Surgeons Who Use Informed Consent
What Is Informed Consent?
Informed Consent is a healthcare model that empowers patients to make decisions about their own bodies, identities, and medical care. Widely used by providers around the world, it recognizes every individual’s right to self-determination and bodily autonomy.
Traditionally, many people seeking Top Surgery have been required to obtain a letter from a mental health professional confirming a gender dysphoria diagnosis and that they are psychologically ready for surgery. However, a growing number of surgeons reject the outdated notion that being transgender is a mental illness. These surgeons follow the Informed Consent model, which focuses on patient autonomy rather than gatekeeping.
Under this model, surgeons ensure patients receive clear, comprehensive information about the procedure—including techniques, duration, risks, recovery, and long-term outcomes. Patients then sign a consent form confirming they understand the procedure and are making an informed, voluntary decision to proceed.
Important Note: If you're using insurance to cover Top Surgery, most insurance providers still require one or more mental health letters to approve the procedure—even if your surgeon uses Informed Consent. Be sure to check your plan's requirements.The surgeons listed below practice Informed Consent. They do not require therapy or a letter from a mental health professional as a precondition for surgery.
California
Gender Confirmation Center
San Francisco, CA
The Gender Confirmation Center is a San Francisco-based, multi-surgeon practice founded in 2013 by board-certified plastic surgeon Dr. Scott Mosser. The practice focuses heavily on gender-affirming top surgery, offering procedures such as double-incision, peri-areolar, and keyhole, as well as less common incision types such as fishmouth and lollipop. They are early adopters of sensory nerve preservation techniques in double-incision top surgery, which aims to improve the return of chest and nipple sensation after surgery. The practice maintains a dedicated insurance advocacy team that has secured coverage for many patients, helping make top surgery more accessible. Throughout the top-surgery process, the team emphasizes informed consent, trans-competent communication, and a highly affirming environment for local and out-of-town patients alike.
Founded in 2013 and based in San Francisco, the Gender Confirmation Center is a multi-surgeon practice focused on gender-affirming top surgery for trans and gender-diverse patients.
Gender Confirmation Center
450 Sutter St, Ste 1000
San Francisco, California 94108
855-398-7778
genderconfirmation.com
Align Surgical Associates
San Francisco, CA
Founded in 2018, Align Surgical Associates is a multi-surgeon, gender-affirming surgical practice with offices in San Francisco and Santa Monica, California, dedicated exclusively to the care of transgender, nonbinary and gender-diverse patients. Top surgery is a major focus of the practice: their surgeons offer a range of techniques, including double-incision with nipple grafts, peri-areolar/keyhole, inverted-T/anchor and buttonhole approaches. Consultations are used to review goals, anatomy and technique options in detail, and the care team guides patients through pre-operative preparation and a structured recovery plan. The environment is intentionally designed as a “sanctuary” and home away from home, with all staff specifically trained in the nuanced techniques and support needs associated with gender-affirming, trauma-aware care from first contact through long-term follow-up.
Founded in 2018, Align Surgical Associates is a multi-surgeon, gender-affirming surgical practice in San Francisco and Los Angeles that devotes its work to trans, non-binary and gender-diverse patients. For top surgery, the team offers a full range of masculinizing chest procedures—double-incision, keyhole/peri-areolar, inverted-T and buttonhole—delivered in a highly supportive, sanctuary-like environment with staff specifically trained in gender-affirming care.
Align Surgical Associates Inc.
2299 Post St, Ste 207
San Francisco, California 94115
415-530-5335
alignsurgical.com
Dr. Walter Lin
San Francisco, CA
Dr. Lin is a fellowship-trained Plastic Surgeon in San Francisco who performs Top Surgery. His expertise in microsurgical breast reconstruction has shaped his approach to gender-affirming care and led to the co-development of a novel nerve transfer technique designed to preserve chest sensation after Top Surgery. He joined the Buncke Clinic and the San Francisco Transgender Institute in 2017. More »
Fellowship-trained, exceptionally skilled plastic surgeon with deep expertise in gender surgery.
Dr. Lin is a fellowship-trained Plastic Surgeon in San Francisco who performs Top Surgery. Drawing on his background in microsurgical reconstruction of the breast, he co-developed a novel nerve transfer technique to help preserve chest sensation after Top Surgery. In his 2025 study of 27 patients, the technique proved safe, did not affect appearance, and showed early signs of improved sensation.
The Buncke Clinic
45 Castro St, Ste 121
San Francisco, California 94114
415-684-5206
www.buncke.org
Board-certified; WPATH member; in-person or phone consultations; uses Informed consent (doesn't require a letter); wait list one month.
Dr. Manish Champaneria
San Diego, CA
Board-certified by the American Board of Plastic Surgery, Dr. Champaneria has extensive training, with a special focus on gender-affirming chest procedures. He accepts insurance and will operate with Informed Consent. Dr. Champaneria practices in San Diego, California. More »
Scripps Clinic Del Mar
12395 El Camino Real, Ste 112
San Diego, California 92130
858-554-9950
drmanishchampaneria.com
Consultation fee $75; uses informed consent (no letter requirement).
Colorado
Dr. Paul Steinwald
Denver, CO
Dr. Steinwald has performed hundreds of Top Surgeries over the last 25 years. He is known for pioneering the Inverted-T procedure, a method designed to preserve as much nipple/areola sensation as possible. People come from around the world to see Dr. Steinwald and to have this specific procedure done. More »
More than 25 years of experience performing Top Surgery. Based in Denver.
501 S Cherry St, Ste 900
Denver, Colorado 80246
Toll-free: 877-255-2600
Local: 303-278-2600
www.topftmsurgery.com
Double-board certified; uses informed consent (no letter requirement); consultation fee $75; minimum age 18; pioneered the Inverted-T procedure.
Connecticut
Dr. Laurel Chandler
Darien, CT
Dr. Chandler is a Harvard fellowship-trained plastic surgeon who has received specialty training in Top Surgery from some of the best experts in the field. Based in Fairfield County, Connecticut, Dr. Chandler provides personalized care for a diverse range of patients, up to 90% of whom are transgender or non-binary. More »
Specialty training in Top Surgery, Connecticut practice dedicated to gender-affirming care.
Chandler Plastic Surgery
777 Post Rd, Ste 304
Darien, Connecticut 06820
203-423-3132
www.topsurgeryconnecticut.com
Fellowship-trained; board-certified; WPATH member; no BMI limit; uses informed consent (no letter requirement); wait list 2-3 months; $200 consult fee.
Florida
Georgia
Hawaii
Michigan
Dr. Lena Weinman
Lansing, MI
Dr. Weinman is a fellowship-trained surgeon in Lansing, Michigan who has a dual background in Obstetrics and Gynecology and Cosmetic Surgery. She brings a distinctive blend of clinical expertise and aesthetic precision to her work. Dr. Weinman is deeply committed to serving the transgender and non-binary communities and focuses her practice on gender-affirming Top Surgery and Body Sculpting. More »
Aqua Body Lab
1720 Abbey Rd, Ste A
East Lansing, Michigan 48823
517-230-8437
www.aquabodylab.com
Fellowship-trained Cosmetic Surgeon; informed consent (no letter required).
North Carolina
Dr. Hope Sherie
Charlotte, NC
Dr. Sherie is a board-certified cosmetic surgeon who has performed thousands of top surgery procedures for transmasculine and non-binary patients. Based in Charlotte, North Carolina, she is widely known for her experience, surgical precision, and patient-centered approach to gender-affirming care. Patients travel from across North Carolina and beyond to seek top surgery with Dr. Sherie at her private, trans-friendly surgical center. Prior to launching her private practice, she served as an active duty Air Force surgeon. More »
Highly experienced, personalized care, leading top surgery practice in Charlotte NC.
The Cosmetic Concierge
325 Arlington Ave
Charlotte, North Carolina 28203
980-938-0459
www.cosmeticconciergemd.com
Fellowship-trained, board-certified cosmetic surgeon; WPATH member; 10% military discount; accommodation package available; BMI limit 40; uses informed consent (no letter requirement).
Pennsylvania
Dr. Aneesh Gupta
Philadelphia, PA
Dr. Gupta is a cosmetic surgeon in Philadelphia who is pleased to provide gender-affirming care for his transgender and non-binary patients. Dr. Gupta completed cosmetic surgery fellowship training at the renowned Marvel Cosmetic Surgery in Nashville and is board-certified by the American Board of Cosmetic Surgery (ABCS). More »
Shiloh Cosmetics
1528 Walnut St, Ste 200
Philadelphia, Pennsylvania 19102
215-999-6695
www.shilohcosmetics.com
Board-certified; short wait list; free virtual or in-person consultation; uses informed consent (no letter requirement); no BMI limit.
Tennessee
Dr. Allison Laffoon
Nashville, TN
Dr. Laffoon is a board-certified cosmetic surgeon based in Nashville, Tennessee, with a growing reputation for her expertise in masculinizing chest surgery for transgender men and nonbinary individuals. With a background in general and cosmetic surgery, she blends technical precision with a warm, affirming bedside manner. Dr. Laffoon approaches each case with the goal of helping patients feel more aligned and confident in their bodies. More »
Marvel Cosmetic Surgery
329 18th Ave N
Nashville, Tennessee 37203
615-861-8174
MarvelCosmeticSurgery.com
Board-certified Cosmetic Surgeon; FREE phone or in-person consultations; uses informed consent (no letter requirement); wait list 1 month following consult.
Texas
Dr. Dustin Reid
Austin, TX
Dr. Dustin Reid a double board-certified plastic surgeon in Austin who has experience performing Keyhole, Peri-Areolar, and Double Incision Top Surgery. In many cases, Dr. Reid is able to do a "drain-free" procedure. Dr. Reid is committed to providing expert surgical care and guidance throughout your Top Surgery experience. More »
Dr. Dustin Reid, MD, FACS
Restora Austin Plastic Surgery Centre
901 W 38th St, Ste 401
Austin, Texas 78705
512-371-8817
www.restoraaustin.com
Double board-certified; WPATH member; uses informed consent (no letter requirement); $150 consultation fee; wait list 3-4 weeks; no drains!
Utah
Washington
Dr. E. Antonio Mangubat
Tukwila, WA
Dr. Mangubat's extensive experience and many years of dedication to transgender health have made him the most sought-after Top Surgery surgeon in the Pacific Northwest. Dr. Mangubat has been performing transgender surgery for more than twenty years. More »
La Belle Vie Cosmetic Surgery Center
16400 Southcenter Parkway, Suite 101
Tukwila, WA, 98188, US
206-575-0300
www.labelleviecosmetic.com
Board-certified Cosmetic Surgeon; WPATH member; informed consent.
Canada
Last updated: 05/29/26