My approach to gender-affirming evaluations is explicitly non-gatekeeping. I recognize the significant harm that psychology and other healthcare professions have historically caused by pathologizing transgender identities and creating unnecessary barriers to affirming care. The purpose of this evaluation is not to question or validate your gender identity. My role is to learn about your experience, understand what you are hoping for from surgery, and make sure you have the information and support needed to make an informed decision and prepare for recovery.