What is Gender-Affirming Care?

Posted June 05, 2023 by Katherine Williams, M.D.

On your journey to becoming more of your true and healthier self, sometimes the body does not appear or do what it "should" do. Sometimes a patient's focus is weight loss, but sometimes the goal is deeper than that.

Many transgender people have intense distress when their appearance does not reflect their gender. Known as gender dysphoria, this distress can trigger poor mental health or even mental illness in transgender people. Gender-affirming care can be an important part of managing this condition in transgender patients.

In fact, studies show patients who undergo gender-affirming care report improved mental health and overall well-being, increased self-esteem and quality of life.

Gender-affirming care can range from simple discussion in the office with use of preferred names, pronouns and gender identity when talking with a patient, to non-surgical medical management, to surgical management.

Gender-affirming care can include non-surgical care, such as hormone therapy, speech therapy and mental health services; and surgical care, including facial reconstruction surgeries and “top” surgeries, to help people transition to their self-identified gender.

Non-surgical gender-affirmation therapies

• Hormone replacement therapy, which involves minimizing feminine or masculine characteristics, while promoting the opposite. Hormone therapy allows for redistribution of body fat, changes in body and facial hair and changes in muscle mass to promote either feminizing or masculinizing changes in the body. Hormone therapy includes the use of testosterone, estrogen/progesterone as well as hormone blockers in some cases to help with these body changes.
• Speech therapy, which may include changes to your habitual speaking pitch, inflection, articulation and nonverbal communication.
• Mental health therapy, which may include exploring gender identity, assistance with coming out and social transition or preparation for gender-reassignment surgery.

Gender-affirmation surgeries

After hormone therapy has been continued for at least 6-12 months, patients may consider surgical procedures. Recovery time from a gender-affirmation surgery varies, depending on the procedure.

For transgender patients who want to become parents, reproductive options, such as egg or sperm banking and pregnancy, should be discussed prior to medical management and surgical procedures that could reduce their future reproductive options.

• Facial reconstruction surgery, which includes a variety of surgical procedures to create more masculine or feminine features and may address reshaping of the nose, eyebrows, cheeks, forehead, jaw, Adam’s apple and more.
• Chest or “Top” surgery refers to surgery that removes or enlarges breast tissue, and then reshapes the chest to create a more masculine or feminine appearance.
• Hysterectomy, which removes the uterus. Oopherectomy, or removal of the ovaries, depends on each patients’ needs.
• Orchiectomy, which removes one or both of the testicles and may include total removal of the scrotum, as well.

Gender affirmation can be a lengthy process. Prior to gender-affirming procedures, patients may be required to have a mental health evaluation to assess their readiness to undergo the physical and emotional stress of the transition, and whether they are suffering from gender dysphoria. It’s also important to understand the risks and benefits of all gender-affirmation therapies and surgeries. Talk to your doctor about your needs and desired outcomes to determine which options are right for you.

If you or a loved one are considering gender-affirming care, Summa Health’s Pride Clinic offers both surgical and non-surgical approaches. We’re proud to provide high-quality, compassionate care for all patients regardless of sexual orientation or gender identity. Learn more about gender-affirmation care and talk to your provider about treatment that best fits your individual needs and desired outcomes as you transition.

For more information, contact Summa Health’s Pride Clinic or call 234.867.7740 to schedule an appointment.