Patient Guide to Gender-Affirming Care

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

Dr. Jens Berli talks about gender-affirming surgery, why transgender care is so important, and the compassionate care at OHSU.

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, though. 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)
  • 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, including hormone therapy, 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: Visit our Resources page for information and links to support groups and other resources.

Jess Guerriero, a social worker and intake specialist at the Transgender Health Program, helps patients of all ages find the services they need.
Jess Guerriero, a social worker and intake specialist at the Transgender Health Program, helps patients of all ages find the services they need.


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 know how you’ll get to and from appointments. If you’ve been advised 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 at home for a while, find someone who can do routine 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 or letters before your first consultation with your surgeon. You will need:

  • One letter of support for top surgery
  • Two letters of support, from different providers, for bottom surgery

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 on our Hormone Therapy page.

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

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.

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 gender-affirming environments.

A man smiling while sitting down with his legs crossed.
Dr. Daniel Dugi, a urologist and surgeon, has extensive experience in
vaginoplasty, vulvoplasty and other gender-affirming surgeries.

Learn more about feminizing options, including:

  • Chest feminization
  • Face and body feminization surgeries
  • Laryngochrondoplasty (Adam’s apple reduction/tracheal shave)
  • Orchiectomy
  • Vaginoplasty/vulvoplasty
  • Vocal surgery

Learn more about masculinizing options, including:

  • Chest masculinization
  • Face and body masculinization surgeries
  • Hysterectomy
  • Metoidioplasty
  • Oophorectomy
  • Phalloplasty

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

  • Some surgeries require one or two mental health letters 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 take our free classes on surgery and fertility. 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 classes about gender-affirming surgeries and fertility treatment. 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


Dillehunt Hall, Room 1007
3235 S.W. Pavilion Loop
Portland, OR 97239

Dillehunt Hall can be reached through Sam Jackson Hall.

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