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These resources offer information about different steps in medical transition someone may consider, including hormone therapy and surgery.

Steps for pursuing hormone therapy (sometimes referred to as hormone replacement therapy), for youth and adults.

Detailed information about masculinizing hormone therapy

Detailed information about feminizing hormone therapy

Guide for self-injecting hormones through the intramuscular technique.


Guide for self-injecting hormones through the subcutaneous technique.


A list of recommended surgeons in or around Portland who offer gender-affirming surgeries (also commonly known as gender confirmation surgery [GCS], sex reassignment surgery [SRS], and others). Providers are organized by type of surgery provided. 

For people seeking support letters for gender-affirming surgeries and can't access letters using insurance or other means: Providers who have signed up for the GALAP project have pledged to provide these letters completely free of costs; check the website for more details and to find local providers who have signed up for the project.

Maximizing Healing: Supporting Surgery with Alternative Medicine is an e-book by Terry Ycasas, D.C., a chiropractor & alternative medicine provider who got top surgery in early 2020. This book offers information about Terry's pre- and post-op healing process with alternative medicine.

A comprehensive planning guide for clients pursuing gender affirming surgeries!  

All rights reserved.  All distributions must retain original formatting and author credits.  

Steps for pursuing top surgery (chest reconstruction and breast augmentation).

Steps for pursuing orchiectomy, hysterectomy,  oophorectomy, vaginoplasty, metoidioplasty ("meta") and/or phalloplasty.

Detailed information about the vaginoplasty procedure through OHSU can be found here.

Are Facial Feminization and Facial Electrolysis covered by OHP? No, AND - OHP has a process for addressing denials and appeals. This means that if you want to try getting Facial Feminization Surgery (FFS) covered by OHP, you have to do the following:

1. Get a primary care doctor's referral to an FFS plastic surgeon or electrologist

2. The surgeon submits a request for an authorization from the insurer

3. Insurance denies it and sends you a notification.

4. Get your two letters from mental health providers that state the information in the above handout.

5. Appeal the denial first at the CCO (like CareOregon), and if that doesn't work, then you appeal at Oregon Health Authority.


This will NOT guarantee that your FFS will be covered; it is the only way to possibly get it covered.

If you want to know what their criteria are for considering an appeal, download the form above. Some of this information should be written in the 2 mental health letters required for this care.  Brave Space can write these letters for you.