How to Choose a Gender-Affirming HRT Provider

Starting HRT can be exciting, emotional, and sometimes overwhelming. Whether you’re just beginning to explore your options or feel ready to start, choosing the right HRT provider is an important first step.

This guide will walk you through what HRT is, what HRT providers do, and how to find a provider that fits your needs.

What is HRT, or GAHT?

Hormone Replacement Therapy (HRT), also known as Gender-Affirming Hormone Therapy (GAHT), is medical care that uses hormones, like estrogen or testosterone, to help align your body with your gender identity.

For many trans and non-binary people, HRT is a life-changing part of their transition. It’s also deeply personal, and there’s no single “right” way to pursue or experience it. (We talk about this and more in our guide on what to consider before starting HRT.)

What does an HRT provider do?

An HRT provider is a licensed medical professional (such as a doctor, nurse practitioner, or physician assistant) who is trained to provide gender-affirming hormone therapy. They can:

• Prescribe and manage your hormones
• Order and review lab work to monitor your health
• Provide letters for legal name or gender marker changes, or surgery referrals
• Support you through the physical and emotional changes of HRT

Some providers offer in-person care, some are fully virtual (telehealth), and some offer a mix of both.

Things to consider when choosing a provider

In-person vs. telehealth

• Telehealth may be a great option if you live in a rural area, face transportation barriers, or prefer care from the privacy of home. Providers like Plume, Folx, Queermed, QueerDoc, TrueU, Spectrum: the Other Clinic, and Outpatient Family Medicine Transformed offer HRT through telehealth.
• In-person care might be the better choice if you already trust a local clinic, or if you need help managing other health conditions. Some primary care providers offer HRT, or you might be referred to a specialist like an endocrinologist.

Cost and insurance

• Does the provider accept your insurance?
• Do they offer payment plans, cash-pay discounts, or sliding scale fees?
• If they use a membership model, what’s included? (Lab work, office visits, prescriptions?)
• Will you be required to use a specific pharmacy?

Gender-informed and inclusive care

• Does the provider have experience working with transgender and non-binary patients?
• Has this provider independently sought education on gender affirming care?
• Most importantly, do you feel safe, respected, and affirmed when you talk with them?

Wait times and access

• How soon can you schedule your first appointment?
• Are follow-ups easy to book, or are there long delays?
• Are there barriers in your state that might limit access?

What to expect at your first appointment

The first visit usually includes a review of your health history, discussing your HRT goals, and covering the possible risks and effects. 

Feeling nervous is completely normal. White coat anxiety is real!  But your voice matters, and it’s okay to take your time, ask questions, or pause if you need to. You deserve a provider who helps you feel at ease.

A few other things to know

• Lab work is a standard part of HRT care, even with telehealth providers. You’ll need to visit a local lab so your provider can monitor your hormone levels and overall health.
• HRT looks different for everyone. Some changes happen within months; others take longer. Some effects that you’re hoping for may never come at all. Talking openly with your provider can help set realistic expectations and prepare for the unexpected.
• It’s okay to switch providers if the one you’re seeing doesn’t feel like the right fit.

Feeling comfortable with your provider matters

The right provider can make a big difference in how supported and confident you feel in your care.

During your HRT journey, there are some necessary vulnerable moments. You will need to share openly about how your body is changing, what emotions you’re experiencing, and what goals you’re hoping to reach. That honesty helps your provider adjust your care to fit you best.

Consistency is very important to ensure your prescriptions and lab work stay on track. If you don’t feel safe or supported, it can lead to missed appointments, delayed care, or additional stress that you shouldn’t have to carry.

HRT is often a long-term journey, and it may take time to find the right fit.

You deserve affirming, accessible care

You deserve care that honors who you are. Whether you’re just beginning or continuing your journey, your provider should help you feel empowered, safe, supported, and seen. Take your time, ask questions, and remember: You’re not alone.

(Need help affording HRT? Learn about Point of Pride’s HRT Access Fund, a scholarship-like program for trans folks who cannot afford or otherwise access it.)