6 Examples of Non-surgical Trans Affirmative Health Care

Sexual Health

6 Examples of Non-surgical Trans Affirmative Health Care

Ash Team

Trans affirmative health care can refer to surgeries such as facial feminization or phalloplasty, but there are many non-surgical procedures that also fall under the umbrella of trans health care, some of which can be performed remotely through store and forward telemedicine or other forms of telehealth. Access to non-surgical care can be crucial for trans and gender noncomforming patients to lead happy, healthy lives. Not all transgender people select surgery or non-surgical care options, but may choose some combination of the two.

Mental Health 

Transgender patients, in particular transgender people of color, may have trouble accessing mental health services due to lack of insurance — 18% of LGBTQ+ adults of color have no health insurance coverage, compared to 8% of all adults — or stigma. Mental health services are important for transgender patients throughout their gender journey. In the United States and elsewhere, rates of suicidal thoughts are much higher for transgender adults than the general population. Remote providers can not only diagnose transgender people with gender dysphoria, which can be a requirement for receiving other forms or gender-affirming care, but also support patients with comorbidities like depression and anxiety. 

STI Testing 

Transgender women experience high rates of HIV and bacterial STIs. This is a result of medical and social factors such as inadequate testing practices, stigma, and medical discrimination. In addition to the risk of AIDS, untreated bacterial STIs can produce a range of debilitating symptoms. STI testing is the first step along the care continuum, but some testing services don’t provide gender-affirming care structures for transgender patients. 

In remote STI testing, the processing lab requires a set of validating information known as a requisition. The requisition ties the order to the patient with basic information like name and sex. This is sometimes confusing for transgender people who do not identify with their sex assigned at birth. It can also lead to misrepresented results, when a reference range is tied to sex without context. Transgender and gender nonconforming patients benefit from testing services that differentiate between sex and gender. 

Chat with Ash Wellness about our gender-inclusive lab testing API for STI testing. 

Laser Hair Removal 

For some transgender patients, laser hair removal can reduce the need for daily grooming to appear clean shaven. Transgender women often seek removal of hair on the ​​face, neck, or genital area, and transgender men sometimes get laser hair removal on the forearm in preparation for a phalloplasty. Access to laser hair removal for transgender patients is expanding, but not yet consistent, so some transgender people may encounter financial barriers to care.

Hormone Therapy 

Hormone therapy is another common type of non-surgical gender affirming care. Sometimes described as a “second puberty,” hormone therapy impacts physical, emotional, sexual, and reproductive health. It can amplify certain sex characteristics while reducing others. Although changes may vary from patient to patient, transgender women and transfeminine people can expect to grow breasts, lose muscle tone, and experience body hair thinning. Transgender men or transmasculine people on testosterone may experience voice changes, oily skin, and more muscle definition. A Stanford study suggests that transgender patients who started hormone therapy as teenagers have better mental health in adulthood as a result.  

Speech Therapy 

Speech therapy is a popular health care option for transgender women and transfeminine people, which can be performed remotely through video chat. Speech therapists can help patients alter style of speech and voice to help them feel more comfortable and communicate in a way that matches their gender identity. In certain circumstances, speech therapy can help transgender people avoid harassment and mitigate other safety issues. 

Puberty Blockers

Puberty blockers, also known as puberty suppression or hormone blockers, are medications that can temporarily pause or delay the physical changes that occur during puberty. They are typically used as a medical intervention for transgender adolescents who experience gender dysphoria. These medications are reversible, meaning that if a patient decides to discontinue their use, puberty will resume its natural course. Conversely, if an individual continues with puberty blockers, they will not progress through puberty until the medication is ceased.


Health care providers should care about trans health issues because it aligns with the broader goals of improving health care access, addressing health disparities, and promoting inclusivity and social equality. Digital health companies in particular have the opportunity to play a pivotal role in advancing trans health care by leveraging technology, innovation, and a patient-centered approach. Check out our How to Support Trans Patients in Health Care blog for more information. 

Reach out to talk about how at-home testing from Ash Wellness can reach marginalized patient populations like transgender adults.

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