Transgender Health Services
The San Francisco Department of Public Health (the Department) has developed a small pilot program for the provision of transition surgeries, also known as Sexual Reassignment Surgeries (SRS) and Gender Confirmation Surgeries (GCS), and related education and preparation services to eligible uninsured transgender adult residents. Currently, the Department also provides a range of health services to transgender residents such as primary care, prevention, behavioral health, hormone therapy, specialty and inpatient care. The SRS program is accompanied by a comprehensive transgender services program that includes procedures for appropriate patient selection, counseling, education, and informed consent.
The Board of Supervisors adopted resolution number 288-12 in July 2012, encouraging the Department to ensure the provision of medically necessary gender-transition-related care. In addition, in November 2012, the San Francisco Health Commission approved the following:
- Developing a new program to provide sexual reassignment and gender affirming surgery to eligible uninsured transgender adult residents
- Using gender identity disorder as a clinical indication for surgical procedures and
- Removing sexual reassignment surgery from the list of excluded services under the Healthy San Francisco (HSF) program.
Who is eligible for this 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).
- According to Department guidelines, participants must have a medical home within the San Francisco Health Network. The Department requires patients to have an ongoing relationship with an in-network primary care provider for at least a year prior to referral for transition surgery.
- Individuals with managed Medi-Cal receiving care within the San Francisco Health Network should also be referred for surgery through Transgender Health Services.
Patient Referral Process for Surgery
- Establish medical care with an in-network primary care provider. If you don't have insurance or aren't sure, start by visiting this website: http://healthcarereformsf.org/ or call 855-355-5757.
- The program requires that you be a patient in the San Francisco Health Network for at least one year prior to being eligible for the program.
- Tell your primary care provider you are interested in surgery. All surgery referrals begin with a referral from your primary care provider. If your provider is unfamiliar with the program or needs more information, direct them to this website or have them contact Transgender Health Services.
- All surgeries require the following:
For the mental health assessment, you can ask your primary care provider for a mental health provider referral or contact the Community Behavioral Health Clinic closest to you. If you need support finding a mental health provider or the closest clinic is unfamiliar with assessments, contact Transgender Health Services for assistance: firstname.lastname@example.org
- 2 mental health assessment letters.
- A medical evaluation.
- A patient education document that explains the risks and benefits of the procedure. Your provider can help you keep track of these documents and will fax them into Transgender Health Services when your referral is ready.