Legally, under the healthcare policies in place during the Obama administration, you cannot be denied coverage for appropriate healthcare services due to your gender marker (e.g., pap smears for transgender men, prostate exams for transgender women, etc.). It is possible for these protections to be weakened and/or repealed. Keep an eye on the law & any changes to these protections.
Places to get affirming care
MyTransHealth.com allows you to search for medical, legal, mental health, and crisis intervention service providers in Chicago, Dallas, Miami, New York City, San Francisco, and Seattle. There’s also an option to search for sliding scale payment services.
Trans-Health.com provides a directory of clinics in Canada, the United States, and the United Kingdom, with experience in providing healthcare services, including primary medical care as well as support services, to transgender persons.
RAD Remedy (Referral Aggregate Database) features providers around the United States and elsewhere that are trans (and queer) affirming, including those that provide care related to transition. It allows the option to search for sliding scale providers.
For those who need financial support for health care (and/or ID documents), the Trans Assistance Project may be able to help.
Hormone replacement therapy (HRT)
The proper medical & legal route to acquire hormone replacement therapy is to find a trans-affirming provider who can work with your health & finances to provide you with the care you need. Taking hormones not written for you by a medical provider who knows your medical history and can monitor your labs may violate the law and/or could be potentially harmful to your health. It is important to properly follow medical guidelines given by your healthcare provider when taking hormone replacement therapy.
Planned Parenthood prescribes hormone replacement therapy. Clinics may offer trans health care services on a sliding-scale basis and/or with financial assistance for covering the costs.
Acquiring medical supplies
You may ask your health care provider to code your visit and/or hormone prescription differently, which may help in dealing with insurance companies that will not pay for gender-affirming care.
Online pharmacies may be an easier & cheaper option for filling prescriptions. Nerd Wallet explains certain things to consider when looking into opting for an online pharmacy.
Some places which are said to be trans-friendly are:
The GoodRX app & website offers coupons & discounts on prescriptions, and shows the costs for different pharmacies around you. You can use this service with or without health insurance coverage. You must have a valid prescription from a doctor first. This service works with all types of prescriptions.
Needles & syringes
Laws permitting sale of needles & syringes without prescriptions are typically dealt with at the state level, and may vary by state. Intramuscular and/or subcutaneous syringes may be obtainable.
Needle & syringe exchanges may be a good source of clean needles & syringes. Each will have its own rules for getting needles; your mileage may vary. The North American Syringe Exchange Network (NASEN) provides a directory of syringe exchange programs.
For Healthcare Providers
Cardea Services offers a Resource Center with educational tutorials on various topics, including several that are relevant to providing LGBT+ affirming health care. These tutorials are free-of-charge and may provide continuing medical education (CME) & continual nursing education (CNE) credits. Relevant tutorials include: