Transgender Health

Lavender Rights Project 

Call or drop in during a clinic to pick up documents and receive one-on-one help with your questions and concerns.

• Legal Clinics – Lavender Rights Project

US Social Security 

• How do I change or correct my name on my Social Security number card?
• How do I change my gender on Social Security's records?

US Department of State

• Change or Correct a Passport

Washington State Department of Health

• Sex Designation Change on a Birth Certificate

Washington State Department of Licensing

• Change your name: Driver licenses and ID cards
• Change your gender designation: Driver licenses and ID cards

King County

• Gender Name Change Information

Q-Law Legal Clinic

The QLaw Foundation LGBTQ+ Legal Clinic is organized by the QLaw Foundation and is one of the King County Bar Association’s Neighborhood Legal Clinics. The LGBTQ+ Legal Clinic offers a free consultation with a volunteer attorney. Attorneys determine whether the client has a legal problem, suggest possible options, and provide appropriate referrals. These attorneys will not represent you in court.

• qlawfoundation.org

Lavender Rights Project

We offer both sliding scale and market rates based on reported income for our clients. Each market rate case subsidizes the costs associated with our sliding scale and pro bono cases, allowing us to serve even more low-income LGBTQ community members and further our mission

• lavenderrightsproject.org

Trans Disaster Relief Fund

The Trans Disaster Relief fund was initially set up as a response to Hurricane Harvey. However, since then, numerous other disasters, ranging from other hurricanes to earthquakes and wildfires, have continued to ravage communities. This means that not only has the Houston trans, intersex, and genderqueer community suffered, numerous other communities have suffered and continues to suffer. Financial assistance is available for members of the trans and gender diverse community who need support due to a disaster/covid 19.

• tdrfund.us

Black Trans Task Force

We provide resources for Seattle-Tacoma Black trans people in collaboration with community partners in order to broaden safety nets and increase avenues for justice that are typically available for white trans people.

• lavenderrightsproject.org

Trans Women of Color Solidarity Network

Trans Women of Color Solidarity Network. The TWOC Solidarity Network upholds the self determination of Two-Spirit, Trans Women and Femmes of color and creates opportunities to exercise collective and community care. The fund is one element of how they are confronting the systemic economic disempowerment and violence that Two-Spirit, Trans Women and Femmes of Color face in their region.

If you are in need of assistance and would like to apply, please email TwocsolidarityNW@gmail.com.

City of Seattle Utility Discount Program

The Utility Discount Program (UDP) offers eligible customers a 60% discount on their Seattle City Light bill and a 50% discount on their Seattle Public Utilities bill. UDP is available for income-qualified residential households.

• Learn more and apply here.

Sex Worker Aid Network (Grants and Supplies) via Green Light Project

We are prioritizing the needs of street based workers, trans, POC, and immuno-compromised workers. We will be using it to purchase medications, sanitation supplies, toiletries, as well as provide cash support for bills and rent.

If you are in need of assistance and would like to apply, please email GLPsani@protonmail.com.

Rental Assistance for Young Adults

Y Social Impact Center is here to support young people through these financially uncertain times. Offering up to six months of rent assistance to community who are:

• Currently 18-24 years old
• Reside in King County
• Income at or below 80% area median income over the past 60 days
• Behind in at least 1 month of rent (full or partial) since 3/1/2020

If you are in need of assistance and would like to apply, please email renthelp@seattleymca.org or call 206-751-7130.

El Centro De La Raza

Assistance available to King County residents for emergency needs, rent assistance, utilities, food assistance and unemployment.

If you are in need of assistance and would like to apply, please call 206-825-0197, 360-986-7086 or visit elcentrodelaraza.org.

Rental Assistance Resources in WA State

An online directory of rental assistance programs in Washington.

• Check out the directory

Arts and Culture Leaders of Color Emergency Fund

The Arts and Culture Leaders of Color Emergency Fund is intended to help those pursuing careers as artists or arts administrators whose income has been directly impacted by the COVID-19 pandemic. This fund is for those who self-identify as BIPOC (Black, Indigenous, People of Color). If you fit this description and you are in need of short-term, immediate financial assistance.

• Visit here to apply.

Hospitality Worker Assistance (Greater Spokane area) via Big Table

Spokane, Spokane Valley, West Plains, Liberty Lake
Initial care may look like utilities assistance, help with rent or a deposit for housing, connections to a counselor, car repair, diapers or food for a single mom, a bike for work transportation, medical or dental help, or assistance with resume development. We do not provide hotel vouchers or long-term financial assistance.

NOTE: This program requires a referral from a coworker or manager.

• Learn more about Big Table

Puget Sound Energy Assistance Programs

Puget Sound Energy offers two programs for residential customers to help pay your electric or natural gas bills. Eligibility is based on your household income and the number of people that live in your home.

• Learn more and apply

One Fair Wage Funds for Restaurant/Tipped Workers

Providing cash assistance to restaurant workers, car service drivers, delivery workers, personal service workers and more who need the money they aren’t getting to survive.

• Learn more and apply

Food Not Bombs

Food Not Bombs provides community members with produce, baked goods, packaged, and deli foods, many of which are organic, and occasional animal products. Some locations also provide hot meals, all of which are free to the public.

For more information please contact via phone 206-729-0384, email seattle-fnb@riseup.net and check out https://www.facebook.com/SeattleFoodNotBombs/

Capitol Hill

Anderson Park, Seattle, WA Tuesdays at 5 p.m.
Hot Food Address 1069 19th Ave, Seattle, 98122
Hot Food Day/Time Tuesdays at 1 p.m. at Peace for the Streets by the Kids From the Streets (PSKS)

Seattle Cascade Free Market

Sundays at 1:30 p.m
309 Pontius Ave North, Seattle, 98109

Yesler Terrace Community Center

Saturdays at 12 p.m.
835 Yesler Way, Seattle, WA
Each week, FNB members and individuals from Yesler Terrace – a government housing complex – collect food donated from local co-ops and distribute it at the Yesler Terrace Community Center. All are welcome.

Occidental Park (in Pioneer Square)

Sundays at 4 p.m.
117 S Washington St, Seattle, WA 98104
A free vegetarian meal open to everyone at Occidental Park. For more information please call 206-397-6815 or email werx.for.me@hotmail.com

Everett

Clark Park, Sundays at 12 p.m.
2400 Lombard Ave. (on the corner of Lombard and 24th Ave)
For more information please email everettfoodnotbombs@gmail.com.

Point of Pride Free Chest Binders

Free chest binders if you identify as transgender (FTM, genderqueer, non-binary, genderfluid, gender non-conforming, and every other non-cis identity within the trans umbrella) and cannot afford to purchase a binder or cannot safely obtain a binder.

• pointofpride.org/free-chest-binders

Point of Pride Annual Trans Surgery Fund

Scholarship-like program that provides direct financial assistance to trans folks who cannot afford their gender-affirming surgery.

• pointofpride.org/annual-transgender-surgery-fund

Point of Pride HRT Access Fund

Scholarship-like program that provides direct financial assistance to trans folks who cannot afford their gender-affirming hormone replacement therapy (HRT).

• pointofpride.org/hrt-access-fund

Point of Pride Electrolysis Support Fund

Financial assistance towards permanent hair removal services (including electrolysis and laser hair removal) for trans femme folks who cannot otherwise afford them.

• pointofpride.org/electrolysis-support-fund

Jim Collins Foundation

Applicant must understand the steps that are currently required to undergo the medical process of transition, and must have completed - or have outlined plans to complete - the following steps:

• Secure a letter of support from a licensed medical or mental health professional such as a psychologist, psychiatrist, social worker, or therapist.
• Select a surgeon who is knowledgeable in transition-related surgeries. If applicant is chosen, the organization assumes this named surgeon is final.
• Identify who will care for and provide support post-surgery.

If applicant has not completed all of these steps, but is planning to do so, please include your plans in your application.

You must comply with any and all requirements according to the Standards of Care of the World Professional Association for Transgender Health (WPATH), formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA), as determined by your selected surgeon.

• Applicant must demonstrate a genuine need for financial assistance.
• Applicant must detail the efforts they have made to fund-raise and the amount of cost they will be able to cover on their own, if any.

If you are selected for funding, the payment will be made directly to the doctor or hospital facility.

• jimcollinsfoundation.org

Black Trans Men Inc

As a part of our mission to improve the health and well-being of the people in the communities we serve, BTMI is offering a grant of up to $1,000 to assist with the financial obligation for undergoing elective gender affirming top surgery for Black and African American trans men. Please note that grants are only available to US residents.

To be considered for this grant, please complete each item on the application in its entirety, including all required documents. Before completing the application, we recommend that you review the following list of required documents, and have them ready to upload.

• Pay stubs and/or other proof of income for household
• Letter from your doctor acknowledging your surgery date
• Please allow up to (6) weeks to have your application processed

Below, you will find information about the Black Transmen, Inc. Gender Affirming Surgery Financial Assistance Application. Completion of this application will enable us to review your request for consideration of financial assistance for your gender affirming surgery ONLY.

• blacktransmen.org/top-surgery-grant

TransMission

TransMission is a small scholarship of funds available to applicants who identify within the trans & non-binary communities to offset medical, surgical, legal and social transition-related expenses which are not otherwise covered by insurance. TransMission scholarships are "microgrants," meant to offset costs related to therapy, hormones, gender-affirming clothing/living expenses, etc. and will not cover the complete cost of most surgical procedures.

• loftgaycenter.org/transmission

CK Life

CK Life, founded in the Bronx by Kim Watson, offers a surgery scholarship, a surgery buddy assistance program and insurance assistance.

• Email scholarshipfund@cklife.org or call 347-881-7005 to learn more

Gender Bands

Gender bands, a nonprofit organization founded by non-binary trans guy Ian Giles, offers multiple top surgery grants on an annual basis and free chest binders. Gender bands also has a variety of gender centric merchandise for sale that assists in funding future grant opportunities. Email genderbands@gmail.com or visit genderbands.org/contact to learn more.

• genderbands.org/grants

The Happy Transgender Center

Rizi Xavier Timaine, a female-to-male transgender singer, actor and trans-specialist coach who advocates for transgender rights, offers an annual scholarship for transgender surgery. This scholarship is administered by The Happy Transgender Center. We have only two requirements in order to keep our program as inclusive as possible.

• Scholarship application

Fenway Health Binding Resources

Binding FAQ.

• fenwayhealth.org

Point of Pride Free Chest Binders

Free chest binders if you identify as transgender (FTM, genderqueer, non-binary, genderfluid, gender non-conforming, and every other non-cis identity within the trans umbrella) and cannot afford to purchase a binder or cannot safely obtain a binder.

• pointofpride.org/free-chest-binders

Point of Care Free Femme Shapewear

Free femme shapewear (specially designed compression underwear/gaffs) to any trans femme person who needs one and cannot afford or safely obtain one.

• pointofpride.org/free-femme-shapewear

Brother 2 Brother Binder Grant Program

Free chest binder for folks who identify as trans masculine, are 16 years of age or older and unemployed or demonstrate financial hardship.

• blacktransmen.org/binder-program

GenderGear

Owned and operated by trans and gender variant folks to make finding gender gear (binders, gaffs, inserts, STP, low-cost preloved binders, etc.) simple, easy and affordable.

• gendergear.ca

Gc2b

Affordable, high-quality binders (they also come in five different shades of “nude” for different skin tones).

• gc2b.myshopify.com

Open chest binding with specially designed tape

• transtape.life

DIY and commercial STP overview

An informative overview of a range of types of STPs, from DIY solutions to commercially available models. This is a great starting place to direct patients, as it discusses the pros and cons of a variety of STPs and links to several different vendors. Prices range from $10 to more than $100.

• transguys.com/features/stp

DIY packer video

Ash Hardell, a nonbinary trans activist, describes how to make a DIY packer using nylons and discusses commercially available packing and STP products.

• Watch on YouTube

Packer straps and packer/STP underwear

FtM Essentials sells packers and STPs, as well as undergarments specifically designed to hold these prosthetics. Prices range from $12 to $80.

• ftmessentials.com

Rodeo is another vendor that sells underwear specifically to be worn with packers. Prices range from $25 to $100.

• rodeoh.com

Ingersoll Gender Center Self Advocacy Guide and Video

• Self-advocacy guide (PDF)
• Self-advocacy video

Gender Diversity

Gender Diversity increases the awareness and understanding of the wide range of gender diversity in children, adolescents and adults by providing family support, building community, increasing societal awareness and improving the well-being for people of all gender identities and expressions.

• genderdiversity.org

Gender Odyssey, an annual conference

Since 2001, Gender Odyssey has been an annual event attracting hundreds of people from across North America and around the world. It is an international conference focused on the needs and interests of transgender and gender diverse children of all ages, their families and supporters and the professionals who serve them.

• genderodyssey.org

Ryland’s Story

A family’s story about accepting and supporting their Transgender son.

• youtube.com/watch?v=yAHCqnux2fk

TransYouth Family Allies

TYFA empowers children and families by partnering with educators, service providers and communities, to develop supportive environments in which gender may be expressed and respected.

• imatyfa.org

Family Acceptance Project

The Family Acceptance Project® is a research, intervention, education and policy initiative to prevent health and mental health risks for lesbian, gay, bisexual, transgender and queer-identified (LGBTQ) children and youth, including suicide, homelessness, drug use and HIV – in the context of their families, cultures and faith communities. We use a research-based, culturally-grounded approach to help ethnically, racially and religiously diverse families learn to support their LGBTQ children.

• familyproject.sfsu.edu

Parents and Friends of Lesbians and Gays (PFLAG)

PFLAG is the first and largest organization for lesbian, gay, bisexual, transgender and queer (LGBTQ+) people, their parents and families, and allies. With more than 400 chapters and 200,000 members and supporters crossing multiple generations of families in major urban centers, small cities, and rural areas across America, PFLAG is committed to creating a world where diversity is celebrated and all people are respected, valued, and affirmed.

• pflag.org

The Trevor Project

Founded in 1998 by the creators of the Academy Award®-winning short film TREVOR, The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people under 25.

• thetrevorproject.org

Trevor Space

TrevorSpace is an affirming international community for LGBTQ young people ages 13-24.

• trevorspace.org

Gender Spectrum

Gender Spectrum works to create gender sensitive and inclusive environments for all children and teens. Support Groups, Chat Rooms, Therapeutic Online Environments.

• genderspectrum.org

Washington DC Children’s National Medical Center

The Gender Development Program at Children's National has been supporting the gender needs of youth and their families for the past 20 years. As one of the earliest founded youth gender programs, we are a multidisciplinary team of specialists who work in the assessment and broad care needs of youth on the gender spectrum and their families. We also conduct cutting-edge research to move forward our understanding of youth gender development and ways to best support gender-diverse and transgender youth.

• childrensnational.org/gendervariance

The Gender Book

The GENDER book is a fun, colorful, community-based resource, which illustrates the beautiful diversity of gender - a gender 101 for anyone and everyone.

• thegenderbook.com

Lambert House

Lambert House empowers lesbian, gay, bisexual, transgender and questioning youth through the development of leadership, social and life skills.

• lamberthouse.org

Helping Homeless Students

The Coalition on Homelessness is a coordinating force on budget and policy decisions which directly affect the lives and futures of people who are homeless and the kind of community we all live in. We work tirelessly to advance reasonable solutions and solid program models; to protect and strengthen the civil rights and dignity of people who are homeless and poor; and to accomplish legislative victories that promote housing, human services, and the public good at the local, state and federal levels.

• www.homelessinfo.org

National Youth Advocacy Coalition

Youth advocacy and life skills.

• nyacyouth.org

TransFamilies

TransFamilies is a nonprofit organization that has been supporting transgender people and their families since 2008. Today, we run parent support groups (including a group for Spanish-speaking families), a trans youth leadership program, special topics groups and youth support groups, with more programs in development.

• transfamilies.org

Hetrick-Martin Institute

Hetrick-Martin creates this environment for lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth between the ages of 13 and 24 and their families.

• hmi.org

Fenway Institute

Becoming familiar with terms used by lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexual and gender minorities (LGBTQIA+) can help you provide patients with the highest quality care. In this glossary, you will find terms relevant to the health care and identities of LGBTQIA+ people.

• lgbtqiahealtheducation.org

The World Professional Association for Transgender Health

The World Professional Association for Transgender Health (WPATH), formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a 501(c)(3) non-profit, interdisciplinary professional and educational organization devoted to transgender health. Our professional, supporting and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender and gender-nonconforming individuals internationally. We are funded primarily through the support of our membership, and through donations and grants sponsored by non-commercial sources.

• wpath.org

Washington State Medicaid

There are different requirements depending on what service you want to have performed. For top surgery, we require a letter from a licensed mental health care provider, a letter from the provider managing your hormone therapy and a letter from the surgeon who will perform the surgery. For bottom surgery, the letters you need are the same with the addition of a second letter from a different licensed mental health care provider. These letters should be given to the surgeon who will submit them with the prior authorization request.

• hca.wa.gov

LifeLong

Our respect for people drives our mission. We celebrate differences in perspectives and treat everyone with dignity as we would our closest friends and family.

We seek to understand, listen and leverage each other’s unique strengths to achieve our collective goals. Whether through partnerships, community connections, or individual relationships, we are committed to client-led care and believe we are stronger together.

We fight for health care, housing and food as basic human rights. Where we do not drive those decisions, we lend our voices, knowledge and resources to break down barriers that limit equitable opportunities for everyone to live their healthiest life.

• lifelong.org

Gay City

Seattle’s LGBTQ Center offers free confidential and anonymous HIV testing and STI screening. Testing includes Rapid HIV Testing (finger poke), HIV antibody testing and screening for syphilis, chlamydia, gonorrhea and Hep C.

• gaycity.org

AIDS Healthcare Foundation (AHF)/ Out of The Closet Thrift Store/ AHF PHARMACY

For more than 30 years, AIDS Healthcare Foundation (AHF) has been committed to providing cutting-edge medicine and advocacy to our patients, regardless of ability to pay.AHF offers advanced medical care for people living with HIV. We provide clients with easy access to specialists, medications and services they would need to be healthy and happy.

• ahf.org

NPAIHB Two Spirit and LGBTQ Health

Welcome to the Northwest Portland Area Indian Health Board website. You will notice that we are engaged in many areas of Indian health, including legislation, health promotion and disease prevention, as well as data surveillance and research. Our strengths include an active board, talented staff and a forward thinking organization. We know that there is much work to be done to improve the health status in Indian Country, but we do not shy away from the challenge.

• npaihb.org

Center for Disease Control

Gender identity and sexual orientation are different facets of identity. Everyone has a gender identity and a sexual orientation, but a person’s gender does not determine a person’s sexual orientation. Transgender people may identify as heterosexual, homosexual, bisexual or none of the above.

• cdc.gov

Ingersoll Gender Center Gender Affirming Healthcare Guides and Videos

• Navigating Health Insurance, Apple Health & Covered Services Guide
• Informed Consent (Video)

T4T Caregiving

We are a group of trans caregivers and doulas for trans people having gender-affirming surgeries. Together, we have a broad history of direct caregiving experience to suit your needs. As trans people who are all post op ourselves, we know how important this time is for each of us. We believe in our community. We believe in caring for each other. And we know that no one else understands the trans experience like another trans person.

• t4tcaregiving.org

Northwest Immigrant Rights Project

Northwest Immigrant Rights Project promotes justice by defending and advancing the rights of immigrants through direct legal services, systemic advocacy, and community education.

• nwirp.org

WA Immigrant Solidarity Network

Protect and advance the power of immigrant and refugee communities through a multiracial, multilingual and multi-faith coalition. Our organizing strategy educates and mobilizes statewide to uphold and defend the rights and dignity of all immigrants and refugees, centering the voices of impacted communities.

• waisn.org

Transgender Law Center

Transgender migrants are building community, safety and power through programs like TLC’s Black LGBTQIA+ Migrant Project and organizations like Familia: Trans Queer Liberation Movement.

• transgenderlawcenter.org

Entre Hermanos

To promote the health and well-being of the Latino Gay, Lesbian, Bisexual, Transgender and questioning community in a culturally appropriate environment through disease prevention, education, support services, advocacy and community building.

• entrehermanos.org

Gender Justice League

SafeHouse is a program of Gender Justice League that provides direct services to transgender and gender diverse communities in Seattle and along the Olympic peninsula, with priority for trans & gender diverse BIPOC. Our services also prioritize those who have experienced houselessness, and survived gender-based violence (i.e. domestic violence, sexual assault and exploitation in the sex trade).

• genderjusticeleague.org/safehouse

The Northwest Network

The NW Network of Bi, Trans, Lesbian and Gay Survivors of Abuse works to end violence and abuse by building loving and equitable relationships in our community and across the country.

• nwnetwork.org

API CHAYA

API Chaya empowers survivors of gender-based violence and human trafficking to gain safety, connection and wellness. We build power by educating and mobilizing South Asian, Asian, Pacific Islander and all immigrant communities to end exploitation, creating a world where all people can heal and thrive.

• apichaya.org

As you navigate through your care, you may find that – depending on the provider and clinic you would like to visit – it may be more beneficial to change your managed care health plan (i.e., Amerigroup, Molina, CHPW, United Healthcare and Coordinated Care). The goal of this section is to coach people who already have Medicaid/Apple Health in how to change their managed care plan in situations where they may need a different managed care plan to access the care that they need.

Please note that it may take up to 30 days (about four and a half weeks) for your new managed care health plan to be effective.

Steps to change Managed Care Plan (Medicaid/Apple Health) via WA Health Plan Finder

• Navigate to wahealthplanfinder.org; use either of the sign-in buttons located on the home page
• Log into WA State Health Plan Finder
• Enter your Username and Password. If you do not have an account, click “Create one now” to create an account. Creating an account will allow you to:
  
  • Update your application for medical coverage and renew your current coverage
  • Report a change
  • Create another application
  • View your current eligibility results
  • Submit a document
  • View 1095 Form (taxes)
  • Find a Broker (insurance)
  • Find a navigator who can support you in applying for benefits and answer any questions pertaining to benefits and the application process
• Select Shop for Current Plans
• Select plan for (Self)
• Select Shop Plans
• Pick your desired plan
• Confirm Plan

Steps to change Managed Care Plan (Medicaid/Apple Health) via phone

Call the Washington State Healthcare Authority: 800-532-3022 ext. 15621

Additional resources

• Change my health plan
• Washington Healthplanfinder YouTube channel

Family Equality

Family Equality, along with partner organization Fertility IQ, is here to help transgender and gender non-conforming members of the LGBTQ+ community who are interested in becoming parents or growing their families find the resources they need on their path to parenthood.

Drawn from dozens of medical and academic studies as well as personal experiences, the resources below cover a wide variety of topics related to trans fertility – including understanding how hormones impact fertility, when and how to preserve your fertility if you’re going to transition, and how to get emotional support throughout your family-building process.

• familyequality.org

Pacific NW Fertility

PNWF has always supported our LGBTQ+ community. We’re proud to formalize our passion for inclusive care with this Center that provides comprehensive, highly successful options for all family building and fertility preservation needs.

• pnwfertility.com

Trans Fertility Co.

Trans Fertility Co. was created by trans community members to make the world of fertility easier for us to understand and navigate.

• transfertility.co

Seattle Reproductive Medicine

We partner with you to provide a customized fertility plan, one that addresses your concerns and meets your objectives. Along the way we refine the plan and adjust as necessary to accommodate your needs. Throughout your journey we educate you on your options and provide honest assessments of how to best proceed. We ensure you are aware of a number of considerations – including investment of time, money and effort; medicinal versus surgical; likelihood of success; and so on – as we make decisions together about your treatment.

• seattlefertility.com/transgender-and-gender-non-binary-fertility-options
• seattlefertility.com/understanding-fertility/lgbt-family-building/

Darlene Tando, LCSW

“This blog is about gender, and all its intricacies. I will be blogging about latest research, reflections from my work with gender-expansive and transgender clients, as well as information about resources.”

• DarleneTandoGenderBlog.com

TransGender Pulse

Over half of us have attempted suicide by age 20. We know. That's an alarming statistic. Our mission at TransGender Pulse is to stop the transgender suicide epidemic. It's a lofty goal, and one we take very seriously. We offer a sense of community and kinship for transgender folks, their families, their friends and their allies. In our forums, you will find a friendly community with a wealth of knowledge and experience at its fingertips. Much the same, our live chat offers experience and moderators who are trained in suicide prevention.

• transgenderpulse.com

National Gay and Lesbian Task Force

The National LGBTQ Task Force advances full freedom, justice and equality for LGBTQ people. We are building a future where everyone can be free to be their entire selves in every aspect of their lives. Today, despite all the progress we’ve made to end discrimination, millions of LGBTQ people face barriers in every aspect of their lives: in housing, employment, healthcare, retirement and basic human rights. These barriers must go. That’s why the Task Force is training and mobilizing millions of activists across our nation to deliver a world where you can be you. Join us!

• thetaskforce.org

Washington State Medicaid

• For patients with Washington State Medicaid, please refer to the Washington State Health Care Authority Transhealth Program page to learn about the letters and additional materials needed, such as the consent form. 
• For more detailed information about requirements, you can refer to the Washington apple health – Gender affirming interventions for gender dysphoria act. 

Private insurance

• For patients with private insurance, please call your insurance plan to verify surgical requirements or reach out to the Swedish Transgender Health Navigator for verification support. 

Mental health letters

Hysterectomy is the surgical removal of the uterus and usually the cervix as well. It can be done vaginally (no abdominal incisions), laparoscopically or robotically with tiny abdominal incisions. It is generally an outpatient surgery with no overnight stay.

Preparation for hysterectomy

No specific preoperative preparation is required outside of meeting with your surgeon who may order an ultrasound if you have not had one, as well as some baseline blood work. A pap smear may be necessary if you have not had one within the past three to five years. 

Considerations and risks

Benefits of hysterectomy can include gender affirmation, relief from pelvic pain or vaginal bleeding and removal of the cervix, which typically ensures you won't need any more pap smears.  Ovaries can be removed at the same time as hysterectomy, or they can be kept intact. This decision involves a discussion of the risks and benefits of the loss of hormones from the ovaries. Keeping the ovaries also allows for future egg harvesting if you desire a biological child. 

Risks of the surgery are low but can include bleeding, infection, pain and damage to surrounding organs. After a hysterectomy it is not possible to get pregnant. If you are interested in discussing fertility preservation options, we can refer you to a fertility specialist. 

For those that may want to have genetic children after removal of ovaries at the time of hysterectomy, it is possible to freeze eggs or embryos prior to surgery. This involves consultation with a fertility specialist and subsequent hormonal stimulation of the ovaries, with a minor surgical procedure to remove eggs from the body. We work frequently with Pacific Northwest Fertility, home of the Center for LGBTQ+ Fertility, with providers that are experienced working with gender diverse patients.  

Recovery

Typical recovery to get back to a desk job is a couple of weeks. Longer restrictions including nothing in the vagina and no heavy lifting for eight to 12 weeks.

Aftercare from surgery 

Once you go home it is safe to eat but listen to your body and eat what feels comfortable, starting with smaller portions. You can shower the day after your surgery, allowing water to run over any incisions. Pain is generally controlled with Tylenol and Ibuprofen, with narcotic medications for breakthrough pain. While on pain medications drinking plenty of water and using a stool softener is key. Incisions heal in the first few days. Talk with your surgeon about the dressings that should be used and when you can remove them as it may vary by surgeon. If there is heavy bleeding, fevers, redness or chills you should contact your doctor's office immediately. Walking is allowed as soon as you are able, stairs are safe to climb. Talk with your surgeon about post operation lifting restrictions as they may vary by surgeon.

Oophorectomy is surgical removal of one or both ovaries. It can be done laparoscopically with tiny incisions as an outpatient surgery with no overnight stay. It can be performed in conjunction with a hysterectomy or can be done separately. Surgical removal of both ovaries removes the hormones they make, which include estrogen, progesterone and testosterone. Typically, the recommendation is to leave normal appearing ovaries in place, even in gender affirming surgery, as they can be a backup source of hormone. Leaving ovaries in place can also allow for use of the eggs at a later time for fertility. Ultimately, however, it is up to the patient.

Preparation for oophorectomy

No specific preoperative preparation is required outside of meeting with your surgeon who may order an ultrasound if you have not had one, as well as some baseline blood work. 

Considerations and risks 

Benefits of oophorectomy can include reduction of the female hormone estrogen for gender affirmation and if the ovaries are abnormal, may also provide pain relief. Risks are low but can include bleeding, infection, pain and damage to surrounding organs. High volume surgeons have better outcomes, so consider seeking out a high-volume minimally invasive gynecologic surgeon. After an oophorectomy you will not have any more eggs, so if you are interested in discussing fertility preservation options, we can refer you to a fertility specialist.

For those who may want to have genetic children after removal of ovaries at the time of oophorectomy, it is possible to freeze eggs or embryos prior to surgery. This involves consultation with a fertility specialist and subsequent hormonal stimulation of the ovaries, with a minor surgical procedure to remove eggs from the body. We work frequently with Pacific Northwest Fertility, home of the Center for LGBTQ+ Fertility, with providers that are experienced in working with gender diverse patients.  

Recovery

You can generally return to a desk type job in two to three weeks. We ask that you refrain from lifting for six to eight weeks.

Aftercare from surgery

Once you go home it is safe to eat but listen to your body and eat what feels comfortable, starting with smaller portions. You can shower the day after your surgery, allowing water to run over any incisions. Pain is generally controlled with Tylenol and Ibuprofen, with narcotic medications for breakthrough pain. While on pain medications drinking plenty of water and using a stool softener is key. Incisions heal over the first few days. Talk with your surgeon about dressings that should be used and when you can remove them as they may be removed by surgeon. If there is heavy bleeding, fevers, redness or chills you should contact your doctor's office immediately. Walking is allowed as soon as you are able, stairs are safe to climb. Talk with your surgeon about post operation lifting restrictions as they may vary by surgeon. 

Rhinoplasty is plastic surgery to change the outer shape of the nose. The surgery is done in an operating room as an outpatient procedure and does not typically require an overnight stay.

Preparation

No specific preoperative preparation is required other than meeting with the surgeon. Depending on your past medical history, you may need to have a primary care provider clearance visit.

Considerations and risks

The benefits of rhinoplasty surgery include gender affirmation as well as potential improvement in nasal breathing. The risks of surgery include bleeding, infection, reaction to the anesthesia, injury to surrounding structures, poor healing, thickened scar, asymmetry, scar bands and septal perforation.

Recovery

The pain is typically managed well with either an opioid pain reliever or acetaminophen l after surgery. Most people are able to return to work after about one week. It is common to have skin bruising for the first one to two weeks. You can also place an ice pack on the surgery site for 20 minutes at a time to help with pain and swelling.

Aftercare from surgery 

For the first week after surgery you will have a tape dressing on your nose which you will need to keep dry. You will perform incision-line cleaning two to three times a day until your first postoperative visit, which is about one week after surgery. The nose is not typically packed with gauze after surgery. There will be dissolvable sutures that come out on their own over the first few weeks after surgery.