Transgender Health Services
Who is eligible for the transgender surgery program?
The program is intended for uninsured transgender adults who are residents of San Francisco. Participants must have incomes at or below 500% FPL (approximately $57,456 for a single person and $117,756 for a family of four in 2013) and be 18 – 64 years old. According to Department guidelines, participants must have a medical home within the Healthy San Francisco network. The Department expects patients to have an ongoing relationship with an in-network primary care provider for at least a year prior to referral for the Transgender SRS Services Program.
What surgeries will be covered?
The Transgender Health Services Program will provide educational materials and support for your doctors, as well as orientation sessions for patients interested in Sexual Reassignment Surgery (SRS), also known as Gender Confirming Surgery (GCS). The surgical services provided will mirror those available for Medi-Cal patients, as listed below:
How will I decide if transition surgery is the right choice for me?
Transition surgery is not right for everyone, and the decision to undergo surgery is an important one. You will work with your primary care and mental health providers to understand your treatment options. Ultimately you will need to decide what is right for you. If you choose to pursue surgery, you will work with your doctor and the Transgender Health Services program coordinator to come up with a plan to make sure you are fully prepared and have the support you need.
What questions should I ask my provider and surgeon when considering surgery?
- What are the expected outcomes of the procedure I'm thinking about?
- Do the expected outcomes match my goals?
- Does the surgeon I am thinking about have pictures available?
- Will I have visible scars and is that okay with me?
- How will my body look and feel different?
- How will my sexual feeling and functioning change?
- Will I lose sensation or function?
- Are there any alternatives to surgery that might achieve my same goal?
- How long will it take me to recover?
- How can I prepare for surgery?
- What will recovery be like?
- I use marijuana daily, will this effect surgery?
- I take X medication, will this effect surgery?
If I decide transition surgery is right for me, how can I prepare?
Some tips to prepare for a life-changing event like transition surgery are to:
- Work towards a healthy lifestyle.
- Talk with your doctor about any health concerns you have.
- Prepare for visits with your doctor by making a list of your questions.
- Educate yourself through research and a comparison of services.
- Seek out one-to-one interviews with others who had the surgery you want. This will help you gain insight and knowledge about what to expect and also help ease anxiety.
- Find a support group to get support with daily challenges so you will be able to keep focused on longer term goals, such as your surgery and the preparation.
How does the referral process work?
Once you and your doctor have decided that transition surgery is appropriate, your doctor will submit a referral to the Transgender Health Services Program. The Transgender Health Services program coordinator will work with your primary care provider to help you plan for surgery.
Because this is a small pilot program, only a small number of patients will be able to get their surgery in the first year. If you are selected, the SRS program coordinator will send a referral to the specialty clinic or contracted surgeon. Then, you will have a consultation visit with the surgeon and set a date for surgery.
What will I need to do to get ready?
The steps you will need to take to get ready will vary by the type of surgery. For all surgeries, you will need to work with your primary care provider and mental health provider to come up with a plan for completing the necessary preparation steps.
How long will I have to wait?
The wait times will vary depending on what type of surgery you need and how much interest there is in the program. The program has a limited amount of funding for the first year and will only be able to serve a small number of patients. Your provider will be able to work with the Transgender Health Services program coordinator to get a better idea of how long you will wait.
How can I get more information on the program?
Ask your provider when the next orientation session is. The orientation session will give you an opportunity to ask any questions you might have about the program.
What should I do if I don’t meet the program eligibility criteria?
The Department encourages all individuals to explore their options for appropriate care with their doctors. An increasing number of insurance plans are covering transition surgery. For more information about which plans cover SRS in California please go to the Transgender Law Center. If you are currently uninsured, keep in mind that you will have more options for coverage in 2014. For more information on options you may qualify for, please go to (link coming soon).