Gender Affirming Hormone Theraphy 

Most gender-affirming hormone care is provided at PPSP by advanced practice providers (physician assistants, certified nurse midwives, and nurse practitioners) in our health centers or over telemedicine. Our health centers also offer a wide range of reproductive and sexual health services, including STI screening, cervical and breast/chest exams, contraception, etc. Clinicians are trained on our medical standards and guidelines and work with patients to determine a plan for their hormone care based on patients’ medical history, embodiment goals, and the bounds of our medical standards and guidelines. Clinicians attend yearly transgender health conferences in order to stay up-to-date on best practices. Our gender-affirming care program is overseen by the Director of Gender Affirming Care, with whom clinicians consult as needed.

There may be protesters in public areas outside our health centers. They can carry signs and approach you to offer you pamphlets or try to talk to you. They are not allowed to touch you or block your way into the health center or the parking lot. You do not have to talk to them or take their literature. The safest strategy is to ignore them. As long as the protestors do not break the law and are on public property, they have the right to protest. If you feel a protester has acted inappropriately, please let us know immediately. At some locations there may be clinic escorts available to walk you into the health center.

Yes, all PPSP health centers have gender-neutral bathrooms. All people are supported in using whatever restroom they feel most comfortable with.

PPSP will always make every effort to communicate with you using your affirming name and pronouns. Name and pronouns can be recorded in our electronic health records and can be updated using your MyChart portal, with the GAC Support Team, or at your visit. Unfortunately, if your legal name with your insurance company differs from your affirmed name, when submitting insurance claims or lab orders we will be required to use your legal name which may result in your deadname being used with various types of billing communication. Please know we are working to educate those around us in hopes of eliminating instances of deadnaming in the future.

If you experience deadnaming or misgendering and you feel the situation is not appropriately handled or corrected, or if you have other concerns about your experience of care, you can contact the Idea Line at 215-351-5500 or [email protected] or the GAC Support Team at 215-351-5561 or  [email protected],  to communicate your concern.

Although PPSP does not provide therapy services, the GAC Support Team includes a licensed social worker who can provide letters of support for surgery and resources connection. We can also provide a letter of support from your clinician, documenting your hormone therapy care with us.

We encourage all people not to smoke or vape tobacco or nicotine products for their general health. Among other risks, cigarette smoking increases the risk of blood clots in the lungs or the legs. Because estrogen can also increase blood clot risks, we require patients to stop smoking/vaping tobacco before receiving a prescription for all types of estrogen except patches. Estradiol patches (transdermal) have the best data to suggest little to no increased risk of blood clots. Tobacco use may also make feminizing hormones less effective. Estradiol patches can be prescribed to people who are vaping or smoking tobacco; however, they should be actively working to stop.

In order to meet the needs of most insurance companies and patients, we typically use the code E34.9 (endocrine disorder, unspecified) and occasionally will use F64.9 (gender identity disorder, unspecified) if necessary. We recognize that much of the language around billing for gender affirming care is troublesome; we recognize this is medically necessary care and will work to decrease barriers to getting folks the care they need. If you have concerns about the specific billing claims being used with your care, please speak with your clinician.

Contact the GAC Support Team: 215-351-556 or [email protected]. If you reach a voicemail, leave a message with your name and phone number and you should get a call back within one business day.

The complete list of gender-affirming hormone medications we can prescribe is as follows:

• spironolactone
• finasteride
• estradiol intramuscular injections
• estradiol patches
• estradiol pills (swallowed or dissolved under the tongue)
• progestin medications (prometrium pills, Depo-Provera injections)
• testosterone intramuscular or subcutaneous injections
• testosterone gels

Unless a change is being recommended based on follow-up of lab results by a nurse or clinician due to lab concerns, you will need to have a follow-up appointment to change your medications. Please note that changes may require additional lab work.

Due to high volume of patient requests, it may take up to 3 business days for your prescription to be sent to the pharmacy. If you are over 3 months overdue for follow up care (appointment or labs), you will need to obtain follow up care before getting further prescriptions.

Most states allow prescribing across state lines, but some do not.

If you are taking a trip you can:

1. Request an early refill from your pharmacy. You may need to call your insurance to request a travel waiver for coverage of an early refill.
2. Request your PPSP clinician send a prescription to a local pharmacy where you will be located. Contact the GAC Support Team to make this request.

If you are moving to another state, we recommend finding a local hormone therapy provider, but you can continue care with PPSP in-person if preferred (telehealth only available to those in Pennsylvania). You can call the GAC Support Team (215-351-5561 or [email protected]) for assistance finding a local provider.

Call the new pharmacy you would like to fill your medication and ask them to request the prescription at your old pharmacy be transferred to them.

If the pharmacy cannot make this transfer (not possible for some medication if you have not filled your first refill yet), contact the GAC Support Team (215-351-5561 or [email protected]) or your health center and explain you are unable to transfer your prescription and need a new prescription to be sent.

Contact the GAC Support Team (215-351-5561 or [email protected]) for assistance in getting a replacement prescription.

Your pharmacy may provide substitution injection supplies when what we prescribed is not in stock. This is a common issue. Recommendations to help you access the correct supplies can be found in the Injection Preparation section of the GAC website.

Yes, we can prescribe testosterone auto-injectors.

We do not have hormone pellets or implants for gender affirming hormone therapy.

We follow Planned Parenthood Federation of America (PPFA) Medical Standards and Guidelines. Based on these guidelines, we cannot offer bicalutamide or selective estrogen receptor modulator (SERM) prescriptions

Estradiol pills dissolved under the tongue do lead to higher estradiol blood levels than swallowed pills, as well as a different profile of hormone highs and lows than swallowed pills. However, to avoid levels that are too high, dosing is adjusted (approximately in half) when transitioning from oral to sublingual estradiol. Please do not change the route by which you are taking your estradiol tablets without speaking to a clinician to ensure appropriate dose adjustment and lab follow-up.

Yes, we can prescribe though compounding pharmacies. Please speak to your clinician about this request.

Activate and sign into your PPSP MyChart account.

You can update your legal name by contacting the GAC Support Team (215-351-5561 or [email protected]), submitting a request through MyChart, or when you attend your next appointment. No documentation is required.

Yes. If you are already being seen by a medical provider for hormone treatment or have been self-managing hormones and wish to transfer your care to PPSP, we would be happy to see you. If seen my another Planned Parenthood affiliate, you can likely schedule to see us as a regular follow up appointment. Otherwise, we will need to schedule you as a new patient. Contact the GAC Support Team (215-351-5561 or [email protected]) for scheduling as a new patient, and alert them you are already on hormones.

You can request your previous hormone provider fax your medical records to the GAC Support Team (fax: 215-351-5561), or contact the GAC Support Team to complete a medical records request for them to send to your previous provider.