Trans Health

AWC provides compassionate caring and accessible reproductive healthcare. Our safe and affirming services include hormone replacement therapy, assistance with legal document changes, upper/lower exams, self-injection instruction, referrals, transition care, and abortion care.

Beginning Hormone Replacement Therapy – First Medical Appointment

  • Medical History: You will be asked to fill out paperwork pertaining to your medical and family history.
  • Physical exam (If you have had a physical exam in the past year, you can bring those records to your appointment or have them faxed to AWC.)
  • You’ll have a chance to meet with our Medical Director to discuss the medical considerations for beginning and/or continuing your transition hormonally.

Beginning Hormone Replacement Therapy – Second Medical Appointment (Must have referral letter from counselor/therapist)

  • Review lab work with Medical Director
  • Discuss next steps in your care

Continuing Care

  • Once prescribed hormones, you should expect to return to AWC within 3 months
  • Blood work will be done to monitor hormone levels
  • If you are using injectable hormones, we will offer self- injection lessons with our medical support staff.

Counseling Services & Referrals

  • AWC does require a referral letter from a counselor/therapist in order to begin hormone therapy.
  • Patients who have already begun hormone therapy and are transferring to AWC, do not require a letter.
  • AWC has a therapist on staff who offers convenient, affordable counseling in the office.
  • For a list of mental health and counseling referrals, including several who offer Skype®, please call the office.

Referral letters from your counselor/therapist can be faxed to AWC or brought in on the day of your appointment.

National Resources

Local Resources

Trans Health FAQ

What are the steps before I can be prescribed hormones to transition to my affirmed gender?

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

What happens during the first appointment with the physician?

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 transition. 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.

What if I have already been prescribed hormones? What if I am transferring care to your clinic?

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.

What if I have been taking hormones without a doctor’s prescription?

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.

How often will I have to have follow-up appointments while on hormones?

After you have been 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.

What if I am a minor or I am a parent whose child is looking to start Hormone Replacement Therapy?

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.

What hormone therapy options do you offer at AWC?

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.

What is Hormone Therapy?

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.

What will my appointments include?

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.

What if I am not comfortable with the self-injection method?

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.

If I choose hormone therapy, how will I get my medication?

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.

Can I still become pregnant or get someone else pregnant while on hormones?

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.

Will my insurance cover Hormone Replacement Therapy?

If 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.

What if I don’t have insurance?

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.

Apart from hormone treatment, what other services does AWC offer to transgender, non-binary, and gender nonconforming patients?

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.

What materials do I need to provide you with for a new patient appointment?

All forms with asterisks next to it are through our electronic health system AdvancedMD. All patients are required to utilize this system as we are doing televisits through it. 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 certified therapist

Where can I get labs done?

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.