Preparing for your Hormone Therapy Visit

Congratulations on taking the first step of your decision to pursue hormone therapy! Planned Parenthood of Western PA is here for you every step of the way as you start or continue your journey of transition.

We here at Planned Parenthood of Western Pennsylvania are committed to helping you access safe, affirming, and affordable care during every step of your transition. We know there can be a lot of questions around what to expect at your first visit, insurance coverage, and costs. Below are some helpful resources and tips for what to expect during your first hormone therapy visit with us.

What services does PPWP provide?

Planned Parenthood of Western PA provides the following services:

Testosterone hormone therapy (sometimes known as "masculinizing" hormone therapy)
Estrogen/antiandrogen hormone therapy (sometimes known as "feminizing" hormone therapy)

Please note that all hormone therapy patients must be 18 or older in order to start or continue care with us. We are also happy to provide referrals for other desired services that fall outside our realm of care.

What should I bring to my appointment?

If you have insurance, please bring your photo ID, insurance card, and specialist copay due at the time of service. If you are in the process of changing your name or gender marker on your ID or insurance, you can bring any supporting documentation, such as a name change card.

If you are not the primary policy holder on your insurance, please bring the full name, address, and date of birth of the person who is. Be aware that whoever is the primary plan holder can typically see what services you have been provided at your appointment through the Explanation of Benefits they may receive from the insurance plan.

If you currently receive hormone therapy from another provider, it is helpful to bring information about the medications you are currently taking (name, dose, and frequency), as well as copies of any recent labs you've had drawn. This will help us continue your care seamlessly.

Is this service confidential?

Yes! All of your medical information is confidential and protected under Federal law.

Be aware if you plan to use private insurance through a parent or spouse that whoever is the primary plan holder can typically see what services you have been provided at your appointment through the Explanation of Benefits they may receive from the insurance plan. If confidentiality is a concern for you, our staff can help you decide what to do.

Do I need to dress a certain way for my appointment?

No, please wear whatever clothing you feel most comfortable in!

Are there gender-neutral bathrooms on site?

Yes, all of our centers have gender-neutral bathrooms. If you're not sure where one is located, ask any of our friendly staff and they will be happy to point you in the right direction.

Criteria to Begin Care

Planned Parenthood of Western PA operates on an informed consent basis for providing hormone therapy. Patients will be provided at the time of their appointment with all information about their medication, including benefits, risks, and expected side effects and changes.

Planned Parenthood's criteria for hormone therapy reflect guidelines set by several centers of excellence for transgender and nonbinary care provision, including WPATH's Standards of Care and guidelines set forth from UCSF's Center of Excellence for Transgender Health. Criteria to start hormone therapy includes, but is not limited to:

Ability to give informed consent
Age of majority (18+ years old)

A therapist's letter is not required to begin hormone therapy at our health centers. However, many patients express an interest in therapy and report that they find it beneficial, particularly during what can often be an exciting and stressful time. Patients who are interested in therapy are encouraged to check out our CARE behavioral health program. Our health centers are also happy to recommend other trans- and nonbinary-friendly therapists in the area.

What to Expect at your First Visit

When booking, you'll be asked about your legal name and gender, as well as the way you identify, pronouns you use, and the name you prefer to be called. We do this so we can ensure we treat you with the highest level of courtesy.

During your appointment, our staff will collect a comprehensive medical history. You'll meet your clinician, who will get to know more about where you are in your process and the changes you hope to see, discuss with you the informed consent process, and will review both the positive effects and possible risk factors for hormone therapy.

The office staff will collect routine lab work to make sure you are a healthy candidate for hormone therapy. Sometimes this lab work includes a blood draw. You do not need to fast in advance of getting your blood drawn.

Most patients are prescribed hormones that day. Our clinicians will work with you to help you decide what is best for you.

At Planned Parenthood of Western PA, we are proud to provide comprehensive reproductive care to people of all genders. In addition to taking care of your hormone therapy needs, our staff will also recommend other services you may be eligible for, such as STD screening, preventive cancer screenings, and immunizations.

Expect your first visit to take anywhere from 1 to 2 hours. Follow-up visits are typically shorter. The total visit time can increase if you receive other services at the same time, such as contraceptive care or STD screening.

Fees and Insurance

Many patients have questions about how much hormone therapy services will cost. Depending on your specific information, click below for more information about costs and insurance coverage. Rest assured that whatever your situation, Planned Parenthood of Western Pennsylvania provides care to everyone, regardless of their ability to pay.

If you have insurance...

We encourage patients to contact their plan -- either at the number located on the back of the card, or using the online portal for your health plan -- to access information on whether or not hormone therapy is covered. Another way to double check if you're covered is to get a copy of the Member Handbook for your plan. Different plans may call this document different things, but normally it will be on the lengthy side -- anywhere from 25 to 100 pages. Trans Health Project is a great resource for tips on what to look for to ensure your care is covered and that there are no surprise costs.

Below are a list of ICD-10 diagnosis codes your provider may use:

E34.9 Endocrine disorder, unspecified
Z79.899 Other long term drug therapy
F64.1 Gender identity disorder in adolescence and adulthood
F64.8 Other gender identity disorders
F64.9 Gender identity disorder, unspecified
F64.0 Transsexualism

(Note that while we don't like the wording used in many of these codes, they are used by insurers and medical billers on a national basis and we are unfortunately required to keep the wording the same when using them because of that.)

When being seen for hormone therapy, patients with insurance may owe copays such as the specialist copay listed on the card. Any in-office costs not covered by insurance will be reduced according to your income.

In addition, some labs we may run, such as hemoglobin testing, testosterone or estrogen level checks, or basic metabolic panels, may be counted as diagnostic labs, which are subject to your plan's deductible. Your plan's Member Services team or online portal has information about what the deductible is for your plan and how much progress you have made toward paying it.

Finally, in order to start hormone therapy, you'll likely want to look up the medications you plan to start with your prescription insurance. Many prescription insurance companies have medication pricing tools on their website. Here are a few handy ones:

If you are paying out of pocket...

If you plan on paying out of pocket for hormone therapy services, we aim to make costs as uncomplicated as possible. During your appointment, our staff will evaluate you for eligibility for programs that can help pay for your visit.

Even if you are not eligible, our services are offered on a sliding scale to help make your care more affordable. Our staff will provide a quote about what you can expect to pay before lab work is drawn and finalized. Typical costs may vary depending on your income level and your individual needs, and can range anywhere from full coverage up to $150-200 if you fall on a higher end of the scale.

Another component of your total costs will be medication costs. Planned Parenthood of Western PA is happy to transmit your prescription to whichever pharmacy is most convenient and affordable for you. GoodRx is a helpful resource if you would like to compare pharmacy pricing.