Gender Affirming Care

At Lavender Spectrum Health, we offer gender affirming care. We believe in an informed-consent model of care for transgender hormone therapy. That means we are not here to gate-keep access to gender affirming care.  We are knowledgeable of present guidelines, such as WPATH, and can provide supportive letters that meet these guidelines.

What is gender affirming care?

Gender affirming care is healthcare that is given to people whose gender differs from the gender they were assumed to be at birth. The term for people whose assumed gender at birth is different than their true gender is transgender. Gender affirming care may include many things, including but not limited to counseling, use of hormones, and surgeries. These treatments allow transgender people to have the appearance, body parts, and other features that support and affirm their gender.

Gender affirming care is known to be medically necessary and helpful to transgender people by many professional medical organizations, including the World Health Organization, the World Professional Association for Transgender Health, the American Psychological Association, and the American Medical Association.

What we can do for gender affirming care:

A model of an estrogen molecule and its structure.

Estrogen Therapy

Lavender Spectrum Health provides gender affirming care with estrogen therapy for transgender, non-binary, intersex, two spirit, and gender non-conforming individuals. Estrogen is typically prescribed in the form of injections, patches, or tablets. Typically, estrogen therapy is prescribed alongside a testosterone blocker, and sometimes is accompanied by progesterone. Common goals of estrogen therapy include body fat re-distribution, skin softening, breast development, body odor changes, libido changes, and emotional changes. We help manage complications from estrogen therapy, including erectile dysfunction. We can also help find sperm-banking services prior to initiating estrogen therapy to preserve fertility. Estrogen therapy requires periodic laboratory monitoring; we partner with Quest Diagnostics for laboratory services. 


A picture of a testosterone molecule with its structure.

Testosterone Therapy

Lavender Spectrum Health provides gender affirming testosterone therapy for transgender, non-binary, intersex, two spirit, and gender non-conforming individuals. For transgender hormone therapy, testosterone is typically prescribed in the form of injections, patches, or gel. Common goals of testosterone therapy include voice deepening, increased muscle mass, body fat re-distribution, growth of facial and body hair, and "bottom growth" (clitoromegaly). We help manage complications from testosterone therapy including treating acne and vaginal dryness. Testosterone therapy requires periodic laboratory monitoring. We partner with Quest Diagnostics for laboratory services. 


Other Gender- Affirming care


Numbing Injections


Click here to learn more!

What We Can't Do:

Resources



Here are some support group resources in Portland and Vancouver for LGBTQ+ issues:

https://transfem.group/

https://www.nwgenderalliance.org/

https://www.childrenshomesociety.org/clarkcowlitz

https://www.pflagswwa.org/

https://www.pdxqcenter.org/groups

https://pflag.org/chapter/portland-2/

Here are some mental health resources I like in Vancouver and Portland where the clinician have experience with neurodivergence and/or LGBTQ+ identity, but please contact them as many places periodically open and close to different insurance companies:

Portland:

Rebel Heart (counseling)

Full Spectrum PDX (counseling)

Portland Mental Health & Wellness (counseling & medication management)

Willamette Health & Wellness (counseling & medication management)

MedRx Partners (medication, ketamine, TMS)

Portland Therapy Center (medication)

Portland DBT Institute (DBT groups)

Northwest DBT (DBT groups)

Integrative Trauma Treatment (trauma counseling)

Vancouver:

Wild Heart Society (counseling

Maitri Mental Health (counseling

A Better Way Counseling (counseling)

MedRx Partners (medication, ketamine, TMS)

Spectrum Mental Health (medication)

TMS NW (TMS)

A Skillful Life: DBT

Associates for Psychiatric & Mental Health (Intensive Outpatient)


Here are some good options for sperm banking:

Legacy - Sperm Banking via telehealth

OHSU - Sperm Fertility Cryopreservation 

Oregon Fertility Institute


Here are my favorite injection teaching videos for how to do subcutaneous hormone injections

https://www.youtube.com/watch?v=ApWiQH4rzlA

https://www.youtube.com/watch?v=DJd02xCNNc0


Here is our favorite video for intramuscular injections


https://www.youtube.com/watch?v=FgCCO9Gqt1Q


If labs were ordered for you during your visit, please schedule yourself for blood tests for labs at Quest Diagnostics. Plan to bring yourself, your ID, and your insurance card to your lab appointment.

Please get labs done fasting, meaning nothing to eat or drink except water or medications for 8-12 hours. This is easiest done if you avoid eating after midnight and get labs done before breakfast. This will allow me to get accurate cholesterol and blood sugar testing. If you are on hormone injections, please schedule your labs about 3-4 days after an injection if possible.

Please also check your supplements and stop any that contain biotin 3 days before lab work. Biotin interferes with many blood test results. Biotin can be found in multivitamins, b-complex vitamins, and "hair skin and nails" vitamins.

Also if you are having hormone labs draw, it takes 10-14 days for testosterone results to come back, so please ensure you have your blood drawn done with enough time for your results to come back before your follow up appointment. 

https://appointment.questdiagnostics.com/schedule-appointment/as-reason-for-visit

Select "all other tests" as your reason for visit

As a reminder, it is your responsibility to understand your insurance coverage of any lab tests ordered during your visit. You can contact your insurance company and provide them with the diagnosis codes and lab codes if you are unsure of your benefits.

Options for PrEP include Truvada (daily or on-demand), daily Descovy, or injectable Apretude every 2 months. 

Here are some PrEP resources:

https://www.cdc.gov/hiv/risk/prep/index.html

https://doh.wa.gov/you-and-your-family/illness-and-disease-z/hiv/prevention/pre-exposure-prophylaxis-prep

If you are interested in learning more about  DoxyPEP for prevention of bacterial sexually transmitted infections, here is some information about it:

https://howardbrown.org/service/doxypep/

Here are the WA Medicaid guidelines for trans health services as well as in network providers.

Gender Affirming Treatment

Other gender-affirming treatments are covered directly by Apple Health fee for service and not by your managed care plan. Apple Health fee for service is also known as ProviderOne (teal-colored card). Use your ProviderOne services card when accessing these services. Services must be provided by an Apple Health approved and enrolled provider. There are different requirements depending on what service you want to have performed.

General requirements

Criteria

Breast augmentation

Providers

The following providers offer top surgery (breast augmentation) to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

Mastectomy

Providers

The following providers offer top surgery (mastectomy) to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

 

Hysterectomy and Orchiectomy

Providers

The following providers offer surgery to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

hysterectomy

orchiectomy

Full bottom surgery

Providers

The following providers offer full bottom surgery to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

Hair Removal

Providers

The following providers offer hair removal to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

 

Facial Feminization

Providers

The following providers offer facial feminization surgery to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

 

Gender Affirming Voice Surgery Criteria

Required Documentation

Providers

The following providers offer voice modification surgery to treat gender dysphoria for Apple Health clients. The names given here are not recommendations based on care provided or provider preference. 

You can see any Apple Health enrolled provider that performs the procedure you are seeking. To get started, call the enrolled provider you are interested in seeing and schedule a consultation. Consultations do not require prior approval. The provider will need to get a prior authorization for the gender affirming treatment.

Transportation services

You may be eligible for help with transportation to your health care appointments at no cost to you. If you need help to find transportation, please call 1-800-562-3022 or visit the transportation services webpage to find a transportation broker for your county. Contact a broker 7-14 days before your appointment. Requests to your broker less than two business days before your appointment may not be scheduled.

You can find more information about the Apple Health Transhealth Program on client webpage for the Transhealth Program.