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Transgender and Gender Affirming Health Care

Parenthood of Greater Washington and North Idaho is proud to serve transgender people and patients on the spectrum of gender identity and expression for their sexual health care needs. Planned Parenthood is committed to improving the way transgender Washingtonians receive health care in our community, including eliminating barriers to that care.

Proud recipient of the 2019 Rainbow Award.

Contents

  • Overview

  • Where to Get Care

  • Criteria for Starting Hormone Therapy

  • What to Expect on Your First Visit

  • Payment Options

  • Learn more about Trans and Gender Nonconforming Identities

  • Learn more about gender-affirming transition options

Overview

In 2018, Planned Parenthood of Greater Washington and North Idaho expanded its current healthcare services for transgender patients to include Gender Affirming Hormone Therapy services. Gender Affirming Hormone Therapy services include:   

  • Transgender Female (MTF/Feminizing) Hormone Therapy including estrogen and spironolactone
  • Transgender Male (FTM/Masculinizing) Hormone Therapy including testosterone

If hormone therapy is a good fit for you, you may be given a prescription to take to your pharmacy as early as the second visit. Planned Parenthood of Greater Washington and North Idaho follows an informed consent treatment model, which means our patients will not be required to provide an approval letter from a therapist to begin hormone therapy. If you are already receiving hormone therapy, you can contact Planned Parenthood for an appointment for ongoing care and monitoring.

Planned Parenthood health center staff will provide referrals for gender-qualified therapy and resources if needed.

Where to Get Care

Gender Affirming Hormone Therapy Services are available for patients 18 years and older at all of our eleven health centers in Eastern Washington.

Criteria for Starting Hormone Therapy

Hormone readiness is determined through Informed Consent. Informed Consent means you can demonstrate understanding of both the risks and the benefits of hormone therapy, and you and your clinician have both decided that this is the appropriate time for you to begin this process. PPGWNI believes that when fully informed, patients are capable of determining what is best for themselves and their health. We do encourage patients to connect with a mental health provider as indicated for quality, comprehensive care.  Referrals for transgender-friendly mental health providers will be provided upon patient request. 

Patients are not required to provide an approval letter from a therapist to start hormone therapy.

Our criteria for hormone therapy reflect the World Professional Association for Transgender Health (WPATH) guidelines. Criteria to start hormone therapy may include the following: 

  • Ability to give informed consent 
  • Age of majority (18+ years old) 
  • Persistent gender dysphoria 
  • Any other medical or mental health issues are reasonably well controlled. 

Your clinician will discuss these criteria in detail during your initial visit and determine whether they are fulfilled.

What to Expect on Your First Visit

Please call 866-904-7721 to make an appointment first and request transgender services/gender-affirming services at any of our health centers. 

All Planned Parenthood patients are asked to provide their preferred name and pronouns, in addition to legal names (for legal and insurance purposes), at check in so that we can serve our patients with the highest level of courtesy. 

Our program starts with a visit with our TGA (Transgender/Gender Affirming) Team Specialist. Please anticipate an hour to an hour and a half for this visit. The TGA Team Specialist will: 

  • Explain the Gender Affirmation Health Program at Planned Parenthood Greater Washington & North Idaho
  • Ask some health history and personal information questions
  • Discuss possible changes, expectations, and limitations of hormone therapy
  • Discuss both reversible and irreversible effects of hormone therapy
  • Provide you a folder of resources and information
  • Discuss any social transition questions or concerns
  • Answer any questions you may have

At your initial clinician visit:

  • Review your medical history, including your sexual and surgical history and current health practices
  • Measure your weight and blood pressure
  • Discuss with you the informed consent process and your gender identity history
  • Discuss your transition goals
  • Will review both the positive effects and possible risk factors for hormone therapy.   
  • Routine blood work to make sure you are a healthy candidate for hormone therapy.
  • Answer any questions you may have
  • Schedule a 2-week follow-up appointment to review lab results

Based on the results of your first visit, you may be prescribed hormones on that 2-week follow-up appointment.  Cooperatively, you and your provider will review your options and come up with the optimal plan for you. 

Once you have started a course of hormones, we will ask you to schedule periodic appointments for routine lab work and monitoring. The frequency of these visits will vary depending on the patient, but typically they become less frequent over time. Your clinician will determine the best follow up schedule based upon your needs. Reaching your individualized transition goals will be a gradual process, and your clinician will discuss in-depth what that may look like.   

Planned Parenthood of Greater Washington and North Idaho is proud to be your sexual healthcare provider in every way. In addition to hormone therapy services, please know that our full spectrum of services, including: well checks, contraception, STD testing and treatment, HIV testing, PrEP/PEP, clinical breast exams, cervical cancer screenings, pregnancy testing, abortion care, and other healthcare services are also available for transgender patients.

Payment Options

Costs vary depending on individual insurance plans. We have billing staff ready to help you figure out cost, billing, and insurance. If you are uninsured or do not wish to use your insurance, we may be able to set up a payment plan: 866-904-7721

Learn More About Trans and Gender Nonconforming Identities: 

Learn More About Gender-Affirming Transition Options

What is hormone therapy?

Gender affirming hormone therapy consists of either feminizing (estrogen) or masculinizing (testosterone) hormones. Many transgender people take hormone therapy as part of a gender transition to help their bodies and appearance align with their gender identity.

Do all people who transition have surgery?

No, many transgender people transition without surgery. Some have no desire to pursue surgeries or other medical treatment. If you're interested in surgical options, we can refer you to other health care providers.

What are the effects of estrogen?
  • Fat may be distributed on the hips.
  • The size of the penis and testicles may be slightly reduced.
  • Erections and orgasms may be harder to achieve.
  • Muscle bulk and strength may be reduced.
  • Breasts may feel tender and lumpy and may sometimes increase modestly in size.
  • The growth of facial and body hair may slow.
  • Androgenetic alopecia (baldness) may be slowed or stopped. 
What is transitioning?

Transitioning, or a gender transition, is the process some people may go through to live as the gender with which they identify, rather than the sex assigned to them at birth. Transitioning can involve medical treatment and hormones, changing name and pronouns, altering appearance and dress, or coming out to your friends and family. Not all transgender people transition. Gender affirming hormone therapy is an essential part of transition for many transgender people.

What physical effects will hormone treatment have on me?

Hormones are helpful in making your appearance more masculine or feminine. Beginning gender affirming hormone therapy has many similarities to going through puberty. Although hormones taken in adulthood can help to keep your bones healthy, they can't alter your skeletal shape or your height.

Will I always have to take hormones?

Yes, in order to maintain the effects of hormone therapy, you'll need to take them for the rest of your life. 

What are the benefits of hormone therapy?

Hormone therapy can make you feel more at ease with yourself, both emotionally and physically. You may be experiencing discomfort because you are not happy with your appearance, or in your gender role. Perhaps your appearance and your gender role are in conflict with your inner sense of gender identity. If this is how you are feeling, hormone treatment may help you to overcome your distress.

How expensive is hormone therapy?

PPGWNI accepts most major insurances and can help you understand the costs of services. Our financial counselors will work with you to determine how to pay for hormone therapy, whether you have insurance or not. We provide care to everyone, regardless of your ability to pay.

What are the effects of testosterone?
  • Beard and body hair growth will be promoted.
  • Androgenetic alopecia (baldness) may develop.
  • The clitoris increases slightly in size.
  • Libido may be heightened.
  • Muscle bulk increases.
  • The voices deepens.
  • Periods will stop, although there may be some breakthrough bleeding.
  • Some individuals develop acne.

Intramuscular injection

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Subcutaneous injection

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Intramuscular injection

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Subcutaneous injection

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