The comprehensive services offered through the Center for Transgender and Gender Diverse Health include connecting transgender patients with primary care providers across Johns Hopkins Medicine who are trans affirming. These providers can manage a patient’s general health care needs as well as specific transgender-health-related needs such as initiating and managing hormone therapy in most cases. Our primary care team members are vital partners in providing holistic care that leverages the resources of our academic medical health care system.
Services and Appointments for Adults
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.
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Our Team
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Services for Adults
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Dermatologists at the Center for Transgender and Gender Expansive Health perform laser hair removal for both aesthetic reasons and as preparation for some surgeries.
During laser hair removal, a dermatologist uses a low-energy beam laser, which results in long-term or permanent hair reduction and removal. Usually, a series of laser hair removal appointments are recommended for best results. Discuss an individualized plan with your dermatologist.
Patient Resources
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In cases where hormone therapy is not enough to achieve desired gender affirming changes to the face, surgery can help. Feminizing facial surgery includes a variety of procedures, such as reshaping the nose; brow lift (or forehead lift); chin, cheek and jaw reshaping; Adam’s apple reduction; lip augmentation; hairline restoration; and earlobe reduction. Masculinizing facial surgical options including hairline reshaping, jaw augmentation, and thyroid cartilage enhancement are also available.
Watch to learn more about feminizing facial surgery.
Watch to learn more about masculinizing facial surgery. -
Our specialists at the Fertility Center coordinate with the Center for Transgender and Gender Expansive Health to provide services for gender affirming fertility preservation, reproduction assistance and contraception. It is recommended that you consider speaking to a specialist before undergoing hormone treatment to review how gender-affirming hormone therapy may affect your fertility options.
Patient Resources
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Our specialists in Geriatric Care coordinate with the Center for Transgender and Gender Expansive Health to provide the highest quality clinical care to improve the health of older adults and society.
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Gyn/Ob specialists provide preventive, gender- affirming gynecologic care throughout your life. This may include routine annual exams/cervical screening for transgender and gender diverse individuals, sexuality and sexual health care, the management of benign gynecologic disorders, transitioning and gender affirmation including menstrual suppression, trauma informed pap smears, local anesthetics for IUD placement and counseling when appropriate. The department also specializes in shared decision making for family planning, care during pregnancy, childbirth and the postpartum period for transgender and gender diverse individuals.
Patient Resources
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The Center for Transgender and Gender Expansive Health partners with endocrinologists and primary care providers. Both endocrinologists and primary care providers work with each patient to prescribe either gender-affirming hormone treatments. Hormone treatments can be part of a pre-surgical plan, or be a stand-alone service, depending on your desired outcomes. Talk to your doctor about the process and any side effects that you can expect.
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Hysterectomy includes the removal of the uterus and ovaries (oophorectomy). Many gender patients are seeking gender affirming hysterectomy as part of their gender journey. Other patients have preexisting conditions such as fibroids, or endometriosis.
Options for oocyte storage and fertility preservation are also available if desired. See eligibility requirements. See surgical timeline
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The Department of Psychiatry and Behavioral Sciences partners with the Center for Transgender and Gender Expansive Health (CTH) to provide mental health services through the expertise of the Sex and Gender Clinic. Assessments for surgical readiness are available. These involve the completion of a comprehensive mental health evaluation, following WPATH guidelines. Other services include recommendations for ongoing care such as support and guidance preoperatively and postoperatively as well as treatment for co-existing mental health conditions. Support and education for families and significant others are further aspects of the team’s services. The aim of the collaboration between CTH and Psychiatry is to maximize the health, well-being and quality of life of transgender and gender diverse individuals.
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Metoidioplasty is a surgical procedure for gender affirmation that is sometimes called a meta procedure or bottom surgery. It is an alternative to phalloplasty.
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Our pelvic health physical therapists are specially trained to evaluate and treat different types of pelvic floor dysfunction and treat a variety of pelvic floor symptoms after performing a complete assessment to best suit your needs. They can also assist with pre and post-operative exercises for genital surgery, and assist with dilation teaching.
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Phalloplasty can include removal of the vagina (vaginoplasty), reconstruction of the urethra, scrotoplasty, penile and testicular implants, and penile construction. Surgeons will use tissue from another part of the body to construct the penis. See eligibility requirements. See surgical timeline.
Patient Resources
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Top surgery is surgery that removes or augments breast tissue and reshapes the chest to create a more masculine or feminine appearance for transgender and nonbinary people. See eligibility requirements. See surgical timeline.
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At the Center for Transgender and Gender Expansive Health, you will receive care from doctors in the Johns Hopkins Department of Urology who have experience in the range of gender-affirming surgeries.
The urology team works closely with the Department of Plastic and Reconstructive Surgery and other members of our integrated team to provide the most up-to-date gender affirmation procedures and ongoing care. Services provided include robot assisted vaginoplasty, orchiectomy, and insertion of penile prostheses. Follow-up visits with urology are available for prostate screening or urological issues. See eligibility requirements. See surgical timeline.
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This surgical procedure is a single stage procedure during which our skilled surgeons may remove the penis (penectomy) and the testes (orchiectomy), if still present, and use tissues from the penis to construct the vagina (vaginoplasty), the clitoris (clitoroplasty) and the labia (labiaplasty). See eligibility requirements. See surgical timeline.
Patient Resources
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The Center for Transgender and Gender Expansive Health works with otolaryngologists who specialize in voice therapy, which some transgender individuals find beneficial. Intervention is designed to meet the individual needs of the person who is transitioning and may include diagnostic evaluation, treatment or surgical intervention. Our team works together to assist in the voice transition. Specifically, we provide a supportive and guided environment to maximize total communication, including aspects of voice such as conversational pitch and inflection, as well as nonverbal communication.
The initial evaluation will include a case history and assessment of voice and speech prosody. All clients are initially screened for any laryngeal pathology to ensure optimal vocal fold health. An individualized treatment plan is created with the client based on the assessment findings and the client’s perceived needs. Some aspects the voice pathologist may choose to address include:
- Habitual speaking pitch
- Resonance
- Inflection (the melodic ups and downs of the voice)
- Rate of speech (how fast or slow the person speaks)
- Non-verbal communication
- Volume/intensity
- Articulation
- Prosody
- Pragmatics (social rules of communication)
Sometimes, voice therapy alone is not enough to achieve your desired outcome. In cases like this, vocal cord surgery is an option and is usually done as an outpatient procedure. Talk to your doctor about surgical options to achieve the vocal identity that is right for you.
Insurance coverage for voice therapy often differs among providers. It is important for the patient to be familiar with their specific contract coverage for this service.
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.
- Chase Brexton
- Whitman Walker
- Johns Hopkins Community Physicians
- East Baltimore Medical Campus
- Johns Hopkins University Student Clinics
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).
Surgical Readiness Letter
All letters must be completed with the Johns Hopkins template. The template can be found on the Johns Hopkins Center for Transgender and Gender Expansive Health's Patient Resources page. Once on the page, click on the first link titled: Evaluation and Letter of Support for Gender Affirming Surgery
Do not copy or recreate the template — the official fillable template must be used and completed in full by a qualified mental health provider.
Gender affirming surgery is only offered to patients aged 18+.
Medical Records
Please send your most recent office visit notes (not the after-visit summary) or annual physical. Please note that records must contain notes from a visit within the last year.
Referral for Specialty Services
Depending on your insurance provider, a referral may be needed from your PCP. Please reach out to your insurance to determine if a referral for specialty services is needed. If needed, please have your Primary Care Provider send us a referral to: Johns Hopkins Center for Transgender and Gender Expansive Health. Diagnosis code F64.9.
Next Steps
All documents must be submitted through MyChart (to the Social Worker or Surgical Team member) or faxed to 410-367-2055. Once all required documents have been received and processed, our team will be happy to assist you with scheduling your consultation. Please allow up to 3 weeks for review and processing. Following document review, you will be contacted regarding next steps for scheduling.
