Transgender & Non-Binary Care
Schedule an Appointment
To schedule an appointment with the Pride Network, call 216-957-4905.
For more than 15 years, MetroHealth’s Pride Network has offered expert transgender and non-binary care. We follow the latest medical guidelines set by the World Professional Association for Transgender Health (WPATH).
Each person’s journey is unique. Your treatment program will depend on your goals and needs, including your overall physical and mental health and your resources. Pride Network providers listen and can offer various choices to best help you.
Treatment Programs
Medical Transition
In the Pride Network, adult gender care is offered as part of primary care. Our physicians are experienced with various options for hormone replacement and related care. Transition related medical care is done with informed consent. That means you do not need to get letters of recommendation or mental health assessment.
Generally, on the first visit you will have a full medial history and physical exam, including discussion about your current and past mental health, current and past medication. We will also talk about your gender journey, your family and community support, and a timeline for treatment. You will usually also have blood drawn. In future appointments your provider will discuss your lab work, your overall health, and your transition plan, as well as discussing informed consent and the outcomes of hormone replacement.
Surgical Transition
The Pride Network Integrated Surgical Transition Team offers a full range of surgeries for transgender patients.
- Facial feminization
- Chest surgery
- Bottom surgery
- Voice surgery
Surgeries may include preparation and health requirements, including stopping smoking and meeting BMI and blood sugar requirements. Some require clearance letters. We follow WPATH recommendations.
Learn more about gender affirmation surgeries at MetroHealth
Behavioral Health
Feeling and being healthy involves more than physical health. Mental and emotional health are just as important. We are here for you – whether you have been here before or are new to MetroHealth. Our behavioral health team offers evaluations and treatment in both inpatient and outpatient settings.
Learn more about our behavioral health services
Please Note: If you are experiencing a psychiatric emergency, call the Mobile Crisis Team at 216-623-6888 or go to the nearest emergency room immediately.
Detransition Care
Sometimes, gender diverse people follow a winding path to their destination. The path may include detransition or retransition or other change of direction.
We know people detransition for many reasons. Occasionally, it just wasn’t the right choice. Other times, it was the right choice, but external pressures around family, employment, or society in general create a need to backtrack, either long-term or short.
Detransition may mean changes in hormone doses or stopping altogether. It may include changes in external presentation, changes in legal paperwork.
We also understand that detransition, for whatever reason, does not automatically mean you are cisgender or heterosexual. Sexual orientation and gender identity is layered and often complicated.
Regardless of your new direction, the Pride Network is here for you. Pride providers will continue to care for your general health and will work with you to make changes you need to live your best life.
Gender Affirmation Services
Gender Affirmation Services
Each person’s journey is unique.
Pride Network providers listen and can offer various choices to best help you.
Hormone Replacement Therapy
Hormone Replacement Therapy
Hormone therapy is a treatment process for people seeking to physically change their bodies to fit their sense of gender identity.
Transgender & Non-Binary Care Frequently Asked Questions
Find questions and answers to topics on gender-affirming surgery, hormone therapy, counseling, and more.
If you are 18 or older, and looking for LGBTQ+ primary care, or interested in discussing medical care for gender affirmation, call 216-957-4905.
If you are under 18, and looking for LGBTQ+ primary care, call 216-778-8564.
If you are 18 or over, our clinic uses an informed consent process, which means that you will discuss your medical history, and the risks and benefits of hormonal therapy, along with lab work and examinations tailored to you.
You and your provider will make the decision together about the best way to begin medical gender affirmation and plan for mental health support, surgical support, speech therapy or other interventions as designed for you.
Gender dysphoria is the condition of feeling one's emotional and psychological identity as male or female to be opposite to one's biological sex. It involves a conflict between a person's physical or assigned gender and the gender with which they identify.
Lots of people have these struggles at all ages. A good way to start is with a psychologist trained in discussing gender. If you are over 18, feel free to make an appointment to talk with any of our PRIDE providers about options for your care and choices you have.
Yes. Living according to your gender identity does not always mean you need to use hormones or surgery.
You can change your clothing, name, speech, or other things about you to be recognized as the gender you identify with.
If you want to talk about all of these options, feel free to come in to talk with our providers.
Kids Pride pediatrics primary care appointments can be made by calling 216-778-8564.
If you are 18 or over, you will be started on hormones after you and your provider decide that you are comfortable moving forward and that you are safe to begin therapy (sometimes this depends on labs or other evaluation). Typically, this takes one or two visits.
This depends on the type of surgery you are seeking. Learn more about surgery requirements. Your insurance may have additional requirements.
Top Surgery (mastectomy)
We look to the WPATH standards of care. The WPATH Criteria for FTM Top Surgery are:
- Persistent, well-documented gender dysphoria
- Capacity to make a fully informed decision and to consent for treatment
- Be of the age of majority in the country of surgery
- Significant medical or mental health concerns, if present, must be reasonably well controlled at the time of surgery
Being on hormone therapy is not a requirement. However, many surgeons request that people on hormones be on those hormones for a year, because hormonal therapy changes people’s chest shape, and that can impact what the surgery will look like. Insurance companies may have different requirements to cover the surgery, if they cover the surgery at all.
Many surgeons want a letter from a mental health specialist that they have assessed your readiness for the surgery.
At MetroHealth, our surgeons require a letter from a mental health specialist and require that you do not smoke tobacco — tobacco smoking decreases the body’s ability to repair itself and can lead to poor surgical results.
Bottom Surgery
For these surgeries, you usually need to have two referrals, from qualified mental health professionals who have independently assessed you.
As well as the criteria listed for top surgery, for bottom surgery the WPATH guidelines call for at least 12 continuous months of appropriate hormone therapy, unless there are reasons why the you can't or won't take hormones.
Breast Enlargement
For transwomen who are not happy with their breast size, we usually encourage them to delay surgery until two (2) years after starting hormones.
This is because, although the breasts usually begin to grow around 3-6 months, a patient won’t get the maximum effect until 2-3 years after starting hormones.