In 2020, Hollywood star Elliot Page came out as transgender and went on to be the first openly transgender man to be pictured on the cover of Time magazine. In 2021, Laurel Hubbard became the first openly transgender athlete to compete in the Olympics. In 2022, Lia Thomas secured her place as the first known transgender athlete to win an NCAA swimming championship title.
In recent years, influential celebrities including Janelle Monáe, Demi Lovato, Sam Smith, and Miley Cyrus have come out as nonbinary or gender fluid.
There's no doubt about it — over the past few years, the gender expansive community has seen a noticeable increase in visibility. And even with the recent increase of anti-trans bills, an overwhelming majority of people in the US are against anti-transgender legislation, and believe that transgender people should have equal rights.
As people have become more accepting of different gender identities, there have been increased efforts to fill gaps in healthcare for gender expansive individuals. Health systems across the country — including Main Line Health — have been amping up gender-affirming care.
What is gender-affirming care?
Gender-affirming care is a type of healthcare that helps people align the physical and emotional aspects of their life with their gender identity. It's often used to diagnose and treat gender dysphoria, which is intense emotional distress that someone may feel if they were assigned the wrong sex at birth.
At Main Line Health, our gender care program provides both surgical and nonsurgical gender-affirming care to improve the overall health of transgender and gender-expansive people.
"Before coming to Main Line Health, a lot of people have had negative experiences when it comes to gender care. They've felt judged or discriminated against, even by their doctors. We work hard to make sure that when you're here, you are comfortable in your care.
Here are 5 things you might not know about Main Line Health's Gender Care Program.
1. Surgery might be more affordable than you think.
For years, many major insurance companies did not cover gender-affirming surgery. But over the past couple of decades, the number of companies providing coverage has greatly increased.
The scope of coverage can vary from state to state and from plan to plan. Here in Pennsylvania, the state Medicaid policy explicitly covers transition-related care. Private insurance companies might have their own policies, like which surgeries they will cover or how old you have to be to get surgery.
Nonsurgical gender-affirming services, like voice therapy or laser hair removal, also may or may not be covered, depending on your specific plan.
Since coverage isn't always so easy to figure out, our nurse navigator can help you navigate the insurance process. If you don't have insurance, they can also help you look for nonprofit organizations that offer financial assistance, like Point of Pride's Annual Transgender Surgery Fund.
2. Gender care includes mental and behavioral health care.
Gender-expansive people have a higher risk for certain mental health concerns, like depression and substance abuse. That's why mental and behavioral health care are cornerstones of the gender care program.
Our behavioral health specialists can talk through your mental health concerns with you in a safe, nonjudgmental way. They can perform presurgical evaluations and assessments for letters of readiness.
"One thing we focus on at Main Line Health's Gender Care program is access to necessary care. This summer (2022), we're embedding a mental health provider right into the program. This means that our patients will have more streamlined access to a mental health provider for shorter term needs. If you need letters, if you need to talk to someone urgently, if you are in distress from a trauma — you have quicker access to the care you need."
— Katherine Rose, MD, Director, Main Line Health Gender Care Program
Also, LGBTQ behavioral health care services aren't limited to the gender care program. For example, Mirmont Treatment Center has a substance abuse program specifically designed to address the issues that LGBTQ people face that can lead to drug use and affect their mental health.
3. And primary care.
Getting the most out of your primary care requires having a good relationship with your provider. And if you identify as LGBTQ, this is especially important for several reasons.
For example, being open and honest with your provider about things like your sexual activity allows them to provide safe-sex education that pertains to you, or stop asking you about birth control if it isn't relevant.
Or, if you are receiving hormone treatments, your primary care provider needs to know so that they don't prescribe other medications that could interact with the hormones.
At Main Line Health, our Gender Care Program works together with our Inclusive Care Program, which is a team of primary care providers that are passionate and knowledgeable about LGBTQ care, to ensure expert level primary care for gender expansive patients. Providers in this program provide exemplary care for all patients and all gender identities. Since every patient is unique, we can help you find the gender-affirming primary care provider who can meet your personal needs.
A note about confidentiality
Your privacy is important. In addition to confidentiality laws, we have our own policies to protect your privacy. You can rest assured that when you talk to your provider about your gender identity, sexuality, and sexual activity, that information will stay between you and your provider.
Learn more about Main Line Health's patient privacy policies.
4. And many other specialties.
Providers from both medical and non-medical specialties all across the system are integrated into gender affirming care. Depending on your personal needs, you may work with providers in specialties like obstetrics/gynecology, physical therapy, plastic surgery, ENT, speech therapy, and social work.
These providers offer specialty services, including:
- Fertility care and family planning, if you hope to have biologic children and are going to be starting hormone therapy or having gender-affirming surgery
- Vocal training/voice therapy to help you change your voice and speech patterns so they are more consistent with your gender identity
- Gender affirming surgery
- Laser hair removal for body or facial hair
- Pelvic floor physical therapy
- HIV treatment, prevention, and screening
5. We work behind the scenes to ensure that everyone you work with at Main Line Health is aligned with — and respectful of — your gender identity.
The Gender Care Program works with people from across Main Line Health, from clinicians to the legal and billing team, to collaborate on inclusivity and gender affirmation efforts on a systemwide level. For instance, we have made changes in our electronic medical record to support the consistent and regular use of one's chosen name and correct pronouns.
We have also carried these efforts beyond your medical care and into areas like hospital experience and communications. We are currently looking at ways to be more inclusive with our communications, such as eliminating presumed salutations and using chosen names in our written communications.
At the end of the day, our promise — whether it's in the medical care we provide or what you get in your mailbox — is to treat you with respect.