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How to Schedule Virtual or In-Person Consultation at the GCC

Pre-Surgery Consultations with the GCC (Gender Confirmation Center)

The first step for many of our patients in getting gender affirming surgery is booking a surgical consultation. Patients that live in the San Fransisco Bay Area can request to have an in-person consultation with one of our board-certified plastic surgeons. We also offer virtual consultations since many of our patients need to travel from out of town to access highly experienced, board-certified plastic surgeons who specialize in gender-affirming care. You can initiate this process by filling out our consultation request form.

Once you have filled out the form, a patient care coordinator (PCC) from our office will reach out to you about next steps. You will be given access to our online, secure patient portal where you can communicate with our patient care team. We ask that patients are ready to communicate to us which procedure(s) you are interested in and how you plan on paying for your surgery so we can support you to secure insurance coverage and/or connect you with financing resources if necessary.

Are consultations free with the GCC (Gender Confirmation Center)?

Yes! At the GCC, we do not charge patients for consultations, virtual or in-person, with our surgeons. We recognize that many trans, non-binary and gender non-conforming patients experience immense financial barriers to accessing medically necessary gender-affirming care. In addition to offering our consultations free of charge, we provide a free insurance concierge service that has successfully secured insurance coverage for over 90% of interested patients. To request a consultation today, click here.

Recently, our practice has experienced several last-minute cancellations and no-shows to consultations. This has a negative impact on our community’s ability to access medically necessary, gender-affirming care.To reduce last-minute cancellations, rescheduling and no shows, we will:

1. Require our Patient Care Coordinators (PCCs) to follow-up with patients more diligently to remind them of their consultation dates and times.
2. Implement a system to deprioritize the scheduling of prospective patients who have canceled, rescheduled or were a no-show for their consultations on multiple occasions.
3. PCCs will work closely with patients to help them complete all the required documentation before surgery. Candidates with completed documentation will be prioritized to schedule a consultation.

Step 1: What documents are required to undergo surgery?

Our practice uses the informed-consent model for most of our procedures. That said, patients who are interested in bottom surgery and/or getting insurance to cover their surgery will need to present certain documentation as a prerequisite for undergoing surgery. The following documents are not required to schedule a consultation; however, patients that have the following documentation ready will be prioritized to schedule a consultation. Please note that our patient care coordinators (PCCs) can help walk you through the process of acquiring these documents if you need help.

Patients who are interested in having their insurance cover their procedure(s): 

• First, a support letter from a mental health professional should be provided so that we can move forward with requesting coverage from your insurance. Second, if GCC (Gender Confirmation Center) surgeons are not considered in-network providers by your insurance plan, you will need a referral letter from your primary care provider.
• Please note that if you are interested in bottom surgery, you will need to present two support letters. At least one should come from a licensed mental health professional. The second can come from a mental health or a healthcare provider: for example, an endocrinologist or primary care provider who has been involved in your hormone therapy.
• We recognize that the two-letter insurance requirement can be an extra barrier for patients to access medically necessary, gender-affirming care. For this reason, once you have requested a surgical consultation, we can help you through securing this documentation.

‘Cash-pay’ patients who will be financing their surgery without insurance:

• Per the WPATH’s Soc 8 guidelines, patients interested in bottom surgery will need to present one support letter from a licensed mental health professional to be eligible for surgery. Dr. Ley does not require support letters for patients
• Dr. Ley does not require that patients present a support letter to undergo a bottom surgery revision procedure. Whether or not you underwent your initial bottom surgery procedure with her, the support letter eligibility requirement will be waived.

Step 2: Patient Information and Clinical History Forms

To get the most out of your consultation with GCC surgeons, we ask that you review and fill-out the “Patient Information” and “Clinical History” forms. Once you have submitted photos, completed your patient information and clinical history forms, our office will contact you to schedule a consultation. If you need to email, fax or mail any documentation to our offices, please use the following address:

The GCC (Gender Confirmation Center)

450 Sutter Street, Suite 1010

San Francisco, CA. 94108

Fax: (628) 867-6510

info@genderconfirmation.com

Step 3: Uploading your photos before a virtual consultation

GCC surgeons will need to evaluate the physical appearance of the part(s) of your body you would like to get surgically modified. For patients coming in for a virtual consultation, you will need to upload photos onto our secure, virtual patient platform. Your photos should be taken in good lighting with a neutral, solid background. We need front and side photos (left and right), as well as 45 degree diagonal photos. If you are interested in top surgery (a chest reconstruction, breast reduction or breast augmentation) and/or body contouring, please consult this guide for taking photos. If you are interested in gender affirming facial surgery, please consult this guide for taking preoperative photos.

Making the most out of your consultations and pre-operative visit

The consultation process is about building trust and a good rapport with GCC surgeons as well as having all your questions answered. Virtual consultations can be carried out over the phone or through video conferencing. During your consultation, it is important to be honest about your goals and expectations. You should also come prepared to discuss your medical history.

Likewise, we encourage patients to bring in pictures that resemble the results they would like to get out of surgery. Having pictures can help advance the conversation about which techniques would be best to use to help you achieve your gender affirmation goals, and determine if you are a good candidate for those procedures.

After your consultation, if GCC surgeons feel that you are a good candidate for surgery, your PCC will contact you with (1) a quote for your procedure or more details about the insurance approval process and (2) further planning details for your procedure, such as travel and accommodation information.

It is important to note that most patients must arrive in the San Francisco area within a day or two of their procedure for a pre-operative visit. Following surgery, patients who have come in from out of town will be asked to stay in the San Francisco Bay Area for at least 7 days post-op to monitor their health–though this period of time varies depending on the procedure. We encourage you to ask your surgeon during your initial consultation how long you should stay in the San Francisco Bay Area for your unique procedure.

Getting the insurance approval process started

If you are interested in having insurance cover your gender affirming surgery with the GCC, you can get started on sending us the necessary information to your PCC. Patients that can provide this documentation will be prioritized in scheduling a surgical consultation. Please note that our insurance advocacy team or insurance consierge offers its services free of charge to all interested patients. The followoing information will help us solicit insurance coverage for your procedure:

• Full Legal Name
• Full Preferred Name
• Preferred Pronouns
• Date of Birth
• Procedure(s) you are looking to have covered
• Scan of your insurance card (both front and back)
• Therapist and/or Doctor letters of support for your surgical procedures. You can read about the requirements for these letters here.
• Best telephone contact number (please verify if it is okay to leave a message)

Set-Up your virtual or in-person consultation with one of our expert surgeons

Are you ready to take the next step? Fill out the consultation request form on our website. If you have any questions about surgical consultations, you can also call our San Francisco office at (415) 780-1515 or (844) 780-1515. You can reach us between 9am and 5:30pm Pacific Standard Time, Monday through Friday. We look forward to helping you on your journey!