We require people to have at least one evaluation from a certified mental health professional such as a therapist, counselor, or psychiatrist. The evaluation should focus on your gender history and ability to understand the risks and benefits of treatment used to transition to another gender. After the evaluation, the mental health professional will provide you with the necessary letter that you will share with the doctor. If you need help finding a therapist who has experience working with transgender and gender non-conforming people, we can help identify a mental health provider for you. While it is not required that you have ongoing appointments with the therapist, the doctor or therapist may recommend this.

Transgender Affirming Therapists
https://www.resetoutdoors.com/
https://www.renaissancelv.org/resources

During the first appointment, you will meet with the physician and he will review your personal and family health history. He will also review medications commonly used for transitioning. The provider will review the risks of the medications and common side effects, as well as a timeline of expected changes. You will have baseline blood work done prior to this visit. If you recently had blood work done within 3 months, please provide that to us. An appointment will not be scheduled until we have all required documentation and forms. All forms will be filled out via AdvancedMD, our electronic health system, and copies of photo ID, insurance card, and letter can be emailed to us.

The doctor will review your personal and family health history and perform an exam. He will discuss your gender history, as well as how long and at what dosage you have been on hormones. If you are a patient transferring care to our clinic, you will not need to provide us with a letter from a certified therapist; however, you will need to send us your medical records from your current clinic. Additionally, all other forms, as well as identification, insurance card, and lab results will still be required.

We are glad that you are considering coming to AWC to receive treatment under the supervision of one of our doctors with expertise in transgender medicine. We strongly believe that under our care, we can decrease the risks associated with the medications while you transition.

After you have started on hormone therapy, you will be seen in approximately 3 months to review the effects of the medication and have lab work completed. The doses of your medicine(s) may be adjusted at this visit. You will be seen every 3 months for the first year or until you are on a stable dose of a medication. Thereafter, you will typically have virtual visits twice a year.

A letter from a licensed therapist and parental consent from one of the patient’s parents or legal guardian is needed. A statement of financial responsibility and HIPAA form must also be signed by one of the patient’s parents or legal guardians. The patient must also provide us a copy of their birth certificate, as well as a copy of recent photo I.D. (ex. School ID, permit, passport). The parent or legal guardian must provide a copy of his/her photo I.D. as well. All other requirements, such as getting lab work done and completing all forms are the same as what is stated above in the “first appointment” question.

We have both feminizing and masculinizing hormone treatments available. That includes testosterone, estrogen, and anti-androgens. Your clinician will talk with you about an individualized care plan.

Hormone therapy is one way for transgender, gender non-conforming, and non-binary individuals to feel more like the gender they identify with. Some people may feel that their body does not reflect their gender identity. Hormone therapy is one of many healthcare options people can use. It is similar to second puberty, where your body will undergo changes to your primary and secondary sex characteristics. It is important to note that not all transgender, non-binary, and gender nonconforming people will want to undergo hormone therapy, and that is OK. Their identities are valid.

Before your appointment, we ask you to complete a Gender History Intake form. This is to help the clinician find out a little more about you and how we can provide you with the best care. Your initial appointment will include a review of medications and the letter from your therapist, an assessment of past and current health status, and education about how to administer the treatment if that is something you are comfortable with.

We do offer education at the initial visit on how to self-administer the medication correctly, but if you are a patient who needs medication injected and aren’t comfortable doing so, you may schedule appointments with the physician, so that he can guide you through the injection via televist.

That will depend on the prescription you are given. We will have estrogen and the anti-androgen medication at our clinics. For Testosterone, you will have to pick up the prescription from the pharmacy. We have pharmacies close by that will have hormones and supplies in stock, as well as pharmacies who will mail the prescription to your door (talk to your clinician or Transition Support Advocate for more information). We also recommend www.goodrx.com (either online or download the app). They will provide you with what you will need to bring to the pharmacy to get their discounted rates.

Although the treatment may not affect everybody in the same way, for people taking testosterone, there is a potential risk of infertility. However, while Testosterone may make you infertile, some people continue to ovulate, and there is a risk of pregnancy, especially in the early months of starting testosterone. If you do not want to become pregnant, you should always use a birth control method to prevent pregnancy. AWC can help you with this. The risk of infertility also comes with taking estrogen. Although changes from hormones are theoretically reversible, there is not enough research on fertility once someone stops taking estrogen. One effect of taking estrogen and anti-androgens is that they decrease sperm production. If you are worried and are thinking of having children in the future, you can discuss the possibility of egg/sperm banking with the provider. Hormones do not protect against STI/STDs and HIV.

Whether you have insurance provided by your employer or through the Marketplace, this will depend on your individual plan’s policy. Pennsylvania Medicaid covers Transgender affirming care. Certain state insurance plans are not in-network with AWC. Please check with our Transition Support Advocate to see if your insurance is accepted at our clinic.

AWC provides these services with an affordable self pay fee for office visits and lab work. We can also provide you with information on how to apply for Pennsylvania Medicaid insurances.

Our Transition Support Services includes hormone replacement therapy, information and letters regarding name & gender marker changes, and letters for gendering confirmation services at a cost-effective price. Our Transition Support Advocate can help link you to other resources in the community. You can request additional information online here. All other services are open to everyone along the gender spectrum as well. That includes birth control, sexually transmitted infection testing & treatment, HIV testing, breast/chest & cervical cancer screening, Colposcopy & LEEP Procedures, emergency contraception, pregnancy testing, and abortion care.

The following forms are available through our electronic health system AdvancedMD. All patients are required to utilize this system in partnership with our telehealth visits. If you are interested in utilizing our gender affirming services, you will first need to request an appointment through our website. A transition support advocate will reach out to you via email and guide you through the initial steps to scheduling your appointment.

*Consent form
*Financial Responsibility form
*HIPAA form
*Medical History form
*Sexual History form
*Reproductive Rights
*Lab results dated within the past 3 months
*Photo ID
*Insurance, if applicable
*Letter from a certified therapist

Typically, our clinic utilizes Quest for labs. However, if you have a laboratory that you would prefer to utilize, please let us know, and we will send your lab script to that location. We do not send out lab scripts until all required documentation listed above is received and correctly documented.