Gender Affirming Evaluations for Trans & Gender Diverse Adults

Providing LGBTQ Healthcare Since 2011 | Fenway Health Trained | Former VA LGBT Health Fellow
Serving Adults (18+) Nationwide via Telehealth
 

WHY CHOOSE D.I.V.E. FOR GENDER AFFIRMING EVALUATIONS

When you're ready to take the next step in your transition journey, you deserve an evaluation process that is affirming, knowledgeable, and respectful. Led by Dr. Speshál Walker Gautier - "Dr. Spesh," our team brings over a decade of specialized LGBTQ healthcare experience in gender-affirming care.

Dr. Spesh's LGBTQ+ Healthcare Background

• Providing LGBTQ Healthcare since 2011

• Fenway Health Trained (Boston's nationally recognized LGBTQ health center)

• Completed LGBT Health VA Postdoctoral Fellowship

• Former Gender Affirming Evaluation Trainer and Supervisor

• Former VA Psychology Diversity Rotation Supervisor

• Specialized training in gender identity and transgender health

• Deep understanding of WPATH Standards of Care

• Committed to affirming, inclusive, culturally responsive care

This specialized expertise means your evaluation will be conducted by providers who truly understand gender diversity and are committed to supporting your authentic self.

WHAT WE EVALUATE

Our team of licensed clinical psychologists provides comprehensive evaluations for:

HORMONE THERAPY (HRT) READINESS ASSESSMENTS

• Testosterone therapy evaluations

• Estrogen therapy evaluations

• Documentation for endocrinologists and prescribers

GENDER-AFFIRMING SURGERY LETTERS

Top Surgery (Chest Masculinization/Feminization)

• Bilateral mastectomy

• Breast augmentation

Bottom Surgery (Genital Reconstruction)

• Vaginoplasty

• Phalloplasty

• Metoidioplasty

• Orchiectomy

• Hysterectomy

Facial & Body Procedures

• Facial Feminization Surgery (FFS)

• Tracheal shave

• Voice surgery

• Body contouring

SECOND OPINION EVALUATIONS

When your first evaluation didn't feel affirming or thorough

WHO WE SERVE

ADULTS BEGINNING HORMONE THERAPY

Starting your medical transition with comprehensive support

ADULTS PREPARING FOR SURGERY

One or two letters may be required, depending on procedure & insurance

INDIVIDUALS NEEDING SECOND OPINIONS

When previous evaluations felt gatekeeping or invalidating

NON-BINARY & GENDER DIVERSE INDIVIDUALS

Affirming care that honors all gender identities

COUPLES NAVIGATING TRANSITION TOGETHER

Supporting relationships through gender transition

OUR EVALUATION PROCESS

STEP 1: FREE 15-MINUTE CONSULTATION

We discuss your goals, what documentation you need, and timeline. This helps us determine which of our clinicians will conduct your evaluation and answer any questions about the process.

STEP 2: RECORD REVIEW (IF APPLICABLE)

We review relevant records including:

• Prior mental health treatment records

• Medical history

• Previous gender-related assessments

• Letters from therapists or other providers

STEP 3: COMPREHENSIVE CLINICAL INTERVIEW

A thorough, affirming interview (typically 60-90 minutes) covering:

• Your gender identity journey and history

• Current social, medical, or legal transition steps

• Mental health and overall well-being

• Support systems and resources

• Informed consent and understanding of procedures

• Goals and expectations for hormone therapy or surgery

STEP 4: PSYCHOLOGICAL ASSESSMENT (WHEN INDICATED)

Assessments may include:

• General mental health screening

• Assessment of readiness and stability

• Evaluation of informed consent capacity

• Psychosocial functioning assessment

STEP 5: WRITTEN LETTER/REPORT

You receive a comprehensive letter including:

• Confirmation of gender dysphoria diagnosis (DSM-5-TR)

• Documentation of capacity for informed consent

• Confirmation that requirements have been met per WPATH Standards of Care

• Specific recommendation for hormone therapy or surgery

• Clear, professional documentation for medical providers

• Delivered within 7-10 business days

All evaluations are conducted following WPATH Standards of Care and are reviewed by our clinical team to ensure the highest quality.

WHAT MAKES OUR EVALUATIONS DIFFERENT

AFFIRMING, NON-GATEKEEPING APPROACH

We believe you are the expert on your gender identity. Our role is to support your goals, not to question your authenticity. We approach evaluations as collaborative assessments, not barriers to care.

DEEP LGBTQ+ EXPERTISE

With specialized LGBTQ healthcare experience, our team understands the nuances of gender diversity and the challenges of navigating healthcare systems.

WPATH STANDARDS OF CARE ALIGNED

All our evaluations follow current WPATH guidelines while maintaining an affirming, supportive approach. We know how to write letters that meet medical requirements without unnecessary gatekeeping.

COMPREHENSIVE YET EFFICIENT

We gather all necessary information without making you "prove" your gender. Our thorough, WPATH-compliant approach produces letters that meet the documentation standards required by surgeons and medical providers while respecting your time and experience.

CULTURALLY RESPONSIVE CARE

We honor the intersectionality of identities and provide culturally responsive care for BIPOC, disabled, neurodivergent, and multiply marginalized trans and gender diverse individuals.

COUPLES & RELATIONSHIP SUPPORT

We understand that gender transition affects relationships. We offer specialized support for couples navigating transition together, including partner consultations when helpful.

LETTERS WE PROVIDE

All letters include:

• DSM-5-TR diagnosis of Gender Dysphoria (when clinically appropriate)

• Confirmation of persistent, well-documented gender identity

• Assessment of mental health stability

• Documentation of informed consent capacity

• Verification of WPATH Standards of Care criteria

• Specific procedure recommendation

• Professional documentation meeting surgeon/provider requirements

• In cases requiring two letters, we can:

  • ​Coordinate with your therapist or another provider for the second letter, or

  • We can provide both letters through our team of independent clinicians

PRICING & INSURANCE

EVALUATION FEES:

• Hormone Therapy (HRT) Readiness Assessment: Starting at $399

• Single Surgery Letter (Top Surgery, Hysterectomy, FFS, etc.): Starting at $499

• Bottom Surgery Letter: Starting at $599 per letter

• Fees vary based on complexity and assigned clinician

PAYMENT:

• Some insurance plans cover gender-affirming assessments with out-of-network benefits

• We provide superbills for insurance reimbursement

• We discuss all costs transparently during your free consultation

FREQUENTLY ASKED QUESTIONS

Q: DO I HAVE TO PROVE OR EXPLAIN MY GENDER?

A: We approach evaluations through an informed consent model, not a gatekeeping model. We believe you know your gender identity best. Our role is to document that you have capacity for informed consent, understand the procedures and their effects, and have adequate support. We're here to support your transition goals, not to judge or question your authenticity.

Q: WHICH PSYCHOLOGIST WILL CONDUCT MY EVALUATION?

A: We assign evaluations based on case needs and clinician expertise. Our psychologists are licensed and experienced in gender-affirming care. We discuss assignments during your free consultation.

Q: DO I NEED TO BE IN THERAPY TO GET A LETTER?

A: Not necessarily. While ongoing therapy can be beneficial, it's not necessarily required for a letter. We assess each situation individually based on WPATH guidelines. We can discuss your specific situation during your consultation and evaluation.

Q: HOW LONG DOES THE PROCESS TAKE?

A: From your evaluation appointment to receiving your completed letter typically takes 7-10 business days. If you need your letter more urgently, let us know during your consultation.

Q: WHAT IF I'M QUESTIONING OR EXPLORING MY GENDER IDENTITY?

A: That's wonderful that you're on this journey of self-discovery. While we provide evaluations for those ready for medical transition, we also offer gender-affirming therapy for individuals who are questioning or exploring their gender identity. We can discuss which service would best support you during your consultation.

Q: WILL MY LETTER BE ACCEPTED BY SURGEONS/PROVIDERS?

A: Our letters follow WPATH Standards of Care and include all documentation required by surgeons and medical providers. We've successfully provided letters for clients seeing providers across the country. If you have a specific surgeon or provider, we can review their requirements during your consultation.

Q: WHAT IF I'M NON-BINARY OR MY GENDER DOESN'T FIT BINARY CATEGORIES?

A: We fully affirm non-binary, genderqueer, genderfluid, agender, and all gender diverse identities. Our evaluations honor your unique gender experience and support your specific transition goals, whatever they may be.

Q: DO YOU PROVIDE LETTERS FOR LEGAL NAME/GENDER MARKER CHANGES?

A: Yes, we can provide letters supporting legal name and gender marker changes for driver's licenses, passports, birth certificates, and other legal documents. Let us know during your consultation if this is what you need.

Q: CAN YOU PROVIDE A SECOND LETTER IF I ALREADY HAVE ONE?

A: Yes, we can serve as the second independent evaluator for bottom surgery procedures. We'll need to review the first letter to ensure we're providing independent documentation.

FOR MEDICAL PROVIDERS & THERAPISTS

WE COLLABORATE WITH:

• Primary care physicians and endocrinologists

• Surgeons and surgical practices

• Therapists and mental health providers

• Gender clinics and LGBTQ health centers

WHAT WE PROVIDE:

• Timely, comprehensive evaluations

• Clear documentation meeting WPATH standards

• Professional letters accepted by medical providers nationwide

• Consultation on complex cases

• Second opinion evaluations

• Coordination of care

CONTACT US

Ready to schedule your confidential consultation?

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AVAILABLE IN-PERSON & VIRTUAL

📞 PHONE: (404) 800-1998
📧 EMAIL: contact@DiveTherapyCo.com
📍 LOCATION: 1055 Howell Mill Rd, 8th Fl, Atlanta, GA 30318
🖥️ VIRTUAL: Secure telehealth available

*Evening & weekend appointments available*​​​​​