Requirements to Receive Hormone Treatment:
  1. Do I need to undergo any psychological counseling or social evaluation before receiving treatment?

    No, we do not require psychological counseling or social evaluation to receive hormone treatment. Our program follows an informed consent model.

  2. Do I need to provide a documented RLE/RLT before receiving a hormone prescription?

    No, we do not require you to provide documentation of a completed RLE/RLT. Our program follows an informed consent model.

  3. What is informed consent?

    Informed consent asks you to consider the expected benefits and the possible side effects of hormone therapy, so that you can decide with your medical provider, if hormone therapy is right for you. When you sign the Informed Consent Form, you will be stating that you have discussed the risks and benefits with your medical provider or a member of the medical team and that you understand how these benefits and risks apply to you personally.

Appointment & Follow-Up Process for Monitored Hormone Care:
  1. How do I make, change or cancel an appointment for monitored hormone therapy?

    Family Health Centers of San Diego
    Call (619) 255-7743 for an appointment and provide a reason for your call (i.e., hormone treatment, HIV testing, STD/STI screening, Hepatitis care, PrEP, primary care, injection teaching, etc.).

    For questions, contact our Transgender Care Coordinator, Tracie O'Brien, at (619) 906-4521.

    Vista Community Clinic
    Call (760) 631-5000 x7000 for an appointment. Prospective transgender patients must first participate in an initial phone consultation. Phone consultations will be provided Sergio Luna (x 7188).

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  2. What should I expect during the registration process as a new patient?

    Family Health Centers of San Diego
    Please arrive at least 20 minutes before your scheduled appointment in order to discuss your insurance information.

    • If you have insurance, please bring all insurance information with you.
    • If you do not have insurance, we can schedule an appointment for you to visit our care coordinator, who can assist with insurance enrollment (Medi-Cal).

    Vista Community Clinic
    As a new patient, you must first participate in an initial phone consultation, which will include discussion of the following topics:

    • Your preferred gender pronouns (PGP)
    • Level of care (e.g., hormones, mental health, etc.)
    • Payment for services
    • HIV screening  
    • Possible referrals to the North County LGBTQ Resource Center for support services

    Phone consultations will be provided Sergio Luna (x 7188).

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  3. What should I expect during my first visit?

    Family Health Centers of San Diego
    You will need to fill out:

    • Registration Form
    • Medical History Form
    • Advance Directive
    • Privacy Act Form

    Your visit with the medical provider may include any or all of the following:

    • Consultation
    • Discussion of existing health conditions (if any)
    • HIV testing and/or STD/STI screening
    • Possible baseline lab work
    • Discussion of your Five-Year Plan

    Vista Community Clinic
    If you are interested in pursuing hormone replacement therapy, you can expect the following to occur during the initial visit:

    • Discuss your clinical goals
    • Review effects of hormones, including reversible, partially reversible and irreversible
    • Discuss fertility and family planning
    • Discuss mental health
    • Test for HIV and STIs
    • Informed Consent

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  4. Are there any fees?

    Family Health Centers of San Diego accepts most insurance plans including Medi-Cal and many of our patients qualify for programs that may offset the total cost of their care.

    • If you have no insurance, there will be a $25 fee, which only covers your visit with the medical provider.
    • If you have insurance, a co-payment will be required for your visit/s.
    • Continuing visits with a medical provider will be based on a sliding fee scale.
    • Nursing visits will also be based on a sliding fee scale.
    • Labs that are required by your provider will be an additional fee. *Note: Labs may be covered by your insurance.
      • Most PPO out-of-network insurance may cover a portion of the cost while the patient is responsible for the rest of the cost.

    Medi-Cal, Medi-Cal carriers and HMO insurance can cover labs when FHCSD is chosen as the Primary Care Provider (PCP).

    Vista Community Clinic
    If uninsured, the Health Educator will work with you to determine payment for services. If insurance is not desired or inaccessible, payment for services will be determined using VCC’s sliding fee scale for office visits and labs. VCC’s sliding fee scale ranges from $45-58.

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  5. When are hormones prescribed?

    Family Health Centers of San Diego
    Hormones are generally prescribed on your follow-up visit AFTER your labs have returned and the doctor has a chance to review them. This allows the medical provider the opportunity to review the results of your lab work, address any pre-existing health conditions, as well as discuss any other concerns/issues that may arise.

    Vista Community Clinic
    You will not receive a prescription for hormones at the initial visit. Prescription of hormones is at the discretion of the medical provider and will be based on medical history, exam, laboratory results and psychosocial assessments.

    Hormone prescriptions are available through Hillcrest Pharmacy or your pharmacy of choice.

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  6. What do the follow-up visits include?

    Family Health Centers of San Diego

    • Further discussion on issues from first visit
    • Follow up on existing health conditions (if any)
    • Discussion of treatment options
    • Further development of your Five-Year Plan
    • Hormone prescriptions
    • Periodic blood work
    • Legal documents (i.e., California DMV ID gender marker change, U.S. Passport Gender Change, etc.)

    Vista Community Clinic
    Follow up visits will typically be scheduled every three months.

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  7. What can I do if I run out of meds?

    Family Health Centers of San Diego providers generally prescribe a three-month supply of hormones. Therefore, please make every effort to return on time to your three-month appointment. This helps to avoid any problems or frustrations that may occur when running low or fully out of hormones.

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  8. What happens if I miss my three-month appointment?

    If you miss your appointment at Family Health Centers of San Diego and do not call to cancel, the next available appointment may not be until three (3) months out.

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All About PrEP:
  1. What is PrEP?

    PrEP, short for pre-exposure prophylaxis, is a once-daily pill, available by prescription, for people who do not have HIV that has been found to be very effective at reducing the risk of getting HIV. The FDA has only approved one drug for use as PrEP, which is sold under the brand name Truvada.

  2. Should I consider PrEP?

    PrEP is for people who do not have HIV currently to help reduce the risk of getting HIV in the future. It is intended for use by anyone at risk of being exposed to HIV through sex or injecting drugs. PrEP provides added protection for someone whose partner has HIV.

    People who use PrEP must commit to taking it every day and seeing their health care provider for follow-up appointments and testing every three months. PrEP is currently approved for people who are 18 years of age and older.

  3. How effective is PrEP?

    PrEP has been shown to reduce the risk of getting HIV by more than 90 percent. It is important to take PrEP exactly as prescribed by your doctor. According to the CDC, PrEP reaches maximum protection from HIV for receptive anal sex at about 7 days of daily use. For all other activities, including insertive anal sex, vaginal sex, and injection drug use, PrEP reaches maximum protection at about 20 days of daily use. Condoms should be used for added protection and to protect against other sexually transmitted diseases (STDs). Consult with a health care provider to confirm the appropriate protocol.

  4. Where can I get PrEP?

    Family Health Centers of San Diego

    Hillcrest Family Health Center
    4094 4th Avenue San Diego, CA 92103
    Monday - Thursday: 8:00AM - 9:00PM
    Friday: 8:00AM - 5:00PM
    For appointments: (619) 255-7743

    We invite community members to also visit our HIV Prevention Center (located at 4040 30th Street San Diego, CA 92104) to meet with a dedicated and knowledgeable Case Manager, receive HIV treatment and prevention services, information and more.

    Vista Community Clinic
    HIV primary care and support services are available at VCC: Grapevine. 

    VCC: Grapevine
    134 Grapevine Road Vista, CA 92083
    Monday, Wednesday - Friday: 8:00AM - 5:00PM
    Tuesday: 8:00AM - 7:30PM
    For more information, call: (760) 631-5000 x7000

  5. Can I afford PrEP?

    Most health insurance plans — including Medicaid, Medicare, and my private insurance plans– cover PrEP. There are also payment assistance programs available for people who are insured or uninsured.

  6. What if I'm under 18 years old?

    For anyone under 18 years old, you have the right to get tested for HIV and STIs in all 50 states (and D.C.) without a parent’s consent. And in many states, PrEP is accessible for youth under 18 without a parent’s consent. If you think your parent(s) may be supportive of you utilizing these services, consider including them in your decision-making process. If they’re not supportive, or you don’t feel comfortable sharing, you still have options to access HIV/STI testing as well as PrEP.

  7. Will PrEP interfere with my hormones?

    Good news – there is no evidence that the PrEP medicines (tenofovir and emtricitabine) interact with estrogens (or progestins) or affect the levels of hormones in your body. Available data on PrEP in transgender women suggest that it very effectively prevents HIV in transwomen who take it every day. Please contact us with questions regarding PrEP to see if it’s right for you.

Questions or comments? Have our medical staff contact you.