It is tube rectified and is truly balanced from input to output
@teajay While this preamp has a balanced output, its incorrect to describe it in the title of this thread as 'truly balanced' and isn't truly balanced from input to output (which is not a claim from their website). You may wish to revise this if that is something that found its way into your review.
The output is truly balanced, but the internals are single-ended (like the venerable Ampex 351 electronics).
Since it uses an output transformer, its capable of supporting AES48 (the balanced line standard). As such is one of the few vacuum tube balanced preamps in high end audio that can make that claim. I think one of the Bachert Labs preamps also uses an output transformer to drive balanced lines. Our preamps use a direct-coupled circuit that also supports AES48.
So that makes three I know of. There's likely more but they are rare. Its frightening to see how many tube preamps have a balanced output but don't support the standard.