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Center for Transgender and Gender Expansive Health

Services and Appointments

A transgender woman speaks with a doctor.

The Johns Hopkins Center for Transgender and Gender Expansive Health offers comprehensive, evidence-based and affirming care for transgender and gender diverse youth and adults that is in line with the standards of care set by the World Professional Association for Transgender Health (WPATH).

Creating an environment in which our patients and their families feel safe and confident in the care they receive is central to the mission of Johns Hopkins Medicine. The multidisciplinary care team takes careful consideration of best practices and the appropriate provision of care for transgender and nonbinary individuals.

Request an Appointment: 844-546-5645

Services

Services for Adults

Teen places book in a school locker.

Emerge Gender Diversity Clinic

The Emerge Gender Diversity Clinic for Children, Adolescents and Young Adults offers fully integrated and interdisciplinary expertise and clinical services in pediatrics, adolescent and young adult medicine, endocrinology, nursing, social work, child and adolescent psychiatry, and mental health care designed to improve the health and well-being of gender variant, gender diverse and transgender youth and young adults.

Through a collaborative relationship with endocrinology and psychiatry, we work to provide comprehensive services for all youth. Clinical services are available for children, adolescents and young adults up to 25 years old and include education, family and individual support, pubertal blockade, cross-hormonal therapy and mental health support and treatment. The clinic additionally provides referrals for gender affirmation surgery for adolescents and young adults, 18 years and older, according to the Johns Hopkins Center for Transgender and Gender Expansive Health guidelines. 

  • Puberty blockade
  • Cross sex hormones
  • Psychosocial support
  • Complex care needs (e.g., autism spectrum, complex family, etc.)
  • Menstrual suppression and management, family planning services
  • Sexual and reproductive/contraceptive health care sexually transmitted infection (STI), HIV, Pre-exposure prophylaxis (PrEP) testing and care
  • Substance use treatment

Center Collaborators

You are being redirected to websites outside of Johns Hopkins for informational purposes only. Johns Hopkins is not responsible for any aspect of the external websites.

Eligibility Criteria

Our team is committed to providing high-quality, compassionate care that is in line with the standards of care outlined by the World Professional Association for Transgender Health (WPATH), including mental health criteria for surgical services. 

Gender affirming surgery is only offered to patients aged 18+.

Consult Requested Documents Needed for Consult Next Steps Needed to Schedule Surgery
Chest Masculinzation One Mental Health letter

Possible insurance requirement: Referral from PCP 		Schedule a consult appointment with Dr. Liang or Dr. Mundy through JHCTH Medical records, pre-operative physical, pre-operative lab work

No BMI Limit

Potential Insurance Requirements: 2nd MH letter and/or MH letter from a doctoral level MH provider
Breast Augmentation One Mental Health letter and twelve month HRT (estrogen) record.

Possible insurance requirement: Referral from PCP 		Schedule a consult appointment with Dr. Liang or Dr. Mundy through JHCTH Medical records, pre-operative physical, pre-operative lab work

No BMI Limit

Potential Insurance Requirements: 2ndMH letter and/or MH letter from a doctoral level MH provider
Facial Feminization (FFS) One Mental Health letter and a head CT scan.

Possible insurance requirement: Referral from PCP 		Schedule a consult appointment with Dr. Liang through JHCTH Medical records, pre-operative physical, pre-operative lab work

No BMI Limit

Potential Insurance Requirements: 2nd MH letter and/or MH letter from a doctoral level MH provider
Hysterectomy, Ovariectomy, Salpingectomy No Mental Health letter or HRT records required to schedule a consult Schedule an appointment with Dr. Martin Medical records, pre-operative physical, pre-operative lab work

If surgery is being done for primarily gender affirming reasons:

Two Mental Health letters- one from a doctoral level MH provider- and HRT records (if indicated for patient).
Metoidioplasty One Mental Health letter.

Possible insurance requirement: Referral from PCP 		Schedule a consult appointment with Dr. Cohen through JHCTH Medical records, pre-operative physical, pre-operative lab work, possibly previous hysterectomy

BMI <= 30

Potential Insurance Requirements: 2nd Mental Health letter and/or MH letter from a doctoral level MH provider
Orchiectomy Two mental health letters (one from a doctoral level MH provider) and twelve month HRT record.

Possible insurance requirement: Referral from PCP 		Schedule an appointment with Dr. Burnett Medical records, pre-operative physical, pre-operative lab work
Phalloplasty One Mental Health letter.

Possible insurance requirement: Referral from PCP 		Begin hair removal

Schedule a consult appointment with Dr. Liang through JHCTH 		Medical records, pre-operative physical, pre-operative lab work

BMI <= 30

Potential Insurance Requirements: 2nd MH letter and/or MH letter from a doctoral level MH provider
Vaginoplasty One Mental Health letter.

Possible insurance requirement: Referral from PCP 		Begin hair removal

Schedule a consult appointment with Dr. Liang through JHCTH 		Medical records, pre-operative physical, pre-operative lab work

BMI <= 35

Potential Insurance Requirements: 2nd MH letter and/or MH letter from a doctoral level MH provider

Surgical Services Timeline

Intake

It all starts with a phone call.

A transgender woman listens intently while on the phone.

First, call 844-546-5645 for an initial intake interview via phone with a clinical specialist. This is your first point of contact with the clinical team, where you will review your medical history, discuss which procedures you’d like to learn more about and what is required, and develop a plan for next steps.

After intake, you'll receive next steps to schedule a consult appointment. Depending on your specific surgery, you'll likely need to prepare the following documentation:

  • Mental Health Evaluations and Surgical Readiness referral letters from mental health providers documenting their assessment and evaluation
  • Pharmacy records and medical records documenting your hormone therapy
  • Medical records from your primary physician (these will be requested by the clinical team)
  • Information about which prescription and over-the-counter medications you are currently taking
  • Insurance information
Consult

Meeting with your surgeon.

A genderqueer person sits on a couch, talking to a healthcare provider.

The consult will be your first appointment with your new healthcare provider. These appointments typically include:

  • Assessment of your medical health status and readiness for major surgical procedures;
  • Discussion of your long-term gender affirmation goals and assessment of which procedures may be most appropriate to help you in your journey;
  • Specific details about the procedures you and your surgeon identify, including the risks, benefits and what to expect after surgery.

After the consult, you'll receive next steps for scheduling the surgery.

Next Steps

Getting ready for surgery.

After your consult with the surgical team, you will receive information regarding next steps. Next steps can include a variety of things, to include:

  • Medical Clearance tests and/or notes from other providers
  • Additional imaging
  • Updated mental health evaluation letters
  • Hair removal, or other pre-operative readiness

Once all these things have been completed, you will receive a surgery date.

Preoperative Appointment

A preoperative anesthesia and medical evaluation.

Your surgeon may need to meet with you before surgery to finalize your surgical plan and go over any questions you may have before the morning of your procedure. You may also be asked to complete these evaluations at the hospital, which ensure that you are healthy enough for surgery.

Surgery

Your surgery.

A transgender woman wearing a hospital gown sits in an exam room, talking to a doctor.

On the day of your procedure, you'll arrive at the hospital two hours prior to surgery. You will be brought back to the pre-op area where you'll change into a surgical gown and nursing staff will begin your check in. This involves asking questions, taking blood samples, starting an IV for fluids, and monitoring your vital signs with a blood pressure cuff and oxygen monitor.

In addition to the nurse that checks you in, you will see your surgeon, our PA, anesthesiologists, and possibly other surgical attending’s and surgical residents who assist in the operating room. Together everyone works as a team to ensure the best possible outcome.

Read FAQs for more information about what you can expect during your hospital experience at either the Levi Watkins, Jr., M.D., Outpatient Center or the Harry and Jeanette Weinberg Building.

Read more about preparing for gender affirmation surgery

Post-Operative Care

What can you expect after gender affirming surgery?

For specific questions, please refer to the post-operative instructions you received from your surgical team.

If you have any of the following signs and symptoms, please call us: temperature greater than 101.5˚F; redness or rapidly changing shape of the surgical area; pus and/or large quantities of drainage from your incision or drain site; continuing inability to urinate; severe and unremitting pain not relieved by maximum doses of pain medications.

If you have any questions or concerns during regular business hours between 8:00 am and 5:00 pm, please call 844-546-5645 to reach the Center for Transgender and Gender Expansive Health. If you have questions or concerns after regular business hours, please call 410-955-5000 and ask for the “Plastic Surgery Resident On Call” to be paged. A doctor is available and present in the hospital 24/7/365 in case of emergencies.

For life-threatening symptoms such as shortness or breath, difficulty breathing, dizziness or fainting, chest pain, or mental status changes, call 9-1-1 or go to your nearest emergency department immediately.

Long-Term Follow-Up

We're here for you.

A transmasculine person sits on a bench outside.

When you’ve finished the surgical aspects of your gender affirmation, we encourage you to follow up with your primary care physician to make sure that they have the latest information about your health. Your doctor can create a custom plan for long-term care that best fits your needs.

Among other changes, you may consider updating your name and identification. This collection of resources for transgender and gender-nonconforming individuals can help you in this process.

Browse Resources

Patient storyThe Joy of Being Yourself

In a little more than a year, the Center for Transgender and Gender Expansive Health has provided gender affirming surgeries that changed the lives of about 150 people. Here are the stories of best friends Dylan Ballerstadt and Kez Hall, and Dariel Peay.

Read more
A group of transgender individuals smiling.