For transgender, gender-nonconforming or nonbinary folks from all identities, it's important to find a doctor who provides gender-affirming care, which will "support and affirm an individual's gender identity," according to the World Health Organization.
This is a particularly significant step for people who are transgender and transitioning, and may require regular visits to the doctor to start taking hormones or prepare for one or more surgeries that are essential for their transition.
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In larger cities, gender-affirming doctors can be found in primary care, internal medicine or other medical specialties. Some public health clinics may provide gender-affirming hormones, says nurse practitioner Kate Steinle, chief clinical officer at FOLX Health.
"A lot of sexual and reproductive health care centers, like Planned Parenthood and others like it, are some of the biggest providers of in-person gender-affirming hormones," she says. Residents in more rural areas can take advantage of online options.
Finding a gender-affirming doctor can be a process. Here's exactly how to get started.
1. Determine What You’re Looking For
Before you can really start looking for a provider, you need to pin down the type of care you're seeking.
Some primary care doctors specialize in gender-affirming care, providing gender-affirming hormone treatment as well as general medical care. That is, you can go to these doctors for hormone treatment, and also schedule a visit if you have the flu, suspect you have a sprained ankle or have other medical issues that require follow up with a GP.
There are also providers who only do gender-affirming hormone treatment, prescribing masculinizing or feminizing hormone therapy. These providers would likely refer you to another doctor if you have any other underlying issues that aren't directly related to your hormones.
If you feel like you don't have many medical concerns, seeing a provider just for hormones is a great way to get started. But if you do have other underlying health issues, a primary care doctor with special focus in LGBTQ+ care can help with hormones as well as provide gender-affirming care for all types of concerns.
How to Find a Surgeon
If you’re at a point where you’re looking to get one or more gender-confirming surgeries done, the process to find a surgeon is much the same as finding a provider who oversees your health and/or prescribes you hormones. Depending on the type of surgery, you will likely only interact with your surgeon for a limited amount of time until all of your procedures are finished.
Some key questions to consider as you look for a surgeon:
- What kinds of surgeries are you looking to get done?
- Are you able to travel out of state, or do you need someone nearby?
- Are you planning to use insurance, or will you be paying out of pocket?
Knowing exactly what your options are and how far you can travel will help you narrow down surgeon choices.
2. Look for Providers Through Your Insurance
Not everyone has insurance, but if you do, check which providers and procedures are covered.
Insurance can be a barrier to seeking gender-affirming care. Even if you have insurance, you may have to pay out of pocket for some clinical care — that's the case for many of the patients at FOLX Health, which provides gender-empowering care for transgender, non-binary and intersex people, Steinle says. "But if they want their prescription sent to a local pharmacy, they can use their insurance to pick up those prescriptions," she says.
Most insurance companies have online portals where you can log in to look up all kinds of information. With insurance plan portals, you can search for gender-affirming care without having to talk to someone and tip your hand about your identity. If you can't find anything online, there's also a number on your insurance card that you can call and ask for help finding a doctor covered under your plan.
Some health care plans deny certain health care services to transgender people, according to the U.S. Centers for Medicare & Medicaid Services (CMS). To find out what your plan covers, or to confirm what's covered before signing up for a plan, look at the summary of benefits, review the complete coverage details or contact the insurance company. And, if your insurance refuses a claim, know that "you also have the right to appeal the decision and have it reviewed by an independent third party," per CMS.
3. Consider Telehealth
Telehealth opens up options to people who face barriers to gender-affirming care, including living in a rural area with few providers or an inability to afford the costs. Here are two of the most well-known telehealth gender-affirming care providers:
- FOLX Health: This telehealth gender-affirming healthcare provider provides care via a one time fee of $59 per visit, with clinician support for general health, sexual health and gender-affirming health issues. You can make an appointment for an initial consultation to ask questions, or, if you're certain you want to get care and hormones with FOLX, you can become a member for a monthly fee, Steinle says.
- Plume: Like FOLX, Plume provides telehealth services on a membership basis. For $99 a month, you can get telehealth visits that will help you with everything you need concerning gender-affirming hormone therapy, including how to inject or otherwise take your hormones. Plume also provides one-off visits for letters required for gender marker changes as well as those required for gender-affirming surgery approval.
4. Connect With Your Community
One of the best ways to find a doctor in your area is to check with your local transgender community:
If you aren't personally connected with anyone, most states will have an area-wide or state-wide Facebook group, like TransgenderUtah or Trans Maryland. Once you've joined a local group, you can ask about which doctors others see, and if they have any advice for clinics to seek out — or avoid.
Talk to Others
"When I started transitioning seven years ago, I knew I wanted to start the medical aspect right away but didn't know where to start," says Noah Cherry, hair designer at Friar Tuck's Barbershop. "Resources were limited," Cherry says, recalling relying on YouTube videos for information. "I found that finding support was ultimately the first step. I asked other guys who they saw for their hormones and physicals," Cherry says.
Referrals from others can be really helpful.
"Word of mouth is great, asking around with other trans folx about their experiences and who they recommend (or don't)," says Ash Rowan, freelance graphic designer and illustrator. "I've been happily surprised by a few providers, and sometimes they claim to be queer-friendly but still don't really get pronouns or gender stuff."
Plus, as you find providers and clinics from online searches or your insurance company portal, you can ask people in your community about their experience with specific doctors.
Reach Out to Community Organizations
If you aren't able to find any online-based groups for transgender folks in your area, you can also contact your local pride center and ask for referrals. Most pride centers will have resources for transgender folks, or at the very least can connect you with someone who knows the ins and outs of transgender care for your area.
5. Research Specific Providers
Once you've identified potential doctors or clinics, consider doing some additional research before making an appointment:
Visit Clinic and Provider Websites
"I'll also try to look on their website and specifically seek out doctors/clinics who list LGBTQ as one of their specialties," Rowan says. Some clinics or practices may have an about us page, or details on their mission or values.
Once you have a few candidates to compare, you can research their backgrounds, Cherry says. Here, some of the factors Cherry had in mind when first looking for a provider:
- The doctor's credentials
- How long the provider offered transgender services
- The accessibility of the doctor
- Attitude and style of the support staff
"I have been with the same doctor since I started hormones and even years later I still find her practice to be the strongest for my transition. When it came to surgeries, I went about it the same way. I asked questions, did the research and found the best doctor for me and my transition goals," Cherry says.
Here are a few sites you can look at for physician reviews:
When looking at reviews, check if information is available about what to expect when it comes to speed of care, especially if you're going to an in-person clinic. "There's such a wide range of how people approach this care as providers," Steinle says. At some places, you might be able to start hormones with your first visit but other clinics or doctor's offices may require labs beforehand or a second visit, she says.
6. Connect With Finalists
Once you have two or three providers to choose from, it's time to narrow down your list. The best way to get a sense if the clinic or doctor's office is gender-affirming is to book an appointment.
During this visit, "look for representation," Steinle says. That includes having photos on the wall of people who are part of the LGBTQ community, she says. Or, maybe people are asked for their pronouns when they check in at the front desk, Steinle says. Another thing to look for: "Is there an understanding that people's ID and affirming name might be different? And how do they deal with that?"
But if you don't have the time or budget to visit more than one provider, give the office a call, Steinle suggests.
Then, ask questions: Steinle suggests inquiring about the protocols for people whose identification doesn't match their gender marker or how they handle people whose affirming name is different from their legal one. "Ask that and if people are stumped at the front desk... [the] likelihood is maybe that's not a great place [for gender-affirming care]," Steinle says.
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