private gender reassignment clinics

Get Gender Affirming Therapy that is uniquely crafted for you.

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Remote appointments from your home

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Why Circle Medical

Over 1 million.

Video appointments held

Patients treated

Insurance accepted

In network with most HMO plans

Clinics in the USA

Available providers

Therapy referrals

Available for patients in need

How treatment works

Intake appointment (30 min)

Your provider will review your medical and gender affirming history with you.

We will ask you for your previous provider so that we may coordinate having your medical records sent over to our practice.

Your provider will order blood work, if needed. 2

$100 cash pay $0-40 average copay 1 for insured patients*

2 week follow up (20 min)

Your provider will review the results of your blood work, your medical records, and discuss informed consent 3 .

Your provider will create a treatment plan that is unique to you and answer questions you may have about care 4 .

Check-in appointments every 3 months 5 (20 mins)

Follow up appointments may occur with your provider every 1-3 months to ensure that you are meeting your gender affirming goals. If medically appropriate, your provider may discuss adjustments to your dosage and care plan as well ‍

Additional information

* This an example of the cadence most care plans tend to follow. However, your care plan and cadence may vary based on your individual medical history and other factors. ‍ ‍ (1) Co-pay costs will depend on your individual insurance plan, but are typically in the $0-$35 range per appointment. You can see a copay estimate if you begin to book an appointment with Circle Medical. ‍ ‍ (2) Your provider will review your most recent blood work, especially if it is within the last 3 months, and determine if additional blood work is necessary. Blood work requirements will be determined by your provider during an appointment. Costs will vary based on lab and blood work required. ‍ (3) Circle Medical does not always require a therapist letter in order to confirm informed consent. Please read through the FAQ for more details. ‍ (4) PLEASE NOTE: A hormone prescription, or any other medications, are not always guaranteed. Your primary care provider will review your past medical history and blood work to determine which treatment options are right for you. ‍ (5) This is Circle Medical's standard practice for ongoing care.

We accept most PPO plans

If you want to verify if your plan is covered with us, select an appointment time and create an account to submit your insurance. You will not be required to book an appointent.

Want to know more about pricing? Read our FAQs

We can't accept patients with Medicaid or Medi-Cal insurance.

4.98 (1,759)

In the last 180 days, 1,759 patients have given their Hormone Therapy providers an average rating of 4.98 / 5, with 97% of respondents giving a 4 or a 5.

Cash pay price (per appointment)

No memberships or hidden fees, paid by insurance (avg).

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Your total (avg)

*Over the last 12 months, 75% of insured Gender Affirming Hormone Therapy patients have paid $40 or less. Costs are estimates and may change according to your deductible. For a definite price, call your insurance company.

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One practice for all of your primary care needs.

Many telemedicine providers will only treat you for hormone therapy - but you and your health are more complex than any one issue. At Circle Medical, we treat the whole patient. This means the next time you need to discuss any Primary Care-related issue, you’re already where you need to be.

Join 65,000+ patients taking control of their health at Circle Medical.

As a full-service, adult-only, primary care practice, Circle Medical's team of board-certified providers specialize in treating the whole you.

The Circle Medical Difference:

100% board-certified primary care providers

Takes into account your full health picture

Compassionate, comprehensive, evidence-based care

25+ clinics and an easy-to-use app

Family Medicine, 10 years of experience

Family Medicine, 27 years of experience

Board Certified, Family Medicine, 17 years of experience

350+ Providers. 100% Confidence.

Held to an exceptionally high standard of evidence-based care.

Circle Medical is making delightful healthcare accessible. To everyone.

Who is a good candidate for HRT?

Gender-affirming hormone therapy aims to align an individual’s characteristics with their gender identity with the use of hormones.  Our practice provides both masculinizing and feminizing gender affirming care, when medically appropriate, for adults 18+. Receiving gender-affirming hormone therapy is a personal decision. Our goal is to make sure that all people 18+ who want to do so can access safe, gender-affirming care from experienced clinicians.  If you decide that gender affirming hormone therapy is right for you, and is clinically indicated, your provider would assist with: ‍

Feminizing hormone therapy with estrogen, progesterone, or a hormone blocker (such as spironolactone or finasteride).

Masculinizing hormone therapy with the use of testosterone. These could be in the form of pills, topical creams, or a self injection. Your provider will assist you in deciding the right treatment for you.

How can I learn more about Circle Medical’s trans care?

If you have questions and would like to learn more about your options, we recommend booking an intake appointment to speak with a provider. We accept most PPO insurance plans and do not require a membership, so that it's easier for you to meet with a provider. As a patient, you will have unlimited access to message your provider and your care team through our secure in-app chat. Prescriptions for hormones (such as testosterone, estradiol, or progesterone), hormone blockers (such as spironolactone or finasteride), hair loss medications (such as finasteride), and erectile function medications are all available through our practice and may be prescribed if they are appropriate for your specific situation..

Don't take our word for it.

We treat over 50,000 patients every month. Here's what they have to say.

I felt heard. I felt educated by the provider. There’s so much stigma and such a shortage of psychiatrists, I felt alone and judged, but Circle was different.

I rated you a 10 because firstly my experience was excellent, the provider was very professional and easy to talk to, and the medication she recommended seems to be working great!

Easy platform and scheduling, helpful especially when it’s hard to find mental health care.

I put off my mental health for a long time. It took me a lot of courage just to click Book Appointment. It was so easy, the first appointment was great and constructive, The second was scheduled for 3 days later, and I got a treatment plan from my Mental Health Professional within hours.

My provider is wonderful and so accomodating. I've been to psychs in the past that have been very rude and clearly wanted to get the visit over with ASAP, but she never rushes, she listens to me cite my complaints and praises about my current treatment plan, and then responds with true care.

Finding a good and reliable remote healthcare provider to diagnose and treat ADHD is extremely difficult. Circle Medical has made this process easy for me and I am thankful I chose Circle Medical.

This system, the efficiency, and care behind it is the best that I have come across. I have been uncomfortable addressing issues like ADD and ADHD as an adult, so I put this off for years. My provider has already helped in 2 sessions. I have to say, I am already feeling better simply taking the initial steps. A big thanks to this team!

I am very happy with their service, especially after bad experiences with other companies. My provider is very helpful, attentive and genuinely seems to care. Medicine orders are quick and they do what they promise.

As someone who has ADHD, simply setting up an account on the site was so easy. You can tell that this was made with neurodivergent people in mind. Things are just SIMPLE.

ADHD assessment was tailored to adult women, the expert gave nuanced additions and clarification to questions or statements. I feel much better-equipped to handle life and am making progress in ways that seemed impossible before.

Appointment availability. I cannot get an in-person appointment in my city for 6 weeks. This app allowed me to connect with a medical professional the next day. (Same-day was available as well.) And professionalism. I felt that in my two appointments I was treated with respect, not judged, and I was able to express my issues and thoughts to someone who was actually listening.

As far as I’m concerned, this is the future of healthcare. I’ve transitioned all of my primary care to Circle Medical as well as my ADHD management. I’m amazed at the weekend and off-hour options, which are a lifesaver for a busy professional like myself. I recommend this service to anyone who is looking to get a PCP or evaluated for ADHD. Your customer service is top-notch and I’ve never had an issue with insurance or my prescriptions. I’m so glad I found your company!

I recommend Circle Medical because there’s no other app that actually just goes straight to the point in helping your needs; that being needing ADHD diagnosis or anything else that has to do with with your physical and mental health. There are no complications with speaking with the Circle Medical Team let alone any problems period.

I could not believe that I got an appointment for ADHD within hours. I had a terrible time trying to get an appointment with the group my insurance recommended. The health practitioner is knowledgeable and kind, and I feel like I'm getting both good physical and psychological support.

Very convenient. I was shocked that I could get inexpensive mental health services so quickly. Very pleased.

I love how well-informed and empathetic my PCP is. It has been the best psychiatric provider experience I have had thus far in my life, I trust her so much more than my previous providers.

It is so difficult to access mental health care services right now especially for ADHD, I have received immediate and responsive care that has already improved my quality of life, thank you.

My provider has made all the difference. She honestly and genuinely goes out of her way to help me. As a person with serious ADHD all my life I found someone who makes the difference In how I feel. She always has my very best interest at heart. She’s an incredible person and I feel that she has empathy and believes in what she’s doing.

The turnaround time to get an appointment and see a provider was so quick and easy; everything is setup with the neurodivergent brain in mind from the way the app is designed to appointment reminders and calendar syncing. My provider made me feel heard and she kept our appointment focused on the task at hand (so important for adhd minds!)

I love not having to wait before my appointment begins in the lobby and not having to drive there also saves time. It was also great when I had COVID, as I did not have to expose anyone and still could get medical help. I also got life changing diagnosis of ADHD through Circle Medical. I LOVE MY PROVIDER, she is amazing!

Frequently Asked Questions

Gender-Affirming Hormone Therapy

Yes, anyone who is 18+ and permanently resides in a state that we service is eligible for gender-affirming hormone therapy through our practice. There may be instances where your provider may recommend that you see a specialist for gender affirming hormone therapy based on your history. The decision to provide treatment is always up to the providers discretion

During your first appointment, your provider will establish your medical history and ask whether you have had labs done. If you don't have labwork done yet, your provider will place a lab order in to a location near you. Your results will be uploaded to the app automatically. Some providers may request that you obtain a letter from a therapist indicating that you have spoken with them about gender-affirming care. You can upload this letter via the app. Note that this letter request is at the provider's discretion. You can use our in-app chat to message your care team and provider as you complete the labwork. Once you have the needed items indicated by your provider and a completed first appointment with Circle Medical, you are ready to begin hormone therapy. If medically indicated, your treatment will be sent to a pharmacy near you. ‍ You will then follow up with your provider at an agreed upon cadence to see how your treatment plan is going and to ensure you are meeting your gender affirming goals.

Circle Medical practices care in alignment with WPATH (World Professional Association for Transgender Health) Standards of Care. A therapist letter is not always a requirement in order for patients to have access to gender affirming care. Often, we will not require a letter from a therapist or mental health professional prior to beginning gender affirming care. However, there are select times in which we may ask for a letter from a therapist, or mental health professional. For example, we may ask for a letter if a patient is unsure of their gender affirming goals and/or is new to exploring gender affirming therapy and is unsure whether starting gender affirming care is right for them.  Our goal is to improve access to high quality and delightful primary care. Gender affirming care is within the scope of primary care and we are focused on creating a safe environment for people to receive care.

To see a list of states, please start booking an appointment. You will be able to select from a list of all of the states where we are currently practicing. You must be currently residing in the state of treatment as well as have your primary pharmacy be in that same state in order to be a patient at our practice.

The decision to start your transition is a deeply personal one. We recommend booking a video appointment to speak with one of our experienced clinicians to get your questions answered. All of our clinicians are primary care practitioners, which means that they are experienced in providing care beyond gender-affirming hormone therapy. Your clinician will be able to discuss your treatment options with you and answer any questions you may have, about gender-affirming care or about any other health topic you may want to discuss in a safe environment.

Your provider will be able to place a lab order to a lab near you to get bloodwork and hormone monitoring completed. Your results will be uploaded automatically to the app, where you can view and download them at any time.

Our providers are primary care providers (MD's, DO's, NP's, and PA's) who have experience in providing gender-affirming care and behavioral health care. They are allies and proud members of the LGBTQIA+ community. We encourage you to read more about each provider on their profiles above!

You do not need to book your appointment with a doctor. You can book your appointment with any provider that we have available. Our providers all work closely together to make sure that we are providing the same excellent standard of care to all patients regardless of which provider you book your appointment with. The type of provider you book with will not limit the type of treatment or medications that you are able to be prescribed.

The first intake appointment is 30 minutes. Follow-up appointments are 20 minutes each.

We accept most major PPO plans and we do not have any membership fees or ongoing membership requirements. The only cost that you have from our practice is the cost per appointment (see below for appointment cost estimates). Your other costs include the cost of the medication(s) at the pharmacy (we recommend using GoodRx coupons to lower this cost), and the cost of any lab work or hormone testing at the lab. ‍

With Insurance

$5 - $50 average copay* 1st appointment $5 - $50 average copay* 2nd appointment $10 - $100* total, with $5 - $50* monthly follow-ups once stable. *Note: Your specific copay is dependent on your health insurance coverage. We typically see patients with copays of around $0-$50 per appointment, but this can be higher if you have a high-deductible plan and have not yet hit your deductible this year. To confirm your specific copay estimate, you can click to book an appointment and you will be asked to input your insurance information so that you can receive your cost estimate before confirming the appointment. Our ability to estimate your costs is dependent on your healthcare insurance's database, so we do not guarantee that the estimate you see is the exact amount you will be billed. For the most accurate estimate of your per-appointment costs, we recommend calling the phone number on the back of your insurance card to ask your insurance plan what your primary care appointment costs are.

Without Insurance (out of network or uninsured)

$100 per appointment Your specific follow-up appointment timeline may vary depending on what your provider recommends.

We contract with most PPO insurance plans. If you are a California Bay Area resident, we also work with a small number of HMO plans. To verify if we work with your insurance, simply start booking an appointment online. You will be prompted to enter your insurance details and will receive eligibility results instantly as well as an estimate of your appointment cost prior to confirming your appointment. Some PPO plans that we currently work with are: ‍ Anthem Blue Cross/Blue Shield, Aetna, Blue Shield of California, Cigna, Health Net, Humana, and United Healthcare. Plans that we cannot work with are: Unfortunately, we are unable to provide care for patients who have Medi-Cal or Medicaid insurance. This is because we are not licensed Medi-Cal or Medicaid providers, so we are not able to provide care, even if these patients choose to pay cash instead of use their insurance. If you have Medi-Cal or Medicaid, please do not book an appointment with us, as we will be unable to provide care even if you do not enter your insurance information. We apologize about this.

After booking your first appointment, download the app and make sure that you are able to sign in. Confirm your appointment start time in the app (all times are in your phone's local time). No other actions are needed. You will receive an in-app chat message 1-2 minutes before your appointment start time with the link to join your video appointment.

After you are prescribed medications, we will coordinate sending these prescriptions to your preferred pharmacy. We may have a mail-order prescription delivery service available; please ask your provider about this. We will contact you via the in-app chat regarding ongoing refills and follow-up appointments. Your specific follow-up appointment cadence will be determined by your provider. If you have questions at any time, please feel free to chat with your provider and care team via our secure app.

Talk to a provider about Hormone Therapy today.

Same-day Availabilities

Read more about Hormone Therapy

Overview of feminizing hormone therapy.

Feminizing hormone therapy is a medical intervention that helps individuals match their physical attributes more closely with their gender identity. This typically involves medications such as estrogen, progesterone or hormone blockers.

Estrogen is a hormone predominantly found in females. Estrogen triggers the growth of secondary sexual traits. Changes may include the development of breasts, a decrease in muscle mass and redistribution of body fat. Meanwhile, hormone blockers slow the production of testosterone, minimizing its influence on the body. This helps to reduce physical characteristics typically associated with males.

Remember to regularly consult your health care provider throughout feminizing hormone therapy. They can help monitor progress, manage side effects and adjust treatment as needed.

Overview of masculinizing hormone therapy

Masculinizing hormone therapy is a medical intervention that helps individuals match their physical attributes more closely with their gender identity. Masculinizing hormone therapy uses testosterone in the form of pills, topical creams or self-injection.

Testosterone is the hormone responsible for the emergence of secondary sex characteristics typically associated with males. Changes such as growth of facial and body hair, increased muscle mass and voice deepening may occur when taking testosterone. 

Remember to consult your health care provider throughout your masculinizing hormone therapy. They can monitor progress, help manage side effects and adjust your treatment as necessary.

How to start online hormone replacement therapy (HRT) as an adult

If you’re interested in starting hormone replacement therapy, finding a primary care provider will be the first step. Make sure to choose a provider that offers HRT and understands the needs of LGBTQ+ patients, like Circle Medical. 

Once you find a provider, the first step will be an intake appointment. This involves reviewing your medical history with your provider, discussing your goals for HRT and having blood work ordered. You will then schedule a follow-up appointment where your provider will review your blood work with you and, if appropriate, prescribe the appropriate HRT medications.

It’s important to understand that hormone replacement therapy is an ongoing process that requires patience and an open dialogue with your health care provider. After starting HRT, you will have follow-up appointments to track progress, adjust dosage as necessary and discuss any changes or side effects you experience. By working with your health care provider, you can make significant steps to align your physical characteristics with your gender identity.

How to get a quality LGBTQ+ health care from the comfort of your home

It can sometimes be difficult to access LGBTQ+-focused care, especially if you live in a remote or rural area. Fortunately, there are online solutions. Circle Medical is a full-stack primary care clinic that offers comprehensive LGBTQ+ care.

It’s easy to make an appointment to discuss HRT with a Circle Medical provider. You can make an online appointment that is convenient for your schedule and speak to a provider from the comfort of your home. Make an appointment with Circle Medical today to get started on your healthcare journey.

Medical services provided by Circle Medical Care of California, an independent medical practice. CA Medical Board permit #FNP3274.

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* Patient names and identities have been changed to protect Patient Health Information (PHI)

© 2015-2023 Circle Medical Technologies, Inc. 333 1st Street #A, San Francisco, CA, 94105

Full names have been changed in compliance with federal patient privacy laws.

Real Hormone Therapy patient reviews

I have nothing but good things to say. Very professional, detailed, and  polite. The best experience I‚Äôve ever had with a medical professional.

I appreciate it a lot with my follow ups and medication for my journey along  the way.

Always friendly! I always feel comfortable talking to him and he asks me  my thoughts on his treatment plans and allows it to be more of a collaborative process.  I love it!

Ms. Smith has been the best PCP I have ever worked with. I'm very glad for  both my physical and emotional health, she listens to every one of my concerns and  ACTUALLY addresses them!

Very kind and informative. Absolutely one of the best interactions I have ever had with a health care provider.

I amso grateful to have found Dr. Mirza. She was warm, patient, wise, and always leaves me feeling seen and heard.

Daniela was great. She explained the process of care and path quite well.  I felt seen, heard, and posessed self agency during the visit. I would highly recommend  Daniela.

I love Dr Fontanilla. I have never felt so comfortable receiving gender  affirming care before. thank you so much Dr Fontanilla!!!

What a phenomenal person Mia is. She was kind, compassionate, and knowledgeable.  I am grateful to her for her fantastic care and looking forward to talking further  with her about my journey. Thanks Mia!!

She is awesome as always. She always make sure that I feel better and comfortable.  She really takes good care of my health too. She does not just give me meds but  made sure that I'd be healthy. You can ask her anything without feeling anxious.

Awesome Doctor, Listens and Cares.

Elizabeth is amazing! She takes excellent care of me during appointments  and in-between

My first time ever having a consultation about hormone therapy and Dr. Ibarra  made it the best!

I am so happy with Dr. Lauren, she has been so understanding and compassionate  towards my health and wellbeing. I would give her a 1000 star rating if it left  me. Much Light, Love and Positivity to Dr. Lauren and all of the wonderful folks  at Circle Medical

Excellent bedside manner honest and trustworthy. A fantastic Physician and  a amazing ally to have throughout my transition journy. She will slow me down if  its needed and i always feel shes doing her due dilligence in my case.

She has a level of care i need and i was pleasantly surprised at the depth of social concern she has. Im excited to continue working with her!

Katelyn was very helpful and provided a lot of great direction in our conversation.  I felt like she genuinely cared about my medical needs, and was a great conversationalist,  in addition to providing great care.

Love the convenience of the video consultations for refills on my ADHD medication!!! This is wonderful!!! Also love my health practitioner— he is fantastic!!! A++++++

1,000+ more reviews available upon request.

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To see if your plan is in network, select a provider and time and create an account. You will be able to check if your plan is in network without having to confirm your appointment or enter any payment information.

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Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

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Center for Transgender and Gender Expansive Health

Services and appointments.

The Johns Hopkins Center for Transgender and Gender Expansive Health offers comprehensive, evidence-based and affirming care for transgender and gender diverse youth and adults that is in line with the standards of care set by the World Professional Association for Transgender Health (WPATH).

Creating an environment in which our patients and their families feel safe and confident in the care they receive is central to the mission of Johns Hopkins Medicine. The multidisciplinary care team takes careful consideration of best practices and the appropriate provision of care for transgender and nonbinary individuals.

Request an Appointment: 844-546-5645

Children, Adolescents and Young Adults

Center collaborators, eligibility criteria, services for adults, dermatology.

Dermatologists at the Center for Transgender and Gender Expansive Health perform laser hair removal for both aesthetic reasons and as preparation for some surgeries.

During laser hair removal, a dermatologist uses a low-energy beam laser, which results in long-term or permanent hair reduction and removal. Usually, a series of laser hair removal appointments are recommended for best results. Discuss an individualized plan with your dermatologist.

Patient Resources

Vaginoplasty Hair Removal Template

Phalloplasty Hair Removal Template

Our Experts

Myriam Lucia Vega Gonzalez, M.D., M.P.H. Assistant Professor of Dermatology

Farah Succaria, M.D. Assistant Professor of Dermatology

Facial Surgery

In cases where hormone therapy is not enough to achieve  desired gender affirming changes to the face , surgery can help. Feminizing facial surgery includes a variety of procedures, such as reshaping the nose; brow lift (or forehead lift); chin, cheek and jaw reshaping; Adam’s apple reduction; lip augmentation; hairline restoration; and earlobe reduction. Masculinizing facial surgical options including hairline reshaping, jaw augmentation, and thyroid cartilage enhancement are also available. Watch to learn more .  See eligibility requirements . See surgical timeline .

Our specialists at the Fertility Center coordinate with the Center for Transgender and Gender Expansive Health to provide  services for gender affirming fertility preservation, reproduction assistance and contraception . It is recommended that you consider speaking to a specialist before undergoing hormone treatment to review how gender-affirming hormone therapy may affect your fertility options.

• Gyn/Ob Care for Transgender and Gender Expansive Patients

Geriatric Care

Our specialists in Geriatric Care coordinate with the Center for Transgender and Gender Expansive Health to provide the highest quality clinical care to improve the health of older adults and society.

Gynecology, Obstetrics and Family Planning for Gender Diverse Patients

Gyn/Ob specialists provide preventive, gender- affirming gynecologic care throughout your life. This may include routine annual exams/cervical screening for transgender and gender diverse individuals, sexuality and sexual health care, the management of benign gynecologic disorders, transitioning and gender affirmation including menstrual suppression, trauma informed pap smears, local anesthetics for IUD placement and counseling when appropriate. The department also specializes in shared decision making for family planning, care during pregnancy, childbirth and the postpartum period for transgender and gender diverse individuals.

Hormone Treatment

The Center for Transgender and Gender Expansive Health partners with endocrinologists and primary care providers. Both endocrinologists and primary care providers work with each patient to prescribe either gender-affirming hormone treatments. Hormone treatments can be part of a pre-surgical plan, or be a stand-alone service, depending on your desired outcomes. Talk to your doctor about the process and any side effects that you can expect.

Hysterectomy

Hysterectomy  includes the removal of the uterus and ovaries (oophorectomy). Many gender patients are seeking gender affirming hysterectomy as part of their gender journey. Other patients have preexisting conditions such as fibroids, or endometriosis.

Options for oocyte storage and fertility preservation are also available if desired.  See eligibility requirements .  See surgical timeline

Mental Health

The Department of Psychiatry and Behavioral Sciences partners with the Center for Transgender and Gender Expansive Health (CTH) to provide mental health services through the expertise of the Sex and Gender Clinic. Assessments for surgical readiness are available. These involve the completion of a comprehensive mental health evaluation, following WPATH guidelines. Other services include recommendations for ongoing care such as support and guidance preoperatively and postoperatively as well as treatment for co-existing mental health conditions. Support and education for families and significant others are further aspects of the team’s services. The aim of the collaboration between CTH and Psychiatry is to maximize the health, well-being and quality of life of transgender and gender diverse individuals.

Metoidioplasty

Metoidioplasty is a surgical procedure for gender affirmation that is sometimes called a meta procedure or bottom surgery. It is an alternative to phalloplasty .

Pelvic Physical Therapy

Our pelvic health physical therapists are specially trained to evaluate and treat different types of pelvic floor dysfunction and treat a variety of pelvic floor symptoms after performing a complete assessment to best suit your needs. They can also assist with pre and post-operative exercises for genital surgery, and assist with dilation teaching.

Pelvic Floor Physical Therapy

Occupational Therapy

General Physical Therapy

Penile construction (phalloplasty)

Phalloplasty  can include removal of the vagina (vaginoplasty), reconstruction of the urethra, scrotoplasty, penile and testicular implants, and penile construction. Surgeons will use tissue from another part of the body to construct the penis.  See eligibility requirements .  See surgical timeline .

Arm Phalloplasty Hair Removal Template

Thigh Phalloplasty Hair Removal Template

Penile Implant

Phalloplasty

Primary care for gender diverse patients.

The comprehensive services offered through the Center for Transgender and Gender Diverse Health include connecting transgender patients with primary care providers across Johns Hopkins Medicine who are trans affirming. These providers can manage a patient’s general health care needs as well as specific transgender-health-related needs such as initiating and managing hormone therapy in most cases. Our primary care team members are vital partners in providing holistic care that leverages the resources of our academic medical health care system.

Top surgery (chest feminization or chest masculinization)

Top surgery is surgery that removes or augments breast tissue and reshapes the chest to create a more masculine or feminine appearance for transgender and nonbinary people.  See eligibility requirements . See surgical timeline .

At the Center for Transgender and Gender Expansive Health, you will receive care from doctors in the Johns Hopkins Department of Urology who have experience in the range of gender-affirming surgeries.

The urology team works closely with the Department of Plastic and Reconstructive Surgery and other members of our integrated team to provide the most up-to-date gender affirmation procedures and ongoing care. Services provided include robot assisted vaginoplasty, orchiectomy, and insertion of penile prostheses. Follow-up visits with urology are available for prostate screening or urological issues.  See eligibility requirements . See surgical timeline .

Vaginoplasty

This surgical procedure  is a single stage procedure during which our skilled surgeons may remove the penis (penectomy) and the testes (orchiectomy), if still present, and use tissues from the penis to construct the vagina (vaginoplasty), the clitoris (clitoroplasty) and the labia (labiaplasty).  See eligibility requirements . See surgical timeline .

Voice Therapy

The Center for Transgender and Gender Expansive Health works with otolaryngologists who specialize in voice therapy, which some transgender individuals find beneficial. Intervention is designed to meet the individual needs of the person who is transitioning and may include diagnostic evaluation, treatment or surgical intervention. Our team works together to assist in the voice transition. Specifically, we provide a supportive and guided environment to maximize total communication, including aspects of voice such as conversational pitch and inflection, as well as nonverbal communication.

The initial evaluation will include a case history and assessment of voice and speech prosody. All clients are initially screened for any laryngeal pathology to ensure optimal vocal fold health. An individualized treatment plan is created with the client based on the assessment findings and the client’s perceived needs. Some aspects the voice pathologist may choose to address include:

• Habitual speaking pitch
• Inflection (the melodic ups and downs of the voice)
• Rate of speech (how fast or slow the person speaks)
• Non-verbal communication
• Volume/intensity
• Articulation
• Pragmatics (social rules of communication)

Sometimes, voice therapy alone is not enough to achieve your desired outcome. In cases like this, vocal cord surgery is an option and is usually done as an outpatient procedure. Talk to your doctor about surgical options to achieve the vocal identity that is right for you. 

Insurance coverage for voice therapy often differs among providers. It is important for the patient to be familiar with their specific contract coverage for this service.

Emerge Gender Diversity Clinic

The Emerge Gender Diversity Clinic for Children, Adolescents and Young Adults offers fully integrated and interdisciplinary expertise and clinical services in pediatrics, adolescent and young adult medicine, endocrinology, nursing, social work, child and adolescent psychiatry, and mental health care designed to improve the health and well-being of gender variant, gender diverse and transgender youth and young adults.

Through a collaborative relationship with endocrinology and psychiatry, we work to provide comprehensive services for all youth. Clinical services are available for children, adolescents and young adults 5–25 years old and include education, family and individual support, pubertal blockade, cross-hormonal therapy and mental health support and treatment. The clinic additionally provides referrals for gender affirmation surgery for adolescents and young adults, 18 years and older, according to the Johns Hopkins Center for Transgender and Gender Expansive Health guidelines. 

• Puberty blockade
• Cross sex hormones
• Psychosocial support
• Complex care needs (e.g., autism spectrum, complex family, etc.)
• Menstrual suppression and management, family planning services
• Sexual and reproductive/contraceptive health care sexually transmitted infection (STI), HIV, Pre-exposure prophylaxis (PrEP) testing and care
• Substance use treatment

Primary Care Sites

Psychiatric services include mental health treatment with Psychiatry Community mental health providers.

Pediatric Endocrine

Pediatric endocrine services include pubertal blockade, cross sex hormones, and underlying endocrine disorder.

Reproductive Endocrine/Urology

 Johns Hopkins Community Physicians works to provide the best reproductive endocrine and urology services.

Sexual and Reproductive Health Care

Sexual and reproductive health care services include sexually transmitted infection (STI) and HIV testing. 

Center for Adolescent and Young Adult Health

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• East Baltimore Medical Campus
• Johns Hopkins University Student Clinics

Our team is committed to providing high-quality, compassionate care that is in line with the standards of care outlined by the World Professional Association for Transgender Health (WPATH), including  mental health criteria for surgical services . 

Gender affirming surgery is only offered to patients aged 18+.

Surgical services timeline, it all starts with a phone call..

First, call 844-546-5645 for an initial intake interview via phone with a clinical specialist. This is your first point of contact with the clinical team, where you will review your medical history, discuss which procedures you’d like to learn more about and what is required, and develop a plan for next steps.

After intake, you'll receive next steps to schedule a consult appointment. Depending on your specific surgery, you'll likely need to prepare the following documentation:

• Mental Health Evaluations and Surgical Readiness referral letters from mental health providers documenting their assessment and evaluation
• Pharmacy records and medical records documenting your hormone therapy
• Medical records from your primary physician (these will be requested by the clinical team)
• Information about which prescription and over-the-counter medications you are currently taking
• Insurance information

Meeting with your surgeon.

The consult will be your first appointment with your new healthcare provider. These appointments typically include:

• Assessment of your medical health status and readiness for major surgical procedures;
• Discussion of your long-term gender affirmation goals and assessment of which procedures may be most appropriate to help you in your journey;
• Specific details about the procedures you and your surgeon identify, including the risks, benefits and what to expect after surgery.

After the consult, you'll receive next steps for scheduling the surgery.

Getting ready for surgery.

After your consult with the surgical team, you will receive information regarding next steps. Next steps can include a variety of things, to include:

• Medical Clearance tests and/or notes from other providers
• Additional imaging
• Updated mental health evaluation letters
• Hair removal, or other pre-operative readiness

Once all these things have been completed, you will receive a surgery date.

A preoperative anesthesia and medical evaluation.

Your surgeon may need to meet with you before surgery to finalize your surgical plan and go over any questions you may have before the morning of your procedure. You may also be asked to complete these evaluations at the hospital, which ensure that you are healthy enough for surgery.

Your surgery.

On the day of your procedure, you'll arrive at the hospital two hours prior to surgery. You will be brought back to the pre-op area where you'll change into a surgical gown and nursing staff will begin your check in. This involves asking questions, taking blood samples, starting an IV for fluids, and monitoring your vital signs with a blood pressure cuff and oxygen monitor.

In addition to the nurse that checks you in, you will see your surgeon, our PA, anesthesiologists, and possibly other surgical attending’s and surgical residents who assist in the operating room. Together everyone works as a team to ensure the best possible outcome.

Read FAQs for more information about what you can expect during your hospital experience at either the Johns Hopkins Outpatient Center or the Harry and Jeanette Weinberg Building.

Read more about preparing for gender affirmation surgery

What can you expect after gender affirming surgery?

For specific questions, please refer to the post-operative instructions you received from your surgical team.

If you have any of the following signs and symptoms, please call us: temperature greater than 101.5˚F; redness or rapidly changing shape of the surgical area; pus and/or large quantities of drainage from your incision or drain site; continuing inability to urinate; severe and unremitting pain not relieved by maximum doses of pain medications.

If you have any questions or concerns during regular business hours between 8:00 am and 5:00 pm, please call 844-546-5645 to reach the Center for Transgender and Gender Expansive Health. If you have questions or concerns after regular business hours, please call 410-955-5000 and ask for the “Plastic Surgery Resident On Call” to be paged. A doctor is available and present in the hospital 24/7/365 in case of emergencies.

For life-threatening symptoms such as shortness or breath, difficulty breathing, dizziness or fainting, chest pain, or mental status changes, call 9-1-1 or go to your nearest emergency department immediately.

We're here for you.

When you’ve finished the surgical aspects of your gender affirmation, we encourage you to follow up with your primary care physician to make sure that they have the latest information about your health. Your doctor can create a custom plan for long-term care that best fits your needs.

Among other changes, you may consider updating your name and identification. This collection of resources for transgender and gender-nonconforming individuals can help you in this process.

Browse Resources

Patient story The Joy of Being Yourself

In a little more than a year, the Center for Transgender and Gender Expansive Health has provided gender affirming surgeries that changed the lives of about 150 people. Here are the stories of best friends Dylan Ballerstadt and Kez Hall, and Dariel Peay.

Find a Surgeon

Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps

Gender Surgeons in United States

Learn about Surgeons in the U.S. who offer Male to Female (MTF) and Female to Male (FTM) procedures, also known as Gender Confirmation Surgery (GCS), Sex Reassignment Surgery (SRS) or Gender Reassignment Surgery (GRS).

Dr. Charles Garramone

Dr. Garramone is one of the most experienced Top Surgery surgeons in the world, having performed thousands of Top Surgery procedures since 2005. With Dr. Garramone, you won’t have to worry about what your Top Surgery results will look like. His FTM Top Surgery technique is sought after by thousands of patients for its consistent and predictable results.

Dr. Scott Mosser

Dr. Mosser is an award-winning surgeon in San Francisco who has been helping transgender and non-binary patients for more than 10 years. He is board-certified by the American Board of Plastic Surgeons, co-founder of the American Society of Gender Surgeons (ASGS), Medical Director of the Gender Institute at Saint Francis Memorial Hospital, a member of WPATH, and co-chair of the Surgery and Beyond professional conference. Dr. Mosser is California’s FTN / FTM Top Surgery and Breast Augmentation expert.

Dr. Loren Schechter

Dr. Schechter is one of the country’s foremost experts on transgender surgery. He is the Medical Director of the Gender Affirmation Surgery Program at Rush University Medical Center in Chicago. Dr. Schechter has been performing gender-affirming surgeries for more than 20 years. Since 2013, he has performed approximately 100-150 gender-affirming procedures every year. He offers the full spectrum of gender-affirming procedures.

Dr. Angela Rodriguez

Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery.

Dr. Daniel Crane

Dr. Crane is a plastic surgeon who joined Dr. Drew Schnitt’s Inspire Aesthetics in 2022, expanding access to gender-affirming surgical care in South Florida. After completing a highly specialized aesthetic surgery fellowship where he performed countless breast, body contouring and facial surgeries, Dr. Crane worked with Dr. Schnitt to refine his skills with Top Surgery and Facial Feminization. His broad training in plastic and aesthetic surgery provides him with the knowledge and experience to help you achieve your transition goals.

Dr. Drew Schnitt

Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. His experience in cosmetic and craniofacial surgery makes him an excellent choice for gender-affirming facial surgery, as well as Top Surgery, Breast Augmentation and Body Sculpting.

Dr. Daniel Jacobs

Dr. Jacobs is an award-winning and board-certified plastic surgeon in San Francisco who joined The Gender Confirmation Center in July, 2022. Dr. Jacobs has more than 30 years of plastic surgery experience and provides outstanding surgical care for transmasculine, transfeminine and non-binary patients.

Dr. Josef Hadeed

Dr. Hadeed is a board-certified surgeon who specializes in Transgender Surgery, including chest/breast procedures, facial surgeries and body sculpting for both trans men and women. Dr. Hadeed’s practice now has two locations: Beverly Hills, California and Miami, Florida.

Dr. Michelle Lee

Dr. Lee is a fellowship-trained and board-certified plastic surgeon with deep expertise in aesthetic and reconstructive procedures for the chest/breast and face. Based in Beverly Hills, California, Dr. Lee is as well-known for her surgical precision as she is for the compassion, care and understanding that she has for all of her patients. She has the skill and artistry to help produce the aesthetic goals that transgender and non-binary patients seek with Top Surgery, Breast Augmentation and Facial Gender Confirmation Surgery.

Dr. Russell Sassani

Dr. Sassani is a board certified plastic and reconstructive surgeon who performs chest procedures, facial surgeries and body sculpting for both trans men and women in Florida. With unanimous 5 star reviews from his trans male patients, Dr. Sassani has quickly become one of the most popular Top Surgery surgeons in the Southeastern United States.

Dr. Daniel J. Freet

Dr. Freet leads a multidisciplinary team at the University of Texas that performs both male-to-female and female-to-male surgery procedures, including facial and chest surgeries as well as Vaginoplasty, Metoidioplasty and Phalloplasty. Dr. Freet accepts both insurance and Medicare.

Dr. Alvina Won

Dr. Won is a board-certified surgeon who is committed to providing the highest quality of care in a welcoming environment for all patients. Dr. Won gained significant experience with gender-affirming surgery during a year-long cosmetic surgery fellowship. Finding this work to be extremely gratifying and interesting, Dr. Won now devotes part of her practice to serving the transgender patient population. Based in Washington state, just north of Seattle, she offers Top Surgery, Breast and Buttock Augmentation, and Body Sculpting.

Dr. Gabriel Del Corral

Dr. Del Corral is a double board-certified plastic and reconstructive surgeon who offers Gender Affirmation Surgery at the MedStar Center for Gender Affirmation in Washington D.C. and Baltimore, Maryland. He is an Assistant Professor of Plastic Surgery at Medstar Georgetown University Hospital. Dr. Del Corral is fellowship trained in microsurgery, and has expertise in reconstructive surgery, maxillofacial surgery and cosmetic surgery. He specializes in gender-affirming procedures with a special focus on Vaginoplasty, Facial Feminization and Phalloplasty.

Dr. Praful Ramineni

Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. Recognized for his exceptional surgical skills and natural-looking results, Dr. Ramineni’s patients also praise his friendly, compassionate and professional nature.

Dr. Cassie Nghiem

Dr. Nghiem is an Ivy League-educated, fellowship-trained plastic surgeon in Washington, D.C. who specializes in transgender surgery, including Chest Masculinization and Breast Augmentation. She believes in a shared vision and works closely with her patients to deliver the best quality care that is in line with their needs. Known for her surgical skill and artistry, Dr. Nghiem’s patients also love her kind and caring demeanor.

Dr. Curtis Crane

Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. Dr. Crane is one of only a few surgeons in the world who is trained as both a plastic surgeon and urologist and has also completed fellowships in reconstructive urology and gender reassignment surgery. He has been performing gender surgery since 2005.

Dr. Dany Hanna

Dr. Hanna is a Urologist and fellowship-trained Gender Surgeon who works exclusively with transgender and non-binary patients at the Hanna Gender Center in Dallas, Texas. He completed a yearlong fellowship in gender-affirming surgery and also trained with the renowned Dr. Miroslav Djordjevic in Belgrade, Serbia. Dr. Hanna specializes in Vaginoplasty and also offers Nullification, Metoidioplasty, Top Surgery and Breast Augmentation.

Dr. Thomas Satterwhite

Dr. Satterwhite is a board-certified Plastic and Craniofacial Surgeon in San Francisco who is dedicated to offering the highest level of surgical care to the transgender community. Dr. Satterwhite works exclusively with trans women, trans men and non-binary patients seeking Gender Confirmation procedures such as Vaginoplasty, Facial Feminization, and FTM Top Surgery.

Dr. Dev Gurjala

Dr. Gurjala joined Align Surgical Associates in 2019, after five years of performing gender surgery, microsurgery, and general reconstructive and aesthetic surgery in the Kaiser Permanente healthcare network. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization.

Dr. Lorelei Grunwaldt

Dr. Grunwaldt is a double board-certified plastic surgeon who is recognized as one of the best plastic surgeons in the Pittsburgh area due to her exceptional skills and compassionate bedside manner. Dr. Grunwaldt has helped countless transgender and non-binary adults and teens by providing a safe and caring atmosphere throughout their Top Surgery and Breast Augmentation journeys. She is honored to be able to share her surgical talents and be a trusted member of her patients’ transition team.

Dr. Michael Safir

Dr. Safir is a board-certified urologist in Los Angeles who specializes exclusively in gender-affirming bottom surgery procedures. With subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery, Dr. Safir is one of a handful of urologists in the world with individual fellowship training and experience in both male and female genital reconstruction. He gained extensive experience over five years performing genital surgeries at one of the highest volume gender surgery centers in the world and is now affiliated with Align Surgical Associates out of Los Angeles. Dr. Safir’s vast experience in urology has made him a popular choice among transgender people from across the U.S. seeking bottom surgery.

Dr. John Henry Pang

Dr. Pang is a double board-certified plastic and reconstructive surgeon who performs gender-affirming genital, face and chest reconstruction surgeries. In 2019, Dr. Pang completed the intensive Transgender Surgery Fellowship training program at Mount Sinai. Now an associate surgeon at Align Surgical in San Francisco, Dr. Pang’s practice is dedicated to providing specialized care to the transgender and gender-nonconforming communities.

Dr. Drew Marano

Dr. Marano is a highly skilled plastic and reconstructive surgeon in New York City specializing in Gender Affirmation Surgery. Dr. Marano is fellowship-trained in gender-affirming facial, chest and genital surgeries, including Phalloplasty and Vaginoplasty. He is passionate about gender-affirming care and committed to providing a comfortable and supportive environment for his patients.

Dr. Paul Steinwald

Dr. Steinwald has performed FTM Top Surgery hundreds of times, and he’s well-known for having pioneered the Inverted-T procedure. Dr. Steinwald has the most experience with Top Surgery than any other surgeon in Colorado. Body Feminization and Breast Augmentation are also offered for trans feminine folks.

Gender-Affirming Treatment and Transition Care

Duke Health offers a comprehensive array of health services to transgender, gender-diverse, nonbinary, and gender-nonconforming people. Our team of experts is trained to provide high-quality, compassionate care to individuals who are considering transitioning, going through the process, or have already completed their transition and require ongoing care. Many of our providers are members of the World Professional Association for Transgender Health (WPATH) , a non-profit, professional organization devoted to transgender health.

Call us at 919-660-LGBT (660-5428) to make an appointment or click on the icon below to chat to a live agent from 8:00 am-12:00 pm and 1:00 pm-5:00 pm, Monday through Friday.

Gender Care Services

• Dermatology
• Family Medicine
• Gender Care for Children and Adolescents
• Gender-Affirming Hormone Therapy
• Gender-Affirming Surgery (Top Surgery)
• Gender-Affirming Voice Care
• Gynecological Care
• LGBTQ+ Fertility Options
• Lifestyle and Weight Management
• Physical Therapy for Gender-Affirming Care
• Skin Care Treatments

Comprehensive Transgender Care

Trained providers offer a range of culturally sensitive, knowledgeable, medical services to the lesbian, gay, bisexual, transgender, queer, and questioning community. We can help you if you are considering, going through, or have completed your transition. We provide wellness care that is specific to your individual needs right in our office. We also partner with specialists throughout Duke. Services you may receive at our family medicine clinic include:

• Gender-affirming hormone therapy
• Gynecological care, including birth control, menstrual suppression, and STD testing
• Ongoing cancer screenings including pap smears, cervical exams, and referrals for regular mammograms and colonoscopies.

PrEP for People at High Risk for HIV Infection If you have a primary care doctor and are at high risk for HIV, infectious disease providers in our specialized PrEP clinic prescribe therapy to prevent infection if you are exposed to the virus.

Transgender Care for Children and Adolescents Our team of specialists provides quality, comprehensive, and compassionate family-centered care to transgender youth, gender-expansive youth, and children with differences of sex development . Our team includes a pediatric endocrinologist, pediatric urologist, adolescent medicine specialist, pediatric psychologist, and social worker. We work with specialists in gynecology, fertility, and family and community medicine to provide holistic, individualized care that considers all aspects of your child’s life.

Reproductive Health Duke ob-gyn specialists offer comprehensive care and resources and support for all ages. Our care includes:

• Family planning, including contraception and IUD placement
• Pregnancy care, including high-risk obstetric care
• Bleeding management
• Hysterectomy surgery

Infertility Treatment and Fertility Preservation We support LGBTQ+ people who want to start a family. The first step is a consultation to fully understand your health and priorities for family planning so our fertility specialists can tailor a care plan to meet your needs. It is important to understand your reproductive potential and plan ahead if you are currently transitioning or planning to in the future. Your planning process may include freezing eggs or sperm. Research has shown that both can be frozen and safely preserved, so you’ll have them available when you’re ready.

Medical Weight Management Our lifestyle and weight management specialists can help you learn to manage your weight if it has been affected by hormone therapy or if you need to reach a weight loss goal to be eligible for surgery.

Gender Affirming Treatments and Procedures

Gender-Affirming Hormone Therapy Our specially trained endocrinologists and family care providers provide gender-affirming hormone therapy to help transgender adults (ages 18 and older) achieve the changes they seek and live healthy, fulfilling lives. ​

Gender-Affirming Surgery We offer several top surgery options to transgender, gender-diverse, nonbinary, and gender-nonconforming people who want their appearance to align with their internal identity. If, after a consultation with our doctors, you decide to pursue top surgery, we work toward a positive outcome that improves your physical, emotional, and psychological well-being. This may include other cosmetic surgical and nonsurgical procedures.

Orchiectomy (Testicle Removal) Orchiectomy may be performed to remove one or both testicles in transgender individuals. The procedure reduces the need for feminizing hormone therapy as your body will produce less testosterone.

Physical Therapy Physical therapists offer personalized exercise plans to help you manage your weight when on hormone therapy, increase muscle strength and mobility, and help with body shaping. Physical therapy can also help you rehabilitate after surgery. It may be recommended to manage lymphedema after top surgery and to help with pelvic pain or discomfort.

Learn how Duke Health supports the LGBTQ community.

Additional Services

Mental Health Counseling Transgender-specific counseling can help you manage depression, anxiety, and other conditions that affect your emotional health. It may be needed to confirm a diagnosis of gender dysphoria, which can be an insurance prerequisite for some gender-affirming surgical procedures. We also offer support groups for transgender people ages 40 and older who are in the process of transitioning.

Gender-Affirming Voice Services Our voice therapists and laryngologists offer gender-affirming voice services, including trans-competent voice evaluations and behavioral voice intervention, to transgender and gender-diverse adults and children. In-person and virtual appointments are available. We can help you alter your vocal pitch, intonation, timbre, nonverbal communication style, and more. Our Gender-Affirming Vocal Skills Virtual Group is open to transgender and gender non-conforming adults who want to practice their modified voices in a group setting.

Dermatology Treatments Our dermatologists offer a variety of services designed to help you look and feel your best. These services may not be covered by health insurance. Check with your plan to determine what your out-of-pocket expenses may be.

• Acne treatment: Hormones and other medications used during the gender transition process can cause skin changes, including acne. We offer a variety of medications and procedures to minimize acne. 
• Hair loss treatment: Hair loss on the scalp (balding) may accompany hormone therapy or result from naturally occurring testosterone -- for example, in transgender women. We treat hair loss as early as possible with oral and/or topical medications.
• Permanent hair reduction: Laser hair removal can reduce unwanted hair on the face and body. This service requires multiple sessions.
• Nonsurgical cosmetic procedures: Nonsurgical procedures like Botox injections and dermatologic fillers can be performed in our offices. 

Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital are recognized as LGBTQ+ Healthcare Equality Leaders by the Human Rights Campaign Foundation and received perfect scores for providing patient-centered care, support services, and inclusive health insurance policies to LGBTQ+ people.

Welcome to Simply better transgender

Dai Davies has over 20 years’ experience of Transgender Surgery and an International reputation for his surgical expertise. His staff provide an understanding and caring environment and work with both private patients and NHS referrals from all over the country. Together with Miles Berry  a major paper  was published in JPRAS  (Journal of Plastic, Reconstructive & Aesthetic Surgery) . This reported the scientific analysis of 100 cases of Female to Male Transgender Chest Reconstruction and is currently the world’s largest series.

FtM Chest Wall Surgery

M2F Breast Augmentation

Facial Feminisation

Body Contouring

Before & After Gallery

View examples of patient before and after photos

Make an enquiry

In association with, the london gender clinic..

The London Gender Clinic is run by the well-respected and highly experienced Dr Richard Curtis.

As the largest private Transgender clinic in the United Kingdom it provides comprehensive healthcare tailored to the individual to act as both supporters and facilitators of well-informed solutions involving gender reassignment.

Gender Care

GenderCare is a network of individual healthcare practitioners, all qualified, Consultant-level professionals experienced in the gender field. We work directly with a number of practitioners including Dr Stuart Lorimer

Harley Street Gender clinic

Providing guidance, support and treatment toward authentic gender expression in association with Dr Vickie Pasterski.

Home > HealthCARE > Scottish Gender Identity Services

Scottish Gender Identity Services

In Scotland, there are currently four NHS Gender Identity Clinics (GICs) – Glasgow Sandyford GIC (adults and young people), Edinburgh Chalmers GIC (adults), Aberdeen Cornhill GIC (adults), and Inverness Raigmore GIC (adults). There is also a private sector GIC for adults provided by Your-GP in Edinburgh.

Glasgow Sandyford GIC

Adult and Young Peoples Gender Identity Services, Sandyford, 6 Sandyford Place, Sauchiehall Street, Glasgow, G3 7NB

Website: https://www.sandyford.scot/sexual-health-services/gender-identity-service/

Sandyford GIC accepts GP and self-referrals for adults and young people from across all parts of Scotland. It is the only GIC for young people under 18 in Scotland.

The waiting time for a first appointment at the young peoples service is currently around four years.

The waiting time for a first appointment at the adults service is currently over five years.

Phone lines are open from 8:30am–11:30am Monday–Friday . Please call 0141 211 8137 for the adult service and 0141 211 8618 for the young person’s service during this time. (If you can’t get through to the gender service and need to speak to someone urgently try calling the Sandyford main switchboard on 0141 211 8130.)

You can email the Sandyford adult service on [email protected] and you can email the Sandyford young person’s service on [email protected]

Lothian Edinburgh Chalmers GIC

Chalmers Gender Identity Clinic, 2A Chalmers Street, Edinburgh, EH3 9ES

Website: https://www.lothiansexualhealth.scot/gender-identity-clinic/gic/

Chalmers GIC accepts GP referrals for service users aged over 17 living in NHS Lothian, NHS Borders and NHS Fife areas.

The waiting time for a first appointment is currently around two years.

Telephone: 0131 536 1570 , phone lines open 1pm-4pm Monday-Friday .

Chalmers GIC does not accept emails from patients. It will respond to emails from GPs.

Grampian Aberdeen Cornhill GIC

Grampian Gender Identity Clinic, Royal Cornhill Hospital, Cornhill Road, Aberdeen, AB25 2ZH

No Website.

Grampian GIC accepts GP referrals for service users aged over 18 living in the NHS Grampian area only.

Telephone:  01224 557651

You can email Grampian GIC on [email protected]

Highland Inverness Raigmore GIC

Highlands Gender Identity Clinic, Zone 14, Clinic 1 Raigmore Hospital Old Perth Road, Inverness IV2 3UJ

Website: http://www.highlandsexualhealth.co.uk/services/gender-identity

Highlands GIC accepts GP referrals for service users aged over 18 living in the NHS Highland area only.

Telephone: 01463 888300

Private Sector: Your-GP GIC

Your-GP is currently the only private sector GIC located in Scotland. Website: https://your-gp.com/gp-services/all-gp-services/gender-clinic/

National Gender Identity Clinical Network for Scotland

The National Gender Identity Clinical Network for Scotland (NGICNS) aims to work with gender identity clinics, gender reassignment surgical providers, primary care, patient and third sector representation to achieve timely, coordinated, service provision and equitable access to planned gender identity clinical services across Scotland.

On its website, you can find lots of useful information about hormones, surgeries and other medical services provided under the NHS Scotland Gender Reassignment Protocol.

NGICNS website

Join our eNewsletter

30 Bernard Street Edinburgh EH6 6PR

+44 (0)131 467 6039 [email protected]

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Scottish Trans is part of the Equality Network

Scottish Trans is the Equality Network project to improve gender identity and gender reassignment equality, rights and inclusion in Scotland. The Equality Network is a leading Scottish lesbian, gay, bisexual, transgender and intersex (LGBTI) equality and human rights charity.

The Equality Network is a registered Scottish charity: SC037852, and a company limited by guarantee: SC220213.

We are grateful for funding from the Scottish Government

• © 2024 Scottish Trans

WORLD LEADER IN GENDER REASSIGNMENT SURGERY

The most advanced clinic in Europe

Gender reassignment surgery, what is gender reassignment surgery.

Gender reassignment surgery, confirmation surgery or sex reassignment surgery means a variety of procedures that allow people transition to their self-identified gender. These surgical treatments modify a physical person’s appearance and sexual characteristics to approach their identified gender.

The most common treatments are feminization surgeries are vaginoplasty, breast augmentation or facial aesthetic procedures. In the cases FTM, phalloplasty, breast reduction or facial masculinization operations are the most demanded surgeries.

Our gender affirming treatments and procedures

We offer a wide range of gender confirmation procedures to help our patients to achieve the results they are looking for, supporting and providing professional advice throughout the transformation process.

Feminisation surgery

MTF Vaginoplasty

Facial feminization

BREAST AUGMENTATION

MTF body surgery

FEMINIZING VOICE SURGERY

AESTHETIC MEDICINE

Masculinisation surgery.

Phalloplasty

Metoidioplasty

FTM top surgery

FTM Hysterectomy

Body Masculinization

OTHER MASCULINIZATION SURGERIES

Before and after gender-affirming surgery results.

Knowing the results of some sex reassignment surgeries could be helpful to make a decision and to have an idea about what to expect.

Dr. Ivan Mañero, a reference

Dr. Ivan Mañero, reconstructive and aesthetic plastic surgeon, is an international leader in gender affirmation surgery (ies) for trans people. He has been performing and perfecting gender reassignment surgeries for more than two decades, both inside and outside our borders.

His professionalism has led him to be internationally known and sought after, participating and moderating events in conferences. From the beginning of his professional career, he has always advocated for specialized and sensitive care for trans people. However, in the beginning, he had to deal with other peers who did not understand why a specialist like him cared about this matter.

A pioneer in unique surgical techniques for gender reassignment, Dr. Ivan Mañero has collaborated with various administrations to ensure that this type of a surgeries re included within the public health service in Spain. . In order to be able to offer greater and better care to trans people who require it.

The IM GENDER team, led by Dr Ivan Mañero, is a leading international reference in sex reassignment surgery and genital reassignment surgery.

World leader in gender reassignment surgery

The IM GENDER Gender Unit opened its doors over twenty years ago and has become an international benchmark in Gender Reassignment Surgery. IM GENDER has cared for more than 3,000 trans people who have decided to carry out some treatment or surgical procedure at the Unit, whether genital affirmation surgery – vaginoplasty, phalloplasty, metoidioplasty -, body surgery – mastectomy, breast augmentation, feminizing liposculpture, among others -, facial surgery – facial feminization, thyroplasty, masculinization of features, etc.- or other plastic surgery procedures.

IM GENDER offers all the advantages of IM CLINIC, a pioneering clinic for its concept of understanding healthcare in a global and personalized way. Our clinic confers differentiating characteristics that allow us to offer a high quality of care.

At IM GENDER you will find a clear commitment to the most cutting-edge and reliable technology, with technologically cutting-edge operating rooms and the most innovative equipment in the sector. All this, added to a medical team expert in gender surgery with more than two decades of experience led by Dr. Ivan Mañero, the most recognized plastic surgeon specialized in gender reassignment surgery in Europe and even internationally. In addition, Dr. Mañero was a pioneer in unique/specific surgical techniques for genital affirmation, such as vaginoplasty with graft.

The entire human team that makes up IM GENDER, from Patient Care to medical, health professionals, psychologists and physiotherapists, are trained in health care based on human rights, respect and privacy of all patients. Our goal is to offer all the necessary information before, during and after the surgery through close treatment and personalized attention.

YEARS OF EXPERIENCE

Im gender specialists.

THEIR EXPERIENCE COULD BE YOURS

Meet IM GENDER’s true stars and learn about their personal experiences, from preoperative consultations to postoperative follow-up care. Discover how our comprehensive approach to gender-affirming surgery, (ies) coupled with our psychological support and family guidance, has made a difference in their lives.

At IM GENDER, we understand that every patient’s journey is unique, and we are committed to providing personalised care that caters to individual needs. Our testimonials are a testament to our dedication to patient satisfaction, and we are proud to share the stories of our satisfied clients with you.

We invite you to explore our website and learn more about our services, team, and testimonials. Our team is available to answer any questions or concerns you may have and to help you start your journey towards gender affirmation.

REQUEST AN APPOINTMENT

Type of consultation: Physical appointment Online consultation

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IM CLINIC  FACILITIES

IM GENDER is the Gender Unit at IM CLINIC, one of the most advanced sex reassignment surgery centers Internationally. A new concept of clinic born from our commitment to experience in the field. IM GENDER is a team of highly qualified professionals, who all believe in the same philosophy of exquisite patient care.

Prepare for your surgery

(18 years in Spain)

Are you 18 years or older?

Gender Hormone Therapy

Embrace Your Journey, Empower Your Transition

The Gender Hormone Clinic

At The Gender Hormone Clinic our aim is to provide affirmative, patient centred gender hormone therapy led by our expert nursing team and multi disciplinary team of psychiatrists, psychologists and specialist surgeons for transgender, non binary and intersex individuals.

Lead clinician Mary Burke (RN NMP) has worked within NHS services for over 30 years accumulating an extensive knowledge base working for many years in general practice, midwifery, family planning, women’s health in the menopause and body identical hormone therapy. She leads our team of expert nurses, all of whom are passionate about providing the absolute best individualised care possible for the community.

Meet Our Nurses

How our service works.

Make an Enquiry

Retrieve a referral from a gender psychologist/ psychiatrist.

Once you complete step 1 we can provide you with a list of available clinicians for you to contact and arrange your appointment. It will be your decision to choose which gender psychologist / psychiatrist you would like to see. Please arrange this appointment directly with the gender psychologist / psychiatrist.

Initial Video Appointment

Once your referral has been received by our team, you will be on the waitlist to be contacted to book an initial video appointment. During this appointment your nurse will go through your medical history and talk you through the initial stages of your hormone care. This is where you will have a chance to ask any clinical questions about your care and discuss your goals for hormone therapy.

Typically your nurse will then book you  your face to face physical examination, during which your treatment plan will be established. 

Complete and Return Your Medical Forms

Once we have booked face to face appointment, we will send you several essential forms to read and sign. Please read these carefully, sign, and return to us as soon as possible. Any delays may unfortunately result in rescheduling your appointment to a later date.

Please remember to organise your blood tests now if you have not already done so. For the full list of blood tests visit our page here .  Once your initial in clinic appointment is booked, you will receive a confirmation email with a link to a digital blood results form . This is where you will be able to upload a copy of your results straight onto your record.

In Clinic Appointment

All there is left to do now is attend your in clinic appointment! Your in clinic appointment will take place at our consultation rooms in Fitzrovia Hospital where, if no contra-indications are identified, you will be provided with a prescription to commence hormone therapy.

Initial Consultation

Medical consultation, certified. responsive. compassionate..

“Our aim is to provide patient centred, affirmative trans healthcare to patients of any gender.

We pride ourselves on being an inclusive service tailored to the goals and needs of each individual persons transition. Meeting our patients in clinic as they progress is so rewarding, they inspire us everyday.”

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@thegenderhormoneclinic.

Join Our Care

Providing affirmative, patient centred gender affirming hormone therapy led by our expert nursing team and multi disciplinary team of psychiatrists, psychologists and surgeons.

Take a tour around Fitzrovia Hospital !

Contact Information

• Phone: +(44) 7403 925117
• Mail: [email protected]
• Address: The Fitzrovia Hospital 13-14 Fitzroy Square London W1T 6AH

What it costs, shared care and what your subscription buys.

At GenderGP we want to make trans healthcare as affordable as possible.

To keep costs as low as we can, we have developed our service around telemedicine which means all of our interactions are done over the internet..

While we offer a fully private service, costs can also be further reduced if we work collaboratively with your healthcare provider. While the degree of support and willingness to collaborate varies, those providers who are willing to do so, can cover the cost of your medication and blood tests. Where this is agreed, GenderGP acts in the capacity of gender specialist, guiding and supporting the primary physician to provide safe and effective gender affirmative care.

There are six charges associated with using GenderGP’s medical services

• Subscription
• Consultations
• Blood Tests

All patients pay a one-off set up fee of £195 which enables them to become a member of our service. Find out more about what us included in your membership by clicking on the subscriptions tab.

Members receive unlimited access to medical advice, blood test result analysis and private prescriptions. Medication is charged separately, unless your healthcare provider has agreed to a shared care arrangement.

Some consultations are optional but useful, and some are compulsory. A list of the the available sessions is outlined below:

Information Gathering Sessions (compulsory): these give us a chance to get to know you and to work out how best to help. It is your chance to tell us how you feel and what you want to achieve. If you have a recent report from another specialist then you can use this here.

Follow-up Sessions (compulsory): arranged every 6 months to see how you are doing. You can have these more frequently if you wish.

Counselling (optional): this is a way for you to really dig deep and talk to one of our specialist gender counsellors about what you are going through.

Ask us Anything (optional):  an opportunity to speak to someone before you start on the Appraisal Pathway and embark on your journey with GenderGP. Ask any questions you want about the support we provide and the process and costs.

Consultation cost – overview:

Information Gathering Session (compulsory unless you already have an assessment report from somewhere else) – £65.00

Follow-up Sessions (compulsory – every 6 months) – £30.00

Counselling (optional) – £60.00-£80.00

Ask us Anything (optional) – £40.00

Blood tests are an essential part of your treatment – to make sure you are fit and healthy, that you are on the correct dose.

There are three ways to can get your blood tests done:

If your doctor will do the blood tests for you on the NHS or your public health system, you can provide us with a copy of the results. Private service

If your doctor can’t do them for you then a local private hospital may be able to help. Home Testing Kit

We can arrange for you to have a home testing kit sent to you.

This can either be done using a finger prick test or by a phlebotomist near you.

The minimum tests you need to ask for are as follows:

• Full blood count
• Hormones (if you are already on hormone treatment)

Blood test costs – overview 

• I have had some blood tests done within the past 6 months and can provide my levels – £0.00
• My doctor will do the tests – £0.00
• Home testing kit – £250.00
• I will use a private hospital – cost varies
• I would like some more information

As outlined above, if your doctor will prescribe for you under our supervision, this can reduce your costs significantly. However, if that is not possible we can still help you by issuing a private prescription which you can use to purchase your medication privately, via our partner pharmacy: ClearChemist

Prescription options – overview

Your doctor will prescribe, under our supervision.

GenderGP will prescribe – we send a private prescription to our partner pharmacy Clear Chemist  and you purchase your medication from them.

Paper Prescription – if you are outside the UK, or would prefer to have a paper prescription to take to your pharmacy, this can be arranged. You can take this to the pharmacy of your choice and purchase the medication from them. Not all pharmacies are willing to accept private paper prescriptions, so it is best to check first.

Estimated Private Medication Costs:

Hormones – from around £10 per month dependent on need.

Anti-androgens – around £10 per month.

Puberty blocking injections – around £100 per month.

Puberty blocking nasal spray – around £60 per month.

Some medicines are given by injection – such as some Testosterone preparations and puberty blockers. There are alternatives available, but if you want to have injections it is important that we know who is going to administer them.

Injection options – overview:

Your doctor’s surgery will help you with the injection.

Private service – you will make arrangements for a local private service to administer your injections.

Self-inject – you have been taught how to inject your own medication.

Family / friends – you know someone who is qualified and willing to help.

Most letters and reports are included with your GenderGP subscription. However, some services such as referrals for surgery incur an additional fee.

To begin your journey click here .

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There’s no right or wrong way to be trans or transition. Some people decide that medical transition is the best thing for them – for others, it isn’t a necessary part of the process. It all depends on how you feel about yourself and your body: only you can make the decision that is right for your life. Unfortunately, it can be quite difficult to access gender-affirming healthcare in Northern Ireland for a number of reasons.

Details on accessing public and private healthcare options can be found below:

Public Options (NHS Pathway) Accessing gender-affirming healthcare in Northern Ireland has been quite difficult, in particular over the past 5 years. For a period of 2-3 years, the adult Gender Identity Clinic (the Brackenburn Clinic) stopped accepting new patients, creating a backlog both within that service and having knock-on effects on other services including the under-18s Knowing Our Identity (KOI) clinic.

The Rainbow Project, alongside our partners across the LGBTQIA+ sector, has been working to improve access to gender-affirming healthcare for all trans people in Northern Ireland. There is currently a review underway looking at improving and streamlining gender identity service pathways, so any information provided within this section is liable to change over the next year or two. You can find some information regarding this review below:

• Outline of the Gender Identity Service Pathway Review Group
• Objectives for the Gender Identity Service Review

In this section, we will cover the pathways for accessing gender-affirming healthcare in Northern Ireland, the public and private services that are available to you, as well as some information on your rights and what to expect when you’re accessing these services.

Under 18 Years Old

The main public health service in NI for trans and gender diverse people under 18 to access gender-affirming healthcare is the Knowing Our Identity Clinic, based in the Beechcroft health centre. This Clinic accepts referrals from anyone under the age of 17 ½ – if you are approaching your 18th birthday you may be referred to the Brackenburn Clinic, discussed in a different section.

NHS Pathway

• Contact your GP and request a referral for gender-affirming healthcare. Your GP may ask you a series of questions in order to fill out a referral form to get the process started. You can have someone, including a parent/guardian or other support, in this appointment with you.
• Your GP will refer you to the Children & Adolescent Mental Health Service (CAMHS) for assessment and further referral to the KOI service. If you are already accessing CAMHS for other reasons, you can speak directly to your CAMHS worker instead of going to your GP.
• You should receive ongoing assessment and support from CAMHS before accessing KOI – the time spent within this service varies from person to person and maybe longer than usual due to staffing issues in KOI and the backlog in the adult Gender Identity Service.
• Your CAMHS worker should refer you to KOI when they are satisfied you fulfil the criteria for accessing the service.
• When in KOI, you should receive ongoing assessment and support with your transition, both in terms of your social transition as well as accessing healthcare intervention. KOI can provide counselling, family & peer support, and support with your mental health. KOI patients should also be able to access hormonal treatments from age 15 and above, following assessment.

NOTE : due to ongoing issues within these services, as of the time of writing, KOI has suspended the provision of puberty blockers and hormone replacement therapy to any new patients referred. We are working with them to urgently resolve this issue and ensure that every trans young person can access the care they need.

In terms of the care you can expect to receive in KOI, you and your family should be supported through talking therapies and exploratory work to fully understand your identity and choose the right path for yourself. There are referral pathways for services including the fertility clinic for fertility preservation, however, places are quite limited and these pathways are currently under review.

The main public health service for trans and gender diverse adults to access gender-affirming care is the Brackenburn Clinic, based in the Knockbracken Healthcare Park. The Clinic accepts referrals from anyone over the age of 17 ½ – if you are a trans child or young person you can access KOI, discussed in a different section.

• Contact your GP and request a referral for gender-affirming healthcare. Your GP may ask you a series of questions in order to fill out a referral form to get the process started. You can have someone, including a friend, advocate or other support, in this appointment with you.
• Your GP should refer you directly to the Brackenburn Clinic. Make sure your address is correct on your GP records, as you may be contacted by letter in order to opt-in to the service. This is done by calling the number on the letter or email you receive to confirm that you are interested in accessing care from Brackenburn.
• When you reach the top of the waiting list, you will be called forward for an initial assessment to ascertain what kind of support you require, including social support and medical intervention.

NOTE: Due to staffing issues and a breakdown in the service which has recently begun to be addressed, the waiting list is currently quite long, with many people have been on the list for 3-4 years. We are working hard with the Department of Health, Belfast Trust and Health & Social Care Board to improve this and ensure timely access to appropriate care.

Our sector partners TransgenderNI created a resource for people accessing Brackenburn to understand what they should expect, including the questions that may be asked and the care you may receive. You can find that resource here .

In terms of the care you should expect to receive, Brackenburn should refer you to other specialities for support with your transition following assessment and diagnosis. The services available include:

• Endocrinology support (Hormone Replacement Therapy)
• Gender affirmation surgeries
• Speech and language therapy
• Fertility preservation (subject to availability)
• Talking therapies and mental health support

Private Options (External to NHS)

There are several options for accessing gender-affirming healthcare privately. Due to the crisis in the gender-affirming services here in Northern Ireland, these options are quite popular, however, accessing them can lead to issues in your journey through Brackenburn or KOI.

Unfortunately, patients enrolled in KOI services will be discharged if they access private healthcare services. This is despite the fact that KOI is currently refusing to provide hormone treatment to any patients referred after [DATE]. This may change as a result of the Gender Identity Service Pathway Review, however, it’s important to be aware of when considering your care options.

Patients enrolled in the Brackenburn clinic are not immediately discharged for accessing private services, and recently there have been indications that they are willing to move people from a private to public prescription with very little fuss. However, due to a lack of communication with LGBTQ+ communities, we cannot guarantee this is the process taken with every individual in the service.

For those who are not current patients of either Brackenburn or KOI, private care can be an appealing option as it is usually a much quicker and easier way of accessing medical transition, avoiding the long waits and often invasive assessment that accompany public services. However, it is important to be aware of the hidden costs of private care, including ongoing blood testing (GPs in Northern Ireland usually refuse to help with this) and, depending on the type of hormone, safe injection processes.

Options for accessing private care include:

• London Transgender Clinic

All of these services are based in Britain or are online providers. From our experience, GenderGP is the most popular for trans people in Northern Ireland who wishing to access treatment privately. This is especially the case for those accessing gender-affirming care for the first time, mostly because they are willing to provide assessment and care through Zoom without requiring an individual to attend an in-person assessment.

All these providers have different processes, pricing structures, and requirements for accessing their services. While we can’t answer all your questions about these providers, you should be able to find most information on their website, including pricing, reviews, and information on how to access support or ask more questions.

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Gender Identity South West was founded by Dr Debby Jackson (she/her) in 2021. The service is based in Exeter, South West England and is for trans, non-binary and gender diverse adults who experience gender related distress and difficulty and are considering, or have decided that they would like to access gender affirming healthcare, including hormone therapy and surgery. ​

Gender Identity South West acknowledges and respects the diversity of gender identity, expression and role and is committed to supporting trans, non-binary and gender diverse people to achieve a greater sense of physical and social comfort in their gendered selves.

Dr Jackson is  a  Chartered Clinical Psychologist and a Gender Diversity Specialist , registered with the Health and Care Professions Council . She is a full member of the World Professional Association of Transgender Health and the British Association of Gender Identity Specialists and is included in the HM Court and Tribunal Services’ List of Specialists in the Field of Gender Dysphoria . Dr Jackson has over 20 years experience working in the NHS including 6 years in a senior role in a Gender Identity Clinic. She continues to work with her NHS colleagues, providing clinical services and support. In her independent practice, she works closely with other independent specialists in the field, including those providing endocrine and surgical interventions, located across the UK. 

The service is delivered in line with the 7th Version of the  World Professional Association for Transgender Health’s Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (2012 ) . 

Specialist gender assessment

We provide a supportive and compassionate assessment that aims to gain an understanding of a person's experience of gender related distress and difficulty, establish their needs and goals and explore how they, and we, may be able to help them to feel more comfortable in their gendered self.  

Gender affirming hormone therapy consultation

We provide a consultation to explore individual patient expectations and the potential short, medium and long term costs, benefits and outcomes of hormone therapy. We provide an opinion regarding eligibility for hormone therapy and make onward referrals to gender specialist endocrinologists.  

Gender affirming surgery consultation

We provide a consultation to explore individual patient expectations and the potential short, medium and long term costs, benefits and outcomes of gender affirming surgeries. We provide an opinion regarding eligibility for surgery and make onward referrals to gender specialist surgeons.

Voice and communication therapy

We provide a consultation to explore your hopes for voice and communication as part of gender comfort and authentic gender expression. We offer help with voice feminisation, voice masculinisation and voice neutralisation based on exploration of a range of vocal dynamics including pitch, resonance and intonation.

Information and support

Information and support for trans and non-binary people, their friends, families and supporters, is widely available from a variety of sources both regionally and nationally. We can provide additional support sessions and/or signpost or refer to a gender specialist  psychological therapist.

If you would like to get in touch please email [email protected]

If you would like to book an appointment then please get in touch, using the email address you would like to use for all correspondence, and let us know the following details; a) preferred name and pronouns, b) brief summary of  your gender concerns, c ) any steps you may have already taken towards social, legal or medical transition and d ) what you would like to get out of contact with the service.

Appointments are most often offered online via secure video link but can be arranged if necessary at our base in Exeter. Please let us know your preference in your email. 

Please note that the service operates on a part-time basis and so there may be a delay in response to your email. In addition the service cannot respond to people in crisis or emergency situations. Please take a look at the ' Information and Support ' page on our website and/or contact your GP or local emergency department if you feel that you and/or others require immediate assistance or are in an unsafe situation. 

Welcome to the GenderCare website

GenderCare GenderCare is a network of individual healthcare practitioners, all qualified professionals experienced in the gender field.

Although working independently of one another, we share a general commitment to providing friendly, accessible private services, tailored to individual needs and timescales, in a variety of comfortable London settings. We work flexibly within national and international guidelines of best practice.

The GenderCare network includes:

As clinicians, each of us operates within a wider network of professionals and we are able to access and refer to colleagues in Clinical Psychology, Surgery, etc.

Gender Dysphoria Gender dysphoria is a term describing the distress and discontent experienced by people whose psychological gender is at odds with aspects of their outward physical sex. Such people might identify as gender variant, transgender, transsexual, transvestite, genderqueer, androgyne, neutrois or other. Sometimes, the distress is so strong that they undergo transition from one point on the gender continuum to another. This typically involves changes to social role and presentation, and may necessitate taking sex hormones or having gender related surgery.

Gender Incongruence Gender incongruence is a newer term, gradually replacing gender dysphoria.

Specialist UK gender clinics

We cannot check the quality or safety of services on this page.

In the UK, people who are changing things linked to gender are supported by a set of specialist centres, often known as “gender identity clinics” (GICs), which offer formal diagnosis and access to other services like hormone medications and surgeries.

Free UK-based services

You can access these gender services for free on the NHS. However, these services have significant waiting lists, and may require a wait of several years before being seen. They will also only accept you as a patient if you are registered with a GP in a specific area.

You can find more information about waiting times - and which services will see you more quickly - on our UK service wait times page .

GP referral only

Northern Ireland residents only

Wales GP only

Borders, Fife, or Lothian GP only

Allows self-referral

England GP only

Scotland GP only

Grampian, Orkney and Shetland GP only

Highland GP only

Not accepting new patients

Invitation only

Very limited access: more info

Not accepting referrals

GP/CAMHS referral only

We have instructions on how to access these NHS services on our Getting A Referral page .

NHS England pilot schemes

There are also a number of pilot schemes run by different organisations within NHS England. The purpose of these schemes is to explore a more holistic and comprehensive model of how gender clinics can function, with patient agency centred more in the process.

These clinics generally have a much shorter wait, but are only open to people who’ve already been referred to another clinic, and who meet particular requirements. Waits vary, usually depending on how long you’ve been on the waiting list for the other clinic.

Transfers only

East of England only

Paid UK-based services

There are also several private gender services which charge fees but which may have significantly shorter waiting lists. You may wish to use these services while on the waiting list for an NHS service. It can overwhelming trying to choose which gender service to be referred to, but you can find useful tips on how to choose on our Choosing a Gender Service page .

Note that while some services will see patients younger than 18 for an assessment, not all will offer hormone therapy. You may wish to contact services to find out if they are willing to prescribe to under 18s before paying money to a service.

Other services

Other services that may be of interest to people in the UK include:

56T at 56 Dean Street

56T is a holistic sexual health and wellbeing service for all trans/non-binary people, their partners and friends. 56T provide gender-based counselling and perform injections for hormones prescribed elsewhere.

Website   Instagram   Facebook  

Clinic T Trans Clinic

Clinic T is a sexual health service based in Brighton for anyone who identifies as trans, non-binary or gender variant (partners are welcome too). Clinic T can provide hormone levels testing and perform injections for hormones prescribed elsewhere, and also testing and treatment for STIS, help with bleeding control and contraception, cervical cytology, vaccination, social support and signposting to local partner support organisations.

Website   Twitter  

International organisation providing services for trans patients of all ages including hormone prescribing and counselling

Website   Facebook   Twitter  

GenderHealthCare

Help, advice and support from registered health professionals with personal and professional experience of non-conforming gender identities. Provides services to people of all ages including offering specialist advice, administering injections, and taking blood samples.

Website  

Choosing a service

It can overwhelming trying to choose which gender service to be referred to. You can find useful tips on how to choose on our Choosing a Gender Service page .

Getting a referral

You do not need to be seen by a local mental health team to be referred to an adult gender service.

All the private gender services accept self-referral. However, it may be helpful to speak to your GP before self-referring to a private service, to find out if your GP will be able to support your treatment and if they are able to support you with blood tests and prescribing.

How much will it cost?

British citizens are able to access the NHS and HSC gender services for free . If you are not a British citizen, you may still be able to access these services for free, and more details can be found on the Immigration page .

Patients in Wales being referred to gender services for children and young people will need to ask their GP to apply for funding from their local Health Board.

You may be able to get help with the cost of travelling to attending appointments at NHS or HSC gender services. Further information about travel costs can be found:

• on the NHS website (valid across the whole of the UK)
• on the Welsh Government website
• on the NGICNS website (Scotland only)
• on the HSC Northern Ireland website

More information about travel funding is also available on the London GIC website .

Costs for private services vary significantly, and you can find detailed information on costs on our Private fees page .

Where can I learn more?

There are official pages about finding a gender clinic available:

• for people in England on the NHS website
• for people in Scotland on the NGICNS website

Errors and omissions

Is there something missing from this page? Have you spotted something that isn't correct? Please tweet us or message us on Facebook to let us know.

How to find an NHS gender dysphoria clinic

Trans and non-binary people's general health needs are the same as anyone else's. But trans people may have specific health needs in relation to gender dysphoria.

Your particular needs may be best addressed by transgender health services offered by NHS gender dysphoria clinics (GDCs).

All NHS GDCs are commissioned by NHS England, who set the service specifications for how they work.

A GP or another health professional can refer you directly to one of the GDCs. You do not need an assessment by a mental health service first. Neither does the GP need prior approval from their integrated care board (ICB). 

The websites of the clinics listed on this page also have useful information for you to think about before you see a GP. 

Children and young people's gender services

Children and young people should be referred to the National Referral Support Service for the NHS Children and Young People's Gender Service .

These NHS services specialise in helping young people with gender identity issues. They take referrals from anywhere in England.

Gender dysphoria clinics in London and the southeast

The Tavistock and Portman NHS Foundation Trust: Gender Dysphoria Clinic for Adults

Lief House 3 Sumpter House Finchley Road London NW3 5HR

Phone: 020 8938 7590

Email: [email protected]

The GDC website has an overview of information useful for anyone with gender identity needs, not just those in the area.

Gender dysphoria clinics in the north

Sheffield Health and Social Care NHS Foundation Trust Gender Dysphoria Service

Porterbrook Clinic Michael Carlisle Centre 75 Osborne Road Sheffield S11 9BF

Phone: 0114 271 6671

Email: [email protected]

The  Sheffield clinic's website includes information about referrals, clinic opening hours and links to eligibility criteria.

Leeds and York Partnership NHS Foundation Trust Gender Dysphoria Service

Management Suite 1st Floor The Newsam Centre Seacroft Hospital York Road Leeds LS14 6WB

Phone: 0113 855 6346

Email: [email protected]

The Leeds clinic's website covers referrals, commonly used medicines and information on the clinic's Gender Outreach workers.

Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust Northern Region Gender Dysphoria Service

Benfield House Walkergate Park Benfield Road Newcastle NE6 4PF

Phone: 0191 287 6130

Email: [email protected]

The Northern Region Gender Dysphoria Service website has a range of leaflets, including information about referral, hormones and support groups.

Gender dysphoria clinics in the Midlands

Northamptonshire Healthcare NHS Foundation Trust Gender Dysphoria Clinic

Danetre Hospital H Block London Road Daventry Northamptonshire NN11 4DY

Phone: 03000 272858

Email:  [email protected]

Visit the  Northampton clinic's website for more information about how to get a referral and the role of the GP.

Nottinghamshire Healthcare NHS Foundation Trust The Nottingham Centre for Transgender Health

12 Broad Street Nottingham NG1 3AL

Phone: 0115 876 0160

Email: [email protected]

Visit The Nottingham Centre for Transgender Health website  for more information about how to get a referral.

Gender dysphoria clinics in the southwest

Devon Partnership NHS Trust West of England Specialist Gender Dysphoria Clinic

The Laurels 11-15 Dix's Field Exeter EX1 1QA

Phone: 01392 677 077

Email: [email protected]

The Laurels' website has information about the types of services on offer and the help available during transition.

New gender dysphoria services in 2020

In 2020 new NHS gender dysphoria services for adults will open in Greater Manchester, London and Merseyside.

These services will be delivered by healthcare professionals with specialist skills and based in local NHS areas, such as sexual health services. Full details will be available once each service is opened.

Initially, access to these services will be available to people who are already on a waiting list to be seen at one of the established gender dysphoria clinics.

NHS England will assess how useful these new pilot services are.

Page last reviewed: 13 May 2020 Next review due: 13 May 2023