to get a workplace accommodation letter, what the law actually requires, and how to get documentation.

Whether you need a mental health letter to start hormone therapy, how the informed consent model works, and when a letter is still required.

Examples of reasonable workplace accommodations for autistic adults, from sensory and communication needs to meetings, and how to request them.

A plain-language guide to WPATH letters for gender affirming care, when you need one for surgery or HRT, and what the letter actually says.

A clear, low-stress guide to requesting ADHD accommodations at work, what you do and don't have to disclose, and how to start the process.

For the last several months I've been working with a group of local health providers and other volunteers to create a gender affirming care clinic in Boone. The goal is straightforward: a place that can offer HRT and other gender affirming care at prices people can actually afford. But the structure we've chosen is deliberate, and it's worth explaining why.