NO BARRIERS
GENDER-AFFIRMING
LETTERS IN IOWA
“Come to me — I will do it that day.”
Community rally in Waterloo · Winter 2023
Letters of support for gender-affirming care. An individual clinical assessment, telehealth or in person in Cedar Falls.
Chad Mohammad, MSW, LISW · Iowa license 110423 · Cedar Falls, Iowa
Or text (619) 559-5769 and say you need a letter.
CHAD’S PROMISE TO THE COMMUNITY
I practice from an informed consent model (ICATH). The assessment respects what you know about yourself, and my job is the clinical documentation that medicine and insurance require.
If you need a WPATH letter for surgery, hormones, or insurance requirements, you can expect this to be done in one visit. In rare situations, depending on what is happening, it can take one to three sessions. When the clinical criteria are met, your letter goes out the same day, signed and on letterhead, sent where it needs to go.
There is no charge for a letter visit, and you do not have to become my therapy client. You do not need to prepare anything. Come as you are.
There will never be a case where I am testing you, trying to catch you in a gotcha, or anything that feels hostile. I am a real person in your corner. You review and approve the draft before anything is signed or sent out. If an insurance reviewer asks for different wording later, updates and re-submissions are included at zero cost.
HOW IT WORKS
- 1Book a visit. Use the schedule button, or call, text, or email and say you need a letter.
- 2When the assessment supports it, the letter goes out. Extra copies, updated versions, and coordination with your surgeon’s office are included.
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. For financial assistance with care, affirming clinics, and sliding-scale healthcare, visit the community resources & mutual aid page.
CAPACITY
I hold a set number of 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 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, and your client remains in your care.
REACH CHAD DIRECTLY
QUESTIONS
- 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?
- Usually one visit. When the clinical criteria are met, I write and send the letter the same day. In rare situations it can take one to three sessions.
- 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 included.
- 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.
For the longer version, including how many letters different surgeons and insurers require, read the 2026 guide to how letters work in Iowa.
STANDARDS AND LAW
- Chad Mohammad holds a master of social work (MSW) and 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 LISW 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), through an informed consent approach. An assessment does not guarantee a letter. Letters are provided when clinically indicated.
- 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.
READY WHEN YOU ARE
Book a visit, or text (619) 559-5769 and say you need a letter. Same day when clinical criteria are met.
IF YOU'RE IN A TOUGH SPOT RIGHT NOW
If you're having a rough night, feeling overwhelmed, or just need to talk to someone right now, these are free, confidential, and open 24/7.
- 988 Suicide & Crisis Lifeline
- The Trevor Project (queer and trans youth)
- Crisis Text Line
