Gender Therapy for Your Truest You
Showing up as yourself, fully and without apology, is harder than it should be. You deserve to stand in your truth with pride.
Trans, non-binary, and gender-expansive folks: we see you and celebrate you.
We offer a safe(r) space in therapy where you will be affirmed, validated, and empowered. The name Panorama isn’t accidental; it’s a commitment to an expansive view of what gender and life can be. Read on for more about gender therapy and affirming referral letters.
I see and admire every day what it’s like to navigate our current world as trans or gender expansive. I strive to be your impassioned champion and a resource to you in every step of the way. – Miranda Nadeau, Ph.D.

Meeting You Where You Are
Whether you’re still figuring things out, deep in the process, or just trying to hold it all together while the political climate does its worst, we’re here.
See if you live in one of the 42+ states we serve.
Affirming & Empowering Gender Therapy

We all flourish best when we are encouraged to find and explore who we are, while being supported and held in our identities.With a Panorama Therapy gender therapist, you’ll work on building resilience, self-compassion, and a sense of affirmation that comes from within.
We prioritize anti-oppressive and anti-racist practice, checking our varying privileges and honoring how your physical and mental health is shaped by a range of intersecting identities and experiences.
Feeling genuinely understood in therapy changes things. That’s what we’re working toward together. Ready to begin gender-affirming therapy with Panorama Therapy?
- Reach out to schedule your free consult using the contact form.
- Get connected with a gender-affirming therapist who is excited to connect with you.
- Experience being heard, affirmed, and empowered in a relationship of earned trust.
Gender-Affirming Referral Letters
We offer gender-affirming referral letters as a core part of our commitment to trans allyship. We provide affirming referral letters for hormone therapy (HRT) and surgeries including top surgery (chest reconstruction & masculinization, breast augmentation), bottom surgery (e.g., orchiectomy, vaginoplasty, metoidioplasty, phalloplasty, etc.), and the many other options for gender-affirming medical care. Schedule here.
Informed consent model. We operate on a simple principle: if you can consent to a treatment, you should have access to it. You know your body and your life; we trust that. Most referral letters are written after a single hour-long session, during which we verify your diagnosis and talk about your hopes and plans.
Affirming referral letters are available to trans and gender-expansive folks in Texas, Colorado, New Jersey, Florida, and 30+ other states nationwide. Letters follow the Standards of Care put forth by WPATH.
We are limited in how many appointments we can offer each month, so you may be asked to wait for your referral letter session. If you are interested in a letter, contact us to get started. Other letter writers nationwide can be found through The Gender Affirming Letter Access Project (GALAP).
Relevant Training

Gender therapy is work we’ve trained in deeply and care about. Some folks we’ve trained with before:
- Fenway Health
- World Professional Association for Transgender Health (WPATH)
- Colt St. Amand, Ph.D., MD
- Aydin Olson-Kennedy, LCSW
- Dara Hoffman-Fox, LPC