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San Francisco Health Network
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Gender Health SF


Patient FAQ

Who is eligible for the Gender Affirming Surgery Access Program?

To qualify, you must be:

  • a San Francisco resident
  • 18 or older
  • covered by Managed Care Medi-Cal (SF Health Plan OR Anthem Blue Cross) or enrolled in Healthy SF, Healthy Workers, or Healthy Families

What if I am not eligible for the Gender Affirming Surgery Access Program but I still need surgery?

An increasing number of insurance plans are covering gender affirming surgery. For more information about which plans cover gender affirming surgeries in California and how to get help troubleshooting insurance problems, please visit Transgender Law Center. To find out which health plans you qualify for, visit Covered California.

What surgeries are covered by the Gender Affirming Surgery Access Program?


Masculinizing Procedures

Mastectomy w/ chest reconstruction

Hysterectomy / Salpingo-oophrectomy

Vaginectomy / Colpocleisis




Urethral reconstruction

Feminizing Procedures

Mammoplasty (some plans may not cover)






How will I decide if surgery is the right choice for me?

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 Gender Health SF staff to come up with a plan to make sure you are fully prepared and have the support you need.

If you are thinking of reproduction or how reproduction may affect your body, please read the following article created by Rainbow Health Ontario for further information.

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 affect surgery?
  • Will the medications I take affect surgery?

If I decide surgery is right for me, how can I prepare?

Some tips to prepare for a life-changing event like 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 surgery is appropriate, your doctor will submit a referral to Gender Health SF. Then we will forward the referral to the specialty clinic or contracted surgeon. Next you will have a consultation visit with the surgeon and set a date for surgery. Gender Health SF will work with your primary care provider to help you plan for surgery. For more information, visit the Gender Affirming Surgery Eligibility, Referral, and Readiness Process page.

Who are the surgeons doing the surgeries?

It depends what surgery you’re seeking and which health plan you have. Please call us to discuss your individual case.

What should I do if I need a type of surgery that isn’t currently covered?

Please call us to tell us that you are interested in a surgery that’s not covered and what specific type of surgery that it is. This helps us keep track of the need for additional surgeries to be covered so that we can ask the health plans to approve coverage for them.

How long will I have to wait?

The wait times will vary depending on what type of surgery you need and how booked up the surgeons are.

How can I get more information about the Gender Affirming Surgery Access Program?
  • Visit our information pages:




Gender Health SF
San Francisco Department of Public Health
628.206.7979 Main Line | 629.206.7999 Fax
Email Us