top of page


Banners are clickable links.

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

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.

Private insurance denied care?  Here's how to advocate for yourself.



bottom of page