Patient Guide to Gender-Affirming Care

Julia O’Neill, RN, and Jean Bryant.
Julia O’Neill, RN, with Jean Bryant, a patient who has received care at OHSU through our program. Bryant volunteers with the Transgender Health Program to help others.

The OHSU Transgender Health Program can connect you with health care in gender-affirming environments for any health need. Though we don’t schedule appointments or provide care directly, we can help you access a wide range of OHSU providers and services. We also offer support, information and advocacy.

We can help you:

  • Find a primary care doctor.
  • Find a mental health therapist.
  • Find providers for transition-related services.
  • Receive care at clinics dedicated to gender-diverse patients.
  • Connect with one of our Here4You volunteers, based on availability, for support before and after surgery.
  • Navigate steps to treatment.

For care for children and teens, see:

Standards of care

We follow the World Professional Association for Transgender Health’s (WPATH) Standards of Care. The standards are based on research and professional consensus. They set guidelines for safe, effective physical and mental health care for transgender and gender-nonconforming patients.

Access to care at OHSU

The Transgender Health Program can help you find a welcoming, gender-affirming provider for any health need.

Our office does not deliver care directly. We also do not schedule appointments or check on referrals or letters of support. For the fastest service, please call the clinic directly. If you don’t see the number you need below, call OHSU’s main number: 503-494-8311.

  • Dermatology: 503-418-3376 (laser hair removal and other skin- and hair-related needs)
  • Doernbecher Gender Clinic: 503-346-0640 (care for children and teens)
  • Endocrinology (adult): 503-494-3273 (specialty hormone therapy)
  • Ear, Nose and Throat: 503-494-5947 (Adam’s apple reduction, vocal surgery)
  • Facial Reconstructive and Plastic Surgery: 503-494-5678 (facial gender-confirmation surgery)
  • Fertility: 503-418-3700
  • Gynecology: 503-418-4500 (gynecologic care, hysterectomy, oophorectomy)
  • NW Clinic for Voice & Swallowing: 503-494-5947 (voice and communication therapy)
  • Obstetrics: 503-418-4500
  • Plastic and Reconstructive Surgery: 503-494-6687 (Adam’s apple reduction, body contouring, electrolysis, facial gender-confirmation surgery, top/chest surgery, phalloplasty)
  • Urology: 503-346-1500 (metoidioplasty, orchiectomy, vaginoplasty, vulvoplasty)

The Transgender Health Program works with three OHSU clinics specifically for transgender and gender-nonconforming patients. 

  • OHSU's Transgender Gynecology Clinic offers a gender-neutral space for your comfort. Referrals and appointments are made through the OHSU Center for Women's Health, but the space is not in the center. Call 503-418-4500 to request an appointment. Services include:
    • Hormone therapy
    • Fertility treatment
    • Contraception
    • General gynecologic care
    • Obstetric care
    • Surgery
       
  • OHSU’s Primary Care at Richmond clinic in Southeast Portland offers a clinic exclusively for transgender and gender-nonconforming patients receiving primary care and/or hormone therapy. Call 503-418-3900 and ask for an appointment for the transgender clinic.
     

  • The Doernbecher Gender Clinic offers expert, family-centered care for children and teens. See our pediatric gender services page for contact and location information.

Primary care

We welcome patients in the Portland metro area who are looking to establish primary care with a gender-affirming provider at OHSU.

If you already have a primary care doctor, including outside OHSU, we can help your doctor provide gender-affirming treatment in a welcoming environment.

Gender-affirming services

We can help you make the best decisions for your health by making sure you have information, including:

  • Honest answers to what’s possible and what isn’t
  • Treatment risks and benefits
  • Requirements and timelines
  • Insurance information
  • Community resources

Contact us:

We can be most helpful if you tell us:

  • Where you live
  • Whether you’re 18 or older
  • Your insurance information
  • What services you’re looking for, if you know

Resources: Find information and links to support groups and other resources.

Jess Guerriero in the Transgender Health Program.
Jess Guerriero, a pediatric social worker with the Transgender Health Program, helps patients find the services they need.

Planning

Gender-affirming care at OHSU takes planning, especially if you’re coming from out of town. Some things you’ll need to do on your own:

Transportation: Make sure you can get to and from appointments. If you’ve been told to have someone drive you home after surgery, set up a ride ahead of time. Our peer advocates are not able to provide rides.

Meals: Budget for meals if needed. OHSU has several cafes, including a 24/7 option. Portland also has many dining options.

Lodging: Portland has many options for patients and families, including the Rood Family Pavilion for patients traveling from out of town. Some businesses offer OHSU patients a discount. Ask when making your reservation.

At-home care: If your surgery requires you to take it easy for a while, find someone who can do chores. Peer advocates are not available for these tasks.

Insurance: Coverage varies. Read your summary of benefits or call a help line so you know what’s covered. Bring your insurance information to your appointments. Learn more on our Insurance Information page.

Mental health therapy

Many patients benefit from working with a mental health therapist during transition. The Transgender Health Program team can connect you with an OHSU provider for shorter-term assessment and support. We can also help you find a community provider for ongoing care if you wish.

Many surgeries require a diagnosis of gender dysphoria by a mental health professional. A therapist can work with you to create an individual plan. The therapist should also discuss expectations and potential timelines with you. Afterward, you will submit a letter of support from your therapist.

See a sample letter of support. Most often, you will submit your letter before your first consultation with your surgeon.

Hormone therapy

Adults: A primary care provider can offer hormone therapy; you do not need to see an endocrinologist. You also don’t need a mental health letter of support. Learn more about hormone therapy.

Children and teens: We recommend that those younger than 18 seeking pubertal suppressants or hormone therapy be treated by a specialist in pediatric endocrinology. The Doernbecher Gender Clinic at OHSU Doernbecher Children’s Hospital offers expert care. Learn more on our For Parents, Children and Teens page.

Hair removal and skin care

Learn about our options for hair removal with expert providers. We offer laser therapy and three kinds of electrolysis. Our specialists treat hundreds of patients a year.

Our dermatology team offers care for a range of skin and hair needs, such as hair loss or acne related to hormone therapy. 

Voice and communication therapy

Our highly trained speech-language pathologists can help you find the voice, body language and other forms of expression to suit your goals.

Gender-affirming surgery

OHSU surgeons are international leaders in gender-diverse care. OHSU offers a full range of surgeries in welcoming environments. We also invite you to ask for any procedure you don’t see specifically listed.

Dr. Daniel Dugi.
Dr. Daniel Dugi, a urologist and surgeon, has extensive experience in
vaginoplasty, vulvoplasty and other gender-affirming surgeries.

Learn about our expert services for top surgery, including:

Learn about services with leading providers for:

Each person’s transition is unique, and paths vary widely. The factors that affect steps and timelines include:

  • Some surgeries require a mental health letter of support.
  • Some surgeries first require hormone therapy for a year.
  • Some surgeries first require hair removal, which can take six months to a year or more.
  • The path to vocal surgery starts with voice therapy.
  • Some surgeries may require 12 continuous months of living as your affirmed gender.
  • Having a strong support network and low-stress living environment is essential to recovering from surgery.

Demand for surgery is high, sometimes leading to long wait times for consultation and surgery. We’re working to reduce wait times. For now, depending on the procedure, wait times can range from a few months to a year or more. If you have the flexibility to be on short notice, you can ask to be added to our cancellation list. 

This is also a good time to prepare. You can read our patient guides and handouts. You can also make sure you have the support and home environment you need for recovery.

You must be capable of consenting to treatment to have gender-affirming surgery. Your surgeon will have you sign a consent form after you have discussed:

  • Benefits and risks
  • Effects on fertility and sexual function
  • Changes that can’t be reversed
  • Potential social and legal effects
  • Alternatives
  • Costs

Fertility and reproduction

OHSU fertility experts offer a range of fertility-preserving options to gender-nonconforming and transgender patients. Our specialists will be sensitive to your needs and goals.

OHSU also provides sensitive and complete obstetric care — prenatal, childbirth services and postnatal — to patients of any gender identity.

Support services

Information: Our staff can answer questions about all aspects of health care for transgender and gender-nonconforming patients.

Education and preparation: We offer patient education and events. The OHSU clinics where you get care will make sure you understand:

  • Your treatment options
  • What to expect
  • How to prepare

Support for medical visits: Here4You peer volunteers can support patients through surgery, from the first visit to recovery, based on availability. Peers, who have been through a similar experience, join patients at appointments and provide other support while the patient is at OHSU. This service is free, and patients can choose how much a peer is involved in care.

Document change letters: OHSU doctors can provide the confirmation letter needed to change your gender marker on official documents.

For patients

Request services

Other questions and concerns

Refer a patient