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Evaluations for Surgery Readiness (Gender Affirming Treatment Evaluations)

We believe that it is vital that trans and non-binary individuals have access to gender affirming medical care, including hormones and surgical options. Currently, in order to access surgery, letters of support from licensed mental health professionals, like Licensed Psychologists, are required by many endocrinologists, surgeons and insurance companies. For many people who are gender-fluid, these surgeries and procedures are life-saving.

At Hope Springs, we follow the World Professional Association for Transgender Health (WPATH) Standards of Care as a guideline in our approach to working with non-binary or transgender people. Our evaluations follow the WPATH guidelines.


  • These service may/may not be covered by your insurance plan, and it will be important for your to review your benefits prior to your sessions in our office. We are in network with Wellmark Blue Cross Blue Shield of Iowa.
  • When not covered by insurance, our fees are as follows:
    • $200 for the initial 60-minute evaluation appointment
    • $195 per each hour of follow-up or report-writing afterwards
    • Two letters sent directly to providers are included in the cost estimate.
    • $25 for each additional letter

Time Commitment

Evaluations may take anywhere from 1-4 sessions. You will be asked to complete paperwork prior to your first visit. Your visits may be rescheduled if this paperwork is not completed prior to your appointment. Occasionally, additional sessions may be needed. It may also take 1-2 weeks for the evaluation report to be sent to the individual and/or other healthcare providers.


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