Services

Care Services

With a comprehensive range of services, care can be tailored to support transgender and nonbinary patients in every step of their personal journey.

Hormonal Care

Every transgender and nonbinary person has their own unique journey. Montefiore provides several options for patients to receive the hormonal care that’s most appropriate for them.

Primary Care

Many choose to receive gender affirming hormone therapy through their primary care physician.

Specialized Approach

For those whose hormonal care may be more complex or for those who prefer a specialty approach, our Endocrinology Department has providers specializing in gender affirming hormones. This program is led by Dr. Vafa Tabatabaie, a renowned endocrinologist who has been instrumental in developing the TC@M for the past 5 years.

The Oval Center at Montefiore

For youth 16 years of age and older, The Oval Center at Montefiore offers a discreet, comfortable and convenient setting for all things related to sexual health, including:

  • Gender-affirming hormone care
  • Letters of support or referrals for surgeons
  • Short or long-term mental health counseling, including biopsychosocial and psychiatric evaluations
  • Case management, including legal affirmation support
  • Gynecological services
  • Psychotropic medication management

HIV and STI Care

HIV Prevention and STI Care are also available, as well as primary care and mental health care for individuals living with HIV.

 

To schedule an appointment or learn more, please call 718-960-2476
or email TransWellness@Montefiore.org

 

Gender-Affirming Surgery

For those seeking gender-affirming surgical transition, we offer personalized coordinated care in a safe and compassionate environment.

The Team

The team is dedicated to serving the TGNB community and providing the highest level of service to patients seeking surgical reconstruction. Dr. Lee and Dr. Lawrence Draper are members of the World Professional Association for Transgender Health (WPATH).

 

We consult closely with you to determine the care that will best support you in reaching your personal transition goals. Procedures are tailored to each patient, with dedicated care provided through the departments of:

  • Plastic Surgery
  • ENT
  • Urology
  • OB/GYN
  • Oral and Maxillofacial Surgery

Surgical Procedures

We offer a broad range of surgical procedures with minimally invasive techniques available:

Trans female

Facial feminization (including tracheal shave)

There are many surgical techniques that can create a more feminine appearance to the face. This may include reducing structures such as the brow bone/forehead, nose, jawline, chin and Adam’s apple (tracheal shave), or moving the hairline forward. This can be performed in one or multiple stages, depending on each person’s anatomy and desires.

Voice feminization

This short outpatient procedure shortens the vocal cords to produce a higher vocal pitch. This is most effective when combined with voice therapy to also develop a more feminine cadence and manner of speaking.

Breast augmentation

This procedure enhances the breast tissue through the use of implants. It is recommended that estrogen and/or progesterone have been utilized for about 1-2 years before (and is insurance dependent) to allow for as much natural growth as possible. This also provides a breast tissue envelope in which to place the implant.

Orchiectomy

Surgical procedure to remove the testicles. This is a short, outpatient procedure for those looking to remove testosterone production and the need to take T-blockers.

Penile inversion vaginoplasty

This is the standard technique for transwomen interested in vaginoplasty. In one operation, the genitalia is reconfigured to create a feminine appearing vulva (external appearance) with a clitoris, labia majora and minora, urethral opening and vaginal opening/canal. The skin from the phallus and scrotum will be used to line the neovaginal canal, the testicles will be removed, the urethra shortened and a clitoris will be created from some of the tissue of the head of the penis. It will be necessary to dilate the vagina after surgery to prevent the canal from narrowing while it heals. You will need to dilate the vagina forever, however the frequency will decrease over time. You will be given a set of dilators after your surgery. While this procedure is done initially in one operation, healing can be variable and some people will require a second stage “touch up” to improve aesthetics or function.

Vulvoplasty

Also known as the “zero depth” procedure, this is similar to penile inversion vaginoplasty except it does not include the creation of the vaginal canal. This option is for those that are not interested in receptive sexual intercourse, maintaining the vaginal canal with dilation or who may not otherwise be surgical candidates for the creation of a vaginal canal.

 

Trans male

Facial Masculinization

There are several surgical techniques that can masculinize the face. This is typically achieved by selectively augmenting certain areas of the face such as the forehead, jaw, nose, and adam's apple. This is performed by using of special filler material or implants. Procedures include, but are not limited to, jaw implants, chin implants, forehead implants or filler, nasal augmentation, Adam's apple augmentation, and more.

Chest Masculinization

To create a masculine appearance to the chest, breast tissue is removed. Depending on your pre-surgical breast tissue volume, the technique and scars will vary, as well as being able to preserve your nipple tissue or needing to remove and replace the nipple. You will speak with your surgeon about what is the best option for you and what you can expect for scars during consultation.

Hysterectomy

Removal of the uterus is typically the first step in transmasculine genital gender-affirming surgeries. This surgical procedure can be done laparoscopically (minimally invasive) or through the vagina. You can discuss with your OB/GYN whether or not you want to remove one or both of your ovaries (salpingo-oophorectomy) at the same time.

Metoidioplasty

This procedure uses the genital tissue you have to create a penis. Typically, after 1-2 years of testosterone, the clitoris enlarges enough to enable reconstruction into a penis. This is a less invasive procedure than phalloplasty, and can include extending the urethra to the tip of the penis to permit standing to void. There are many variations that can also include removing the vagina (colpectomy) and creating a scrotum (scrotoplasty). If testicular implants are desired, this is performed in a second stage with a secondary revision of the scrotum as well.

Phalloplasty

This procedure creates a penis using skin and fascia from other parts of your body. This procedure is more complex than metoidioplasty and is typically performed in a series of surgeries to try and reduce complications. The two main tissue donor sites are the forearm or the thigh. You can discuss with the surgical team which is the best approach for you. You will need to have any hair removed via electrolysis from the donor site. Some of the surgical steps include making the penis out of the skin and grafting it to the pubic area, extending the urethra from its natural location to the graft (urethral lengthening), removing the vagina (colpectomy), creating a scrotum (scrotoplasty), and inserting testicular implants as well as a prosthesis for penetration. This is a complicated set of procedures which can have high complication rates, but can also have high patient satisfaction if appropriate expectations are set.

Vaginectomy

Removal of the mucosal lining of the vagina, with closure of the space. This is typically only performed after a hysterectomy; otherwise surveillance of the cervix for cervical cancer cannot be performed.

 

To schedule an appointment or learn more, please call 718-960-2476
or email TransWellness@Montefiore.org

 

Mental Health

Behavioral Health Services

We offer a comprehensive range of services for gender diverse patients seeking mental health treatment.

Adult Patients

For patients 18 years of age and older, we offer services from the Moses Adult Outpatient Psychiatry Division at 111 East 210th Street, Bronx, NY.

Note: All services are currently provided via telehealth.

  • Psychiatric evaluations
  • Evidence-based psychotherapy offered for a wide-range of mental health concerns
  • Medication management
  • Readiness evaluations for gender-affirming hormone treatment, electrolysis and surgery
  • Support and education for legal transition

Pediatric and Youth Patients

For patients under 18 years of age, we offer services from the Moses Pediatric Psychiatry Ambulatory at 3340 Bainbridge Avenue, Bronx, NY.

Note: All services are currently provided via telehealth.

  • Psychiatric evaluations
  • Evidence-based individual and family therapy
  • Medication management
  • Readiness evaluations for puberty-suppressing hormone blockers
  • LGBTQ+ parenting support group (child must be enrolled in behavioral health services)
 

For more information, please call 718-960-2476 or email
TransWellness@Montefiore.org or ssibers@montefiore.org

 

Voice Therapy

We offer gender-affirming voice therapy to help transgender, nonbinary and gender expansive people better align their voice and communication with their gender identity. Voice therapy can be used in isolation or before and after voice feminization.

Training Your Voice

As speech-language pathologists, we work with each client to assess and modify the aspects of communication that most strongly influence how gender is perceived. This includes vocal pitch, resonance, articulation, intonation, fluency and pragmatics. Our experienced clinicians are mindful of the challenges that many of our clients face daily and the impact that these barriers may have on communication.

 

TGNB Youth

To serve the needs of TGNB youth and their families, Children’s Hospital at Montefiore (CHAM) proudly offers gender-affirming care.

Caring for Families

We provide a supportive and safe environment for families and minors while they explore the care that’s right for them. Here, you’ll find pediatricians specializing in adolescent medicine and endocrinology, and offering expertise in:

  • Pubertal blockade
  • Gender-affirming hormone care
  • Psychosocial support
  • Mental health assessment and treatment, case management, referrals for surgical care, and support via individual or group counseling
  • Family counseling and support.

Gender Dysphoria

Some children may need care for gender dysphoria when they are still too young for medical interventions. For these families, our team offers consultations with parents to learn about the landscape of gender management. These services are provided at both CHAM and the Hartsdale practice.

 

Division of Adolescent Medicine

Adolescents and young adults deserve age-appropriate care suited to their specific medical needs, in an environment where they are heard and respected as partners in their own healthcare. The Division of Adolescent Medicine provides TGNB care for teens and young adults (13-20 years old). Our team includes trans-affirming medical, nursing, social work and mental health providers. The division also provides further counseling and support in coordination with the Umbrella Program at their Bronx location.

 

The Umbrella Program

The Umbrella Program at the AIDS and Adolescent Center is a unique and comprehensive program for LGBTQ+ youth ages 13-24 and their families. Based in the Bronx, the program includes a team of medical, nursing, social work and mental health providers. Medical care is provided under the direction of Donna Futterman, MD, as well as mental health counseling and supportive services to all LGBTQ+ youth ages 13-24 regardless of HIV status.

 

For more information, please call 718-960-2476 or email
TransWellness@Montefiore.org

 

OB/GYN Care

Our gynecology providers are available at various sites throughout the Bronx. We welcome every transgender and nonbinary patient seeking care. Routine preventive care, screening and family planning can be addressed by LGBTQ+ friendly providers in an inclusive, safe and sensitive setting.

Routine Preventive Care

Family planning Pap tests, and other routine preventive care are offered by our LGBTQ+ friendly providers in an inclusive, safe and sensitive setting.

Surgical Procedures

Minimally invasive surgery and counseling are available including hysterectomy, oophoretomy and urogynecological surgery.

Reproductive
Endocrinology

Reproductive Endocrinology doctors are available for counseling and management of fertility preservation options.

Obstetrics Care

Prenatal and high-risk obstetric care is available for transgender and nonbinary individuals along with preconception counseling. We work closely with you to ensure a positive experience in the office and on the labor and delivery unit.

 

For more information, please call 718-960-2476 or email
TransWellness@Montefiore.org