Gender affirming care is an umbrella term for any combination of social, medical, and legal measures that help you feel happy, healthy, and safe in your gender.
This article will focus on gender affirming medical care, which involves a wide range of healthcare approaches that can differ from person to person.
Your individual wants and needs determine what gender affirming medical care looks like for you.
According to the National Transgender Discrimination Survey Report on Health and Health Care, at least 80% of trans people have either taken gender affirming hormone therapy or want to at some point in their life.
Puberty blockers
These medications allow you to delay puberty while you decide whether to begin estrogen or testosterone therapy.
Going through puberty for a gender other than your own can be deeply traumatizing and cause unwanted permanent changes to your body composition and sex characteristics.
The Endocrine Society advises that adolescents who meet the criteria for gender dysphoria and incongruence and are seeking hormone treatment “should initially undergo treatment to suppress pubertal development.”
Puberty blockers have been found to lead to better mental health outcomes in trans people who receive them, specifically
Estrogen or testosterone therapy
Everybody has some degree of testosterone and estrogen. Hormone therapy usually changes which sex hormone is dominant. This can bring about desired changes to your secondary sex characteristics.
Some changes associated with long-term use are permanent, while others are reversible. It’s a common treatment that’s considered safe when monitored by a healthcare professional.
Cisgender people, for example, have been using hormone therapy for decades to treat erectile dysfunction and alleviate menopause symptoms, among other uses.
Testosterone therapy can be administered via injection, topical gel, patch, or through an implanted pellet. These changes may be considered “masculinizing.”
Estrogen therapy can be administered via oral tablet, injection, or patch. These changes may be considered “feminizing.”
Anti-androgens
These medications reduce the level of testosterone in the body. They’re often combined with estrogen therapy.
Nonsurgical cosmetic procedures may help alleviate gender dysphoria related to certain physical attributes.
Botox and dermal fillers
Injectables like Botox and fillers can be used to reshape the face and enhance features. Botox, for example, can relax muscles to add projection to the chin. Fillers can add volume to the cheeks to create a more rounded look.
Laser hair removal
Laser hair removal is commonly used on the face, legs, arms, and back, among other areas. It usually involves multiple sessions.
A licensed healthcare professional uses a special light beam to target hair follicles, damaging them and stopping hair growth. There are many different types of lasers, and finding the right one for your skin type is key.
Surgical procedures that augment the chest are known colloquially as top surgery, and those that change genitalia are often referred to as bottom surgery.
Any surgery comes with the risk of complications, which can vary depending on the procedure. General risks of surgery include bleeding, pain, infection, or requiring revisions.
It’s important to seek out an expert and always follow your surgeon’s pre- and post-operative instructions.
Double mastectomy
There are many types of mastectomy, and the type of double mastectomy procedure you receive usually depends on the size of your chest.
During this surgery, breast tissue is removed to create a flat or flatter chest. This may also involve removing and regrafting your nipples onto your flattened chest.
Breast augmentation
This surgery involves putting in breast implants to create a fuller chest. Breast augmentation is one of
Phalloplasty
This is a complex procedure that constructs a penis out of grafted skin tissue from another place on the body (such as from the thigh or arm) and threads the urethra through it.
Phalloplasty (or phallo) often requires more than one surgery.
Vaginoplasty
This procedure can be used to construct a vagina. The most common type of vaginoplasty is called the penile inversion procedure.
Orchiectomy
This surgery involves the removal of one or both testicles. It is usually done together with a vaginoplasty but may also be performed on its own to reduce testosterone levels.
Hysterectomy
A hysterectomy is the removal of the uterus, and there are several different types of this procedure.
It can be used to treat endometriosis or polycystic ovary syndrome or performed alongside a phalloplasty.
Head and neck surgeries
A plastic surgeon can help you determine which procedures are best suited for your desired results. This may include:
Planning for the future
Some people opt to preserve eggs or sperm before surgery to remove reproductive organs:
Here are some helpful resources about pregnancy:
Informed-consent healthcare is based on the idea that you know yourself best, and it’s your medical team’s job to help you access the care you need in the safest way possible.
Ideally, you should feel comfortable discussing your transition with your healthcare team. Even if you aren’t pursuing medical transition procedures, they’ll be able to update your information with your desired name and pronouns.
If you’re having trouble finding a healthcare professional who is able to do so, this map of informed-consent clinics in the United States may be useful.
If you’re unable to find a clinic that specializes in gender affirming care, it may be helpful to contact your prospective healthcare professional’s office prior to your appointment to let them know about the types of treatments you’re interested in. This will give them time to research anything they’re not familiar with.
Is gender affirming care just for trans people?
Gender affirming care is for anyone who needs it. Many people have received a form of this care without realizing it. Cisgender men who take testosterone therapy, for example, are using the same hormone therapy as people who are transgender, nonbinary, or gender nonconforming.
The only difference is that gender affirming care is heavily stigmatized and restricted for people who aren’t cisgender. Trans and nonbinary folks are often subjected to hurdles and red tape that cisgender folks aren’t in order to receive the same care.
A 2022 study found that only 20% of mental health professionals received relevant training on transgender topics during their graduate studies.
Instead, they were more likely to pursue this training on their own after meeting trans people in need of care.
While that can be frustrating to hear, it does show that clinicians are working to fill in the gaps left by their establishments, often through mentorship or professional conferences.
So, if you’re having trouble finding a therapist or psychiatrist, you might consider reaching out to one that you’re interested in to see if they would be willing to continue their education and take on a trans or nonbinary client.
Many online-based therapy platforms have filters that allow you to search for therapists specializing in queer and trans care. Psychology Today also has a database of trans therapists that you can search to find one in your area.
A mental health professional can help you gain perspective and create a plan for personal growth. A good therapist, for example, can become an essential part of a healthy support system, especially for people with difficult family dynamics.
Additionally, if you pursue some methods of medical transitioning, you may need a letter stating the medical necessity from either a therapist or psychologist. Your care team will let you know if you need this information.
Gender affirming healthcare can improve all areas of life, but it can be difficult to come by. For youth, this can be due to a lack of family support. For adults, this commonly takes the form of medical incompetence.
A 2018 study reported, for example, that up to 70% of trans men had to educate their healthcare professionals in order to access the care they needed.
In another
These barriers affect more than just the healthcare related to a medical transition. Because the traditional healthcare system is designed for cisgender people, it creates gaps that people with expansive gender identities may slip through.
For example, in the United Kingdom and other places, nationwide efforts to increase cancer awareness send reminders for cervical cancer screenings only to those with a “female” marker on their identification. This leaves trans men and some intersex people out of these lifesaving measures.
Likewise, trans women over age 50 may not be receiving regular mammograms, even though current guidelines recommend them for people who have been receiving hormone therapy for at least 5 years.
Receiving gender affirming care is vital to mental health stability, especially for young people. One 2022 study of transgender youth in the United States showed that being able to receive hormone therapy reduced reports of recent depression and suicide attempts in the previous year by 61%.
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Everyone deserves to feel comfortable, safe, and happy in their body and their gender. Research has repeatedly shown that access to gender affirming care reduces depression and suicidal thoughts, in addition to improving self-esteem and overall quality of life.
Building a strong emotional support network — through family, friends, therapists, or mentors — is also an essential component of navigating a transition.
There’s no right way or right time to process and come to terms with your gender identity and expression. Try to give yourself grace, educate yourself on your options, and remember that you aren’t alone.