The Gender Affirmative and Supportive Surgery Evaluation Tool (Gender ASSET) is an assessment tool developed by trans and genderqueer mental health professionals Becca Keo-Meier, MSW and Colt Keo-Meier, Ph.D. The Gender ASSET was designed for mental health providers to use in support of transgender clients preparing to undergo surgery as a part of their gender transition. This online course includes a Gender ASSET workbook along with on-demand training videos and sample letters. 

The World Professional Association for Transgender Health (WPATH) sets forth the Standards of Care (SOC). The 7th version of the SOC recommends transgender clients provide their surgeons with one to two letters from mental health providers before they are cleared for surgery. However, the majority of mental health providers have neither received adequate nor comprehensive training in providing this type of evaluation and are not familiar with the multiple surgical options available or the process of recovering from a major surgery.

Led by Dr. Colt Keo-Meier, this multi-part workshop is designed for mental health professionals who would like to receive training on evaluating and writing letters for transgender clients who desire to undergo gender affirming surgical procedures. The specific focus will be on assisting clients to be practically prepared for the process of surgery and recovery. This course is best suited for mental health providers who have some experience working with transgender clients.

Continuing Education (6 APA CEs)
We have partnered with the National Register to provide continuing education credits for The Gender ASSET. The National Register of Health Service Psychologists is approved by the American Psychological Association to sponsor continuing education for psychologists. The National Register maintains responsibility for this program and its content.

About Instructor

Dr. Colt Keo-Meier

Colt Keo-Meier, Ph.D., is a licensed psychologist who routinely provides training on gender affirmative treatment of transgender clients. He provides education on gender and sexuality as a lecturer in the Psychology Department of the University of Houston and an assistant professor in the Menninger Department of Psychiatry and Behavioral Services at Baylor College of Medicine. In his part-time private practice, Dr. Keo-Meier provides therapy, consultation, and evaluation services to transgender clients as young as 4. He directs the Transgender Health research lab at the University of Houston, which focuses on examining the effects of testosterone on the mental health and quality of life of transgender men as well as the experiences of parents of transgender children. He is a member of the hormone therapy committee for the WPATH Standards of Care version 8. Dr. Keo-Meier is completing his MD at the University of Texas Medical Branch in Galveston, Texas.
Dr. Colt Keo-Meier

WPATH Certified Provider

Course curriculum

Course Completion 1-Year time limit

  • 1


    • Workshop Outline

    • Welcome

    • Welcome Quiz

  • 2


    • History of Role

    • History Quiz

  • 3

    WPATH Standards

    • Standards of Care

    • Deutsch 2016

    • WPATH SOC v7

    • WPATH Standards Quiz

  • 4

    Therapists Preparedness

    • Therapist's Preparedness

    • Psychological Testing Keo-Meier and Fitgerald, 2017

    • Therapist Preparedness Quiz

  • 5

    Gender Affirmative Model

    • Gender Affirmative Model

    • Gender Affirmative Model Quiz

  • 6

    Assessing Preparedness

    • Assessing Preparedness

    • Assessing Preparedness Quiz

  • 7

    Surgical Procedures

    • Section 6_1 Surgery

    • 6.1 Raphael Mastectomy Pre and Post Op Instructions

    • 6.1 FFS and Chest/Breast Surgery Resources

    • Section 6_2 Surgery

    • 6.2 Metoidioplasty and Phalloplasty Resources

    • 6.2 Crane Phalloplasty Pre and Post Op Instructions

    • Section 6_3 Surgery

    • 6.3 Vaginoplasty Resources

    • 6.3 Bowers Vaginoplasty Pre and Post Op Instructions

    • Surgical Procedures Quiz

  • 8

    Post-operative Recovery Supplies

    • Post-Operative Recovery Supplies

    • Post-operative Recovery Supplies Quiz

    • Caregivers: Keeping Track of Recovery

  • 9

    Gender ASSET Review


    • Gender ASSET Review Quiz

  • 10

    Writing Affirmative and Collaborative Letters

    • Section 9 Writing Letters

    • Dr. Sand Chang The Trouble with Templates

    • Sample Letter Criteria

    • Kate Kauffman Insurance Letter

    • Darlene Tando Insurance Denial Appeal Letter

    • Sample Vaginoplasty Letter

    • Sample Phalloplasty Letter

    • Sample Breast Aug and Vaginoplasty Letter

    • Sample Breast Augmentation Letter

    • Sample Mastectomy Letter

    • Sample Hysterectomy Letter

    • Writing Letters Quiz

  • 11

    Frequently Asked Questions

    • Section 10 Q&A

    • Sample Name and Gender Marker Change Letter 1

    • Sample Name and Gender Marker Change Letter 2

    • Sample Safe Passage Letter

    • Frequently Asked Questions Quiz

  • 12

    End of Course Evaluation

    • End of Course Evaluation

Bonus material

  • Workbook

    The Gender Affirmative Supportive Surgery Evaluation Tool (Gender ASSET) to conduct mental health assessments of transgender clients preparing to undergo gender-affirming surgery.

  • CEU Certification

    Continuing Education (6 APA CEs) or Certification of Completion from Gender Education Network

  • Download Materials

    There will be PDFs available with each section for you to keep for your references

Course Beneficiary

Point of Pride

Point of Pride is a non-profit organization that supports the international transgender community through a number of gender-affirming programs that empower them to live more authentically. A portion of proceeds from the sale of this course benefits their Annual Transgender Surgery Fund, a scholarship-like program that provides direct financial aid to trans people in need of gender-affirming procedures they cannot otherwise afford.

Student Reviews

Advanced Training

Patrick Frame

As a Clinical Social Worker, who has been attending trainings specific to LGBTQ+ population and issues for 6+ years, I have been looking for an advanced training that provides me with the specific information I have not yet had access to. This training was very informative about the types of surgeries and options for surgery. I feel more aware of the options for surgery, as well as, better prepared for the assessment piece. The tools, handouts, and materials provided in this training are incredibly valuable. Much thought, intention, and knowledge went into this training and I strongly appreciate it!

The Gender ASSET

Grada-Anjo Wunderl

This course by Colt Keo-Meier, Ph.D. stands out from all other TG and LGBTQ courses I have taken. Dr. Keo-Meier is a knowledgeable and engaging speaker who provides necessary details others leave out.. Overall, an excellent course with great documentation and a much-needed ASSET!

Invaluable and necessary resource!

Ty Stafford

With the Gender ASSET, Dr. Keo-Meier and Mx. Keo-Meier has created an invaluable and necessary resource for anyone working with the trans/gender non-conforming population. Dr. Ty Stafford Licensed Psychologist Starkville, Mississippi

Highly practical training, highly recommend!

Michelle Vaughn

This training provided me with a strong, solid foundation to begin to offer letters for gender-affirming hormones and medical procedures right away. Dr. Keo-Meier has an amazing body of knowledge and experience and made this training highly practical and a wonderful interactive experience as well. Michelle Vaughan, Ph.D. Associate Professor, School of Professional Psychology Licensed Psychologist (OH) Dayton, OH

Must-attend learning experience for all clinicians

Adam Sauceda

Dr. Keo-Meier's Gender ASSET training provides mental health clinicians with the necessary knowledge required to properly assess and prepare clients for gender affirmative surgical procedures. Participants will exit the training feeling more confident with the evaluation process, various surgical procedures, and with providing letters of support/referral letters to medical professionals. This training is a must-attend learning experience for all clinicians seeking to strengthen their level of competency in assessing client’s psychological and practical preparedness prior to receiving gender affirmative surgery. Adam A. Sauceda, LPC-S, NCC Therapist /Owner of Synchronicity Counseling San Antonio, Texas

Mental Health and Surgery Preparedness

Luce Beagle

VERY thorough and appreciate the "real life" case experiences you bring to the material. Appreciate the strength-based lens you used throughout this training. Appreciate your conceptualization! Please make this part of the Global Education Curriculum and Training for WPATH certification. I received this so much better from a trans id clinician in the field rather than older cis men and women who might not be as in touch with the population as you are. Gratitude

Invaluable tool

Carolyn O'Keefe

This course not only introduces an invaluable tool but also provides a comprehensive knowledge base and practical examples for utilizing the Gender ASSET. I highly recommend this course for any mental health professional that works with gender variant/trans clients/patients!!

The Gender ASSET

Halle Ross

This course was very enjoyable and informative! Dr. Keo-Meier is a very informed, knowledgeable, and engaging speaker. The information he presented on the history of transgender mental health and medical care, the WPATH Standards, the process of conducting the Gender ASSET evaluation, and the process for writing a letter of support for different medical procedures had breadth and depth. The layout of the course is attractive and user-friendly. The resources provided in the course were also very beneficial and will continue to inform my future practice. I am excited that I was able to participate in this course, and I hope to continue taking advantage of opportunities to learn from Dr. Keo-Meier and improve my clinical practice!

The program is much more comprehensive than just the ASSET, the background and supporting information is absolutely necessary to understanding the training and ASSET.


The program is much more comprehensive than just the ASSET, the background and supporting information is absolutely necessary to understanding the training and ASSET.


Increase your gender affirmative knowledge and skills for working with transgender and gender diverse clients who ask you for a letter for surgery.
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