What to Know About Gender-Affirming Care

Medically Reviewed by Traci C. Johnson, MD on March 09, 2024
3 min read

Gender-affirmation care refers to treatments, ranging from surgery to speech therapy, that support a transgender or nonbinary person in their gender transition.

Transgender people identify with a gender different from the one they were assigned at birth. Nonbinary people have gender identities that fall outside the categories of male and female.

Transition looks different for each person. But generally, the goal of gender-affirmation care, sometimes called gender-affirming care, is to help your outward traits match your gender identity.

Which gender affirmation therapies you choose will differ depending on your own goals. Some nonsurgical treatments you can get are:

Laser hair removal: A skin doctor (dermatologist) uses a low-energy laser on your hair follicles (the small holes in your skin from which hair grows). Hair won't grow back once it's removed this way. You may need a series of treatments, each lasting a few minutes to a few hours, depending on the size of the area being treated. Your doctor will probably ask you to stop any other hair removal methods 6 weeks before treatment starts.

Masculinizing hormone replacement therapy: In this treatment, a doctor gives hormone medications to lessen female traits and promote male ones. You may notice:

  • More muscle mass
  • More body and facial hair
  • Lower voice
  • Changes in how you sweat and smell
  • Changes in where fat collects in your body
  • Hairline recession or baldness
  • Higher sex drive
  • Growth of the clitoris
  • Vaginal dryness
  • You no longer have periods

Feminizing hormone therapy: This is where a doctor gives you hormone medications to lessen male physical characteristics and increase female ones. You may notice:

  • Breast growth
  • Changes in where fat collects in your body
  • Less muscle mass
  • Less body hair
  • Changes in how you sweat and how you smell
  • Changes in sex drive
  • Changes in penis function (less frequent or firm erections)
  • Lower sperm count
  • Less sexual fluid at orgasm
  • Smaller testicles

Voice and communication therapy: A trained speech and communication therapist can help you change aspects of how you speak to better conform with your gender identity. These changes can improve mental health and quality of life. They might include changes in:

  • The pitch of your voice
  • How quickly you speak
  • How loudly you speak
  • The quality, or “resonance,” of your voice
  • Your inflection, or changes in pitch as you speak
  • How you pronounce words and phrases
  • How you take part in a conversation
  • How you communicate in nonverbal ways (such as body language and facial expressions)

Mental health care: You face many issues when you establish a new gender identity. Should you get sex-reassignment surgery? How do you prepare mentally for the change? How do you deal socially with the transition? What about family, friends, and support systems?

A mental health specialist can help you explore different approaches to your transition. It may help to find one who specializes in transgender care.

Reproductive counseling: Feminizing or masculinizing hormone therapy can limit your fertility. So it’s key to get reproductive counseling before you start hormone therapy or have surgery to change your reproductive organs.

Gender-affirming surgical treatments are divided broadly into 2 categories: male-to-female surgeries, and female-to-male procedures.

Common surgeries include:

  • Facial reconstruction surgery: This can make your face look more feminine or masculine. You might get injections to enhance your cheekbones or surgery to soften or sharpen your chin. The surgeon can also make changes to your nose or jawline.
  • Chest and breast surgery: In “top” surgery, the surgeon may remove breast tissue for a flatter, more masculine chest. Or, they could enhance the shape and size of your breasts to make them look more feminine.
  • Gender affirmation surgery: Sometimes called “bottom” surgery, these procedures transform and rebuild your genitals to come as close as possible in appearance and function to those of your gender identity.

Recovery after gender-affirmation surgeries varies greatly, depending on your health and the type of procedure. Your doctor can tell you what to expect.