Yes, you must be 18 years of age or older to receive GAHT at SHS. Those under the age of 18 will be provided with referrals to a pediatric endocrinologist for evaluation and management.

Yes, as long as you are 18 years of age or older, in most cases, SHS should be able to coordinate with your outside provider and take over management of your GAHT care. In the rare situation where you have had a complicated clinical course or are on a medication not routinely prescribed by SHS, you may be advised to continue with your previous provider or referred to a local specialist for management instead.

SHS only provides hormonal therapy for gender affirmation. However, SHS can help you with referrals to surgeons who provide gender affirming surgical procedures (e.g., top surgery, bottom surgery).

While we always recommend a multi-disciplinary team approach to your care, this is not a requirement for you to receive GAHT at SHS. However, any substantial underlying mental health issues do need to be reasonably well-managed in order to start or continue hormonal therapy. If your evaluation at SHS at any time suggests a substantial mental health condition which is not well-managed, then you may be required to consult with a culturally competent mental health professional before starting or continuing hormonal therapy.

During your first visit*, you should expect your provider to discuss with you:

• Your desired goals in regard to gender affirmation
• Then, based on those goals, discuss the various treatment options which can help you achieve those goals
• An expected timeframe to start noticing these changes, including which changes may be permanent (non-reversible)
• Risks and benefits of such treatments, and suggestions on how to manage them
• Prevention of sexually transmitted diseases, risk of pregnancy (for those who still have a cervix/uterus), and the likely possibility of future infertility
• Any substantial underlying health issues which may require better management in conjunction with, or possibly before proceeding with hormonal therapy
• Signing an informed consent prior to starting a treatment plan at SHS
• Lastly, ordering any required initial screening testing as well as establishing the frequency of follow-up visits and testing

*Please keep in mind that depending on the complexity of your personal history, it is possible that it might take more than one visit to complete your initial intake.

During your follow-up visits, you can expect your provider to

• Review your most recent labs with you
• Review how satisfied you are with the treatment efficacy and adjust the regimen, as needed
• Review any side effects from the treatment plan
• Order any needed labs
• Schedule your next follow-up visit

Yes, a physical exam is necessary in order for your provider to ensure you can start (or continue) your treatment plan safely. However, please know that you can stop or reschedule parts of an exam if you are uncomfortable.