Gender-affirming care is a term that covers a range of health care services and other interventions aimed at supporting and affirming a person’s gender identity when they do not align with the gender they were assigned based on their apparent sex at birth . This can include social, behavioral, medical and psychological choices.
Social Confirmation
One type of gender-affirming care is social affirmation. This can be achieved at any time when a person adopts a gender-affirming name, pronouns, hairstyle, clothing, toilets and/or other facilities.
Sex-affirming hormone therapy
Gender-affirming hormone therapy (GAHT) involves testosterone hormones for people who wish to develop what are traditionally considered “male” characteristics and estrogen hormones for those who wish to develop “female” characteristics.
GAHT promotes the development of secondary sex characteristics in the body. For people taking testosterone, this includes the development of a deeper voice, redistribution of body fat away from the hips and thighs, increased body and facial hair, increased muscle mass, and changes in (or possible cessation of) menstruation. On the other hand, for people taking estrogen and testosterone blockers, this includes redistribution of body fat to the hips and thighs, breast development, reduced muscle mass, and slowing of body and facial hair growth.
Gender confirmation surgery
Gender Affirmation Surgery (GAS) refers to surgeries that aim to help people change their body parts to match their gender identity. There are several types of GAS, including breast or “top” surgery, genital or “bottom” surgery, and facial reconstructive surgery.
Breast GAS involves removing breast tissue for a more masculine appearance or enhancing breast size for a more feminine appearance.
Genitourinary/Reproductive System GAS can refer to a variety of different surgical procedures. For transgender people, options include bilateral orchiectomy (removal of both testicles) and colpoplasty (the surgical creation of a vulva with or without a vaginal cavity). Options for transmen include hysterectomy (removal of uterus and cervix), salpingo-oophorectomy (removal of fallopian tubes and ovaries), metoidoplasty (creating a penis by enlarging the clitoris and using surrounding tissue). , and phalloplasty (the creation of a penis through the use of tissue from other parts of the body).
Facial reconstructive surgery can include any surgery to change aspects of one’s head and neck to create more feminine or masculine features.
Psychological Counseling or Therapy
Psychological counseling with a professional experienced in working with transgender and gender diverse patients can be a helpful way to deal with challenges you may face during transition or in one’s daily life. Some challenges may include discrimination, the financial burden of gender-affirming care, difficulties finding quality care and gender-affirming insurance coverage, unsupportive family members or friends, etc. Here are some resources for finding psychological support:
For more information on this topic, read these publications from ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Open Access Sexual Medicine:
Development of a Decision Aid for Genital Sex Affirmation Surgery in Transmen
Evaluation and treatment of gender dysphoria in preparation for gender confirmation surgery
A simple guide to simple orchiectomy in transition-related surgery
Bibliographical references:
Hadj-Moussa, M., Ohl, DA, & Kuzon Jr, WM (2018). Evaluation and treatment of gender dysphoria in preparation for gender confirmation surgery. Sexual Medicine Reviews, 6(4), 607-617.
Bureau of Population Affairs. (2022). Gender-affirming care and young people.
Siira, M., Getahun, D., Silverberg, MJ, Tangpricha, V., Goodman, M., & Yeung, H. (2023). Satisfaction with current hormone therapy and goals for additional gender-affirming care in transgender adults. The Journal of Sexual Medicine, 20(4), 568-572.
