Is the letter actually free?

Yes. The assessment, the letter, revisions, extra copies, and coordination calls are provided at no charge. This is a standing policy of the practice.

Do I have to become your therapy client?

No. A single visit for the assessment and letter is common. Ongoing therapy is available, and it is never a condition of the letter.

One visit of 30 to 45 minutes. When the clinical criteria are met, I write and send the letter the same day.

Will surgeons and insurance companies accept your letters?

Letters are written by an independently licensed clinical social worker (Iowa license 110423) and follow the WPATH Standards of Care, Version 8, the framework most surgeons and insurers reference. If a provider requires specific language or additional documentation, updates are free.

I am under 18. Can you help?

Iowa Code section 147.164 prohibits gender transition procedures for minors in Iowa, so letters are an adult service here. Therapy is not restricted. I see teens for therapy.

What if the letter slots are full?

You get the next open slot or a direct referral to another clinician who writes letters.

BACK TO THE FARM

FREE GENDER-AFFIRMING
LETTERS IN IOWA

I never charge for letters of support. Not the assessment, not the letter, not the revisions, not the phone call to your surgeon’s office. This is a standing policy of the practice.

Chad Mohammad, LISW · Iowa license 110423 · telehealth anywhere in Iowa · office in Cedar Falls

Schedule Appointment

Or text (619) 559-5769 and say you need a letter.

CHAD’S PROMISE TO THE COMMUNITY

If you need a letter of support for gender-affirming care (a WPATH letter for surgery, hormones, or insurance requirements), I write it at no cost.

One visit, 30 to 45 minutes, by telehealth anywhere in Iowa or in person in Cedar Falls. When the clinical criteria are met, your letter goes out the same day: signed, on letterhead, sent where it needs to go.

You do not have to become my therapy client. The visit is a clinical assessment using an informed consent approach, consistent with the WPATH Standards of Care, Version 8.

HOW IT WORKS

1Book a visit. Use the schedule button, or call, text, or email and say you need a letter.
2We meet for 30 to 45 minutes, by video or in person. It is a clinical assessment. I ask what I need for the letter and nothing more.
3When the clinical criteria are met, the letter goes out the same day. Extra copies, updated versions, and coordination with your surgeon’s office are also free.

Schedule Appointment

When you book, mention the letter so I set aside the right time.

WHAT LETTERS DO IN IOWA RIGHT NOW

Surgery. Most surgeons and insurance plans require at least one assessment letter from a licensed mental health professional, per the WPATH Standards of Care. That includes Iowa programs and out-of-state programs.
Hormones. Many clinics use informed consent and do not require a letter. Some providers and insurers still do.
Records. Senate File 418 (2025) ended gender marker changes on Iowa birth certificates, and Iowa licenses must match the birth certificate. If you were born in another state, that state’s rules control your birth certificate, and a letter can still be part of that process.

Iowa removed gender identity from the Iowa Civil Rights Act effective July 1, 2025 (Senate File 418). Iowa Medicaid no longer covers gender-affirming surgery or hormone therapy (House File 1049), but it still covers mental health care. For ongoing therapy I take Iowa Total Care, Molina, Wellpoint / Amerigroup, Anthem, Wellmark BCBS, Optum, Oscar, and UHC.

CAPACITY

I hold a set number of free letter visits each week. If a week is full, you get the next open slot or a direct referral.

Separate from letters, I hold a small number of no-cost ongoing therapy openings for people who are underinsured or cannot pay. Say so when you reach out. No documentation is required.

FOR PROVIDERS

Therapists, primary care, and surgical coordinators: referrals are welcome. The assessment and letter cost your client nothing, coordination with your office is free, and your client remains in your care.

REACH CHAD DIRECTLY

call(619) 559-5769 text(619) 559-5769 emailchad@waterlootherapist.com

QUESTIONS

Is the letter actually free?: Yes. The assessment, the letter, revisions, extra copies, and coordination calls are provided at no charge. This is a standing policy of the practice.
Do I have to become your therapy client?: No. A single visit for the assessment and letter is common. Ongoing therapy is available, and it is never a condition of the letter.
How fast is it?: One visit of 30 to 45 minutes. When the clinical criteria are met, I write and send the letter the same day.
Will surgeons and insurance companies accept your letters?: Letters are written by an independently licensed clinical social worker (Iowa license 110423) and follow the WPATH Standards of Care, Version 8, the framework most surgeons and insurers reference. If a provider requires specific language or additional documentation, updates are free.
I am under 18. Can you help?: Iowa Code section 147.164 prohibits gender transition procedures for minors in Iowa, so letters are an adult service here. Therapy is not restricted. I see teens for therapy.
What if the letter slots are full?: You get the next open slot or a direct referral to another clinician who writes letters.

STANDARDS AND LAW

Chad Mohammad is a Licensed Independent Social Worker regulated by the Iowa Board of Social Work under Iowa Code chapter 154C. Iowa license 110423. Practice: Chad Mohammad Therapy LLC, 200 State Street, Suite 202K, Cedar Falls, Iowa.
Letters of support are clinical documents prepared after an individual assessment, consistent with the WPATH Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (2022). An assessment does not guarantee a letter. Letters are provided when clinically indicated. No fee is charged in either case.
Iowa law referenced on this page: Senate File 418 (2025), which removed gender identity from the Iowa Civil Rights Act (Iowa Code chapter 216) and ended gender marker changes on Iowa birth certificates (Iowa Code section 144.23), effective July 1, 2025. House File 1049 (2025), which ended Iowa Medicaid coverage of gender-affirming surgery and hormone therapy and left mental health coverage in place, effective July 1, 2025. Iowa Code section 147.164 (2023), which prohibits gender transition procedures for minors.
This page describes services. It is not legal advice.