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Transgender Health Services

Transition Surgery


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.

Criteria and Summary Requirements for Surgery

Eligibility and Referral Process

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Transition Surgery Flowchart