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Here are some frequently asked questions and more detailed information about our practice and services.  If you have a question that is not listed here, please contact us.

Do you accept insurance?


We do not accept insurance at this time, however we strive to make psychotherapy accessible and affordable by providing a sliding scale for clients.  As a licensed therapist in Virginia, we can provide a "superbill" for clients to submit to insurance companies.  

Our fee schedule is indicated below:

Individual counseling or consulting: $160-220 per 50-minute session.

Letters for gender-confirming surgery (includes PhD level "2nd letter" for insurance purposes): $360

Case presentations and options for courts: $300 per hour

Court appearance: $650 per hour (4 hour minimum)


How long are therapy sessions?


Individual therapy sessions are 50 minutes.  We can arrange to schedule additional longer sessions as needed. 



Do you offer online Skype therapy?


We strive to make our psychotherapy services as accessible as possible.  As such, we DO offer teletherapy over our secure, HIPAA compliant server.  We do not use Skype because it is not HIPAA compliant.  The method we use is similar to teleconferencing platforms you may already be familiar with such as Skype.  Teletherapy is available for Virginia residents.  Inquire for more details.

What is the process for obtaining a recommendation letter for gender-confirming medical (surgery) care?


We provide letters/recommendations for blockers and contra-hormone therapy for minors. We strive to follow current best practices in psychotherapy including the recommendations outlined in The Standards of Care, (SOC) Version 7.  Note that while the SOC states that "Psychotherapy is not an absolute requirement for Hormone Therapy and Surgery," we require that individuals seeking a letter of recommendation for gender affirming medical care schedule a therapy session to include intake and a psychological assessment. 


We encourage you to download your own current PDF version of the SOC by going to Below is an excerpt from the SOC to give you an idea of what is currently recommended when working with health care providers in obtaining hormone therapy. 


from the SOC, v7:


"Criteria for Hormone Therapy


Initiation of hormone therapy may be undertaken after a psychosocial assessment has been

conducted and informed consent has been obtained by a qualified health professional, as outlined

in section VII of the SOC. A referral is required from the mental health professional who performed

the assessment, unless the assessment was done by a hormone provider who is also qualified in

this area.


The criteria for hormone therapy are as follows:


1. Persistent, well-documented gender dysphoria;

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

3. Age of majority in a given country (if younger, follow the SOC outlined in section VI);

4. If significant medical or mental health concerns are present, they must be reasonably well-



As noted in section VII of the SOC, the presence of coexisting mental health concerns does not

necessarily preclude access to feminizing/masculinizing hormones; rather, these concerns need to

be managed prior to, or concurrent with, treatment of gender dysphoria."


Do you offer a sliding scale?


Yes.  I dedicate 20% of my practice to providing sliding scale and pro-bono support for clients with financial needs. Call to inquire about my sliding scale appointments.  I will make every effort to accommodate you.


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