Gender Affirmation Services

The Pride Network Integrated Surgical Transition Team offers the full range of affirmation surgery. 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.

Facial Feminization Procedures

Facial feminization surgeries require one year of HRT, and no smoking. Some surgery requires clearance letters from psychology. Some insurance companies require a referral or letter from your primary care physician.

Procedures include:

• Forehead contouring and reconstruction
• Blepharoplasty, upper and lower lid (eye lift)
• Face lift
• Rhinoplasty (nose job)
• Lip augmentation
• Upper lip lift
• Malar augmentation / facial fat injection (cheek implants)
• Genioplasty (chin implant)
• Chin contouring
• Neck lift

Top Surgery

Includes chest masculinization/mastectomy or chest feminization/breast augmentation.

• Masculinization requires a letter from one behavioral health specialist; depending on your insurance a letter or referral from your PCP may be required.
• Feminization does not require a letter if you are self-pay. If the procedure is covered by insurance, letters or referrals may be required. At least one year on HRT is preferred.

Bottom Surgery

All bottom surgery requires letters from behavioral health and there may be other requirements.

• Hysterectomy: Requires two letters, one year HRT, one year real life experience.
• Orchiectomy: One letter from behavioral health, one letter from PCP or endocrinologist.
• Scrotoplasty requires two letters from behavioral health and may require a PCP letter depending on the insurance company.
• Metoidioplasty: Two letters from behavioral health.
• Vaginoplasty: Two letters from behavioral health, BMI and A1C requirements, no smoking, hair clearance.

The network also offers a variety of LGBTQ+ focused specialty care at many locations throughout the county. Providers with an interest in LGBTQ+ care can be found in all specialties at MetroHealth including plastic surgery, OB-GYN, ear, nose and throat (ENT), dermatology and physical medicine and rehabilitation (PM&R).

Some specialty care requires a referral - talk to your Pride Network primary care provider if you have questions.