Beth Firestein, Ph.D.

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Name: Beth Firestein, Ph.D.
Name of Practice: Nyle Biondi, LLC
Address: 200 E. 7th Street, Ste. 406 Loveland, CO
Phone: 970-290-0971
Mental Health Degree/Licensure/Certification: Ph.D.

Do you have a sliding scale for patients with limited resources?


Does your practice accept private insurance payment?

I accept original Medicare, however I am not able to accept Medicare Advantage insurance plans. I also accept TriCare and TriWest for military and retired military individuals. I am not on managed care panels but I can accept payments from HSAs (Health Savings Accounts) and most clients with PPO type plans are able to be reimbursed for some services. Payment is requested at time service is rendered.

Please estimate the number of clients you have worked with in each of the following categories:

Trans* Children-0

Trans* Youth-0

Genderqueer and  Gender Non-Conforming-15

Trans Women-50

Trans Men-10

Trans* Elders-5



Please describe your level of experience (e.g. years,  training, etc. ) in working with Trans* and Gender non-conforming  clients?

I began leading the Northern Colorado Transgender Support Group in 1996 and continued leading the group for 16 years.  During that time I also began serving individuals in various stages of identity exploration and gender transition.  I sought training in multiple places and served on the Executive Committee of Division 44 (The Society of Psychological Study of Gay, Lesbian, Bisexual and Transgender Issues in Psychology) of the American Psychological Association (APA).  I have done presentations at local, regional and national conferences pertaining to working with transgender individuals in therapy and have presented multiple times at the Gold Rush gender conference in Denver.


Please describe your treatment approach (e.g., cognitive behavioral, experiential , body-centered, DBT, etc.).

First, I listen.  I sit down with the person I am here to serve and I let them tell me who they are, what is important to them and where they have traveled so far in their gender journey.  We move forward from there.  I utilize a variety of approaches in helping my client’s achieve their goals. It depends a great deal on where the individual is in their self-discovery, coming out, and transition processes.


Do you provide single case assessments (for individuals not seeking ongoing psychotherapy)  and, as appropriate, letters of eligibility for hormone therapy and gender related surgeries?

No. I only provide letters for individuals who are working with me in therapy for a period of time. I also write secondary GRS letters for clients who are referred by their primary gender therapist and have met criteria for SRS according to their practitioner.  I have written letters for many of my clients, but letters are not guaranteed and are issued based on my professional judgement.


On average, how many sessions or hours of assessment do you require to assess eligibility for?

Hormone Therapy- 3 months in therapy as per Guidelines

Chest Surgery- No set number

Genital Surgery, if primary letter writer- I follow WPATH standards

Genital Surgery, if secondary letter writer (when 1st letter is written by client’s primary/ ongoing psychotherapist) 2-3 sessions, consultation with primary therapist


How do you assess readiness for Hormone Therapy and or Surgery?

Clinical Interview, Collateral Contacts.  I work with someone for a period of time to assess their level of gender identity integration, readiness, and eligibility.  I trust my clinical judgement and experience and always work collaboratively with my clients, taking their perspectives and needs into account.  I take final responsibility for my decision about the appropriateness of giving my professional endorsement for the client’s next steps in transition.


Does a coexisting mental condition preclude providing the client with a letter?

No. Of course, any concurrent issues, such as depression, anxiety disorders, substance abuse issues or other mental health issues would need to be stable and under good control before I would write a letter for any type of surgery.


Does your practice have inclusive paperwork (e.g., list more than male and female gender options, allow a place for preferred name, etc.)?

Paper files that are inclusive?- Yes

Electronic Health records that are inclusive? n/a


Does your practice have a system for recording preferred name and pronoun of patients and communicating that to staff, especially scheduling/appointment and reception staff?



Does your practice have all-gender or gender-neutral restrooms?



Do you have anything in your physical environment that would be welcoming to a Trans* person ( i.e. brochures, pamphlets, magazines, pictures that relate to Trans* people and or Trans* issues?

My waiting room environment is private, attractive and does include magazines, but no posters or brochures of any kind.


Does your practice have an inclusive non-discrimination policy that includes gender identity and expression, and sexual orientation?

Yes. I am a sole practitioner and do not have a staff or formal written policy, however, the ethics and professional standards I follow are always non-discriminatory and inclusive.


Do you have a way of protecting the confidentiality of a patients Trans* status?

Yes. All of my records are entirely confidential and maintained in accordance with professional ethics and standards.  The only exceptions are those reporting requirements (such as imminent danger to self or others, or known or suspected child abuse) required by law.


Have you or your staff attended training or had other education on providing services to Trans* patients apply?

Person responding to survey-Yes


Please describe the training noted above, if applicable.

At this point I have probably conducted as much training as I have attended. My training included reading, workshops and working with well-known trans leaders in the M-t-F and F-t-M communities while writing and editing my books on bisexuality.  I learn continuously from my clients.


Do you have any concerns about the experience level of intake staff that could create an uncomfortable situation for trans clients? Is there someone the patient can contact to assist?

No. There is no issue since I am the only person in the office.