Gender Affirmation Evaluations

Ms. Mansouri offers hormone readiness evaluations (for offices that do not practice the informed consent model) and provides letters for gender confirmation surgeries. Ms. Mansouri follows WPATH standards and writes letters for gender confirmation (top and bottom) surgeries.

What to Expect

A gender affirmation surgery evaluation typically lasts between 1-1.5 hours depending on your history (any previous evaluations, reports, mental health concerns, etc.). Ms. Mansouri follows the World Professional Association of Transgender Health (WPATH) standards which states:

  1. Persistent, well-documented gender dysphoria

  2. Capacity to make a fully informed decision and to consent to treatment

  3. Be of the age of majority in the country of surgery (and follow SOC rules for children and adolescents*)

  4. Significant medical or mental health concerns, if present, must be reasonably well controlled at the time of surgery

The evaluation process consists of a thorough clinical interview, review of any previous medical/mental health records, review of any letters of endorsement by past therapists, and a questionnaire to assess for current mental health functioning.


If a client meets all of the above criteria, Ms. Mansouri will provide a letter indicating the medical necessity of the gender affirmation surgery directly to their provider and/or insurance company (with a signed release of information) within 5-7 business days. Ms. Mansouri will also provide the client with a copy of their evaluation letter. If a client's application for gender affirmation surgery is denied or rejected for a specific reason, Ms. Mansouri will work with the client to re-write a compelling and strongly-worded appeal letter.