Starting gender-affirming care

Gender-affirming care covers a range of support: primary care that respects your name and pronouns, hormone therapy, voice therapy, mental health support, and surgery. Most people start with a primary care or specialty clinic, not surgery.

Many clinics offer hormones under an informed-consent model: the provider explains the benefits and risks and you consent, without needing a therapist's letter first. Others still ask for a letter. Surgery usually requires letters under the WPATH Standards of Care (Version 8) and your plan's rules.

• Your clinic or provider: prescriptions, labs, referrals and letters.
• Your health plan: whether a service is covered and what prior authorization it needs.
• Your state: laws on minors' care, Medicaid coverage and insurance protections vary widely.

• ☐Find an affirming provider (directories below, or search near you).
• ☐Ask: do you offer informed-consent hormone therapy? Do you take my insurance?
• ☐Call your plan and ask for its written policy on gender-affirming care (often called a clinical or medical policy).
• ☐Ask whether the service needs prior authorization, and get a reference number for the call.
• ☐Keep copies of letters, lab results and every denial.
• ☐If you're denied, read the insurance & denials page before you pay out of pocket.

• WPATH provider search

  Providers who are members of the World Professional Association for Transgender Health.

• WPATH Standards of Care 8

  The clinical guidelines most plans and surgeons reference.

• Erin Reed's informed-consent map

  Crowd-sourced map of clinics offering informed-consent hormones. Confirm with the clinic.

• GLMA provider directory

  LGBTQ+-affirming clinicians across specialties.

• Point of Pride

  Grants for surgery, hormones, binders and more.

• Trans Lifeline microgrants

  Peer support and small grants, including for name changes.