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The Center of Excellence for Transgender Health (CoE) combines the unique strengths and resources of a nationally renowned training and capacity building institution, the Pacific AIDS Education and Training Center (PAETC), and an internationally recognized leader in HIV prevention research, the Center for AIDS Prevention Studies (CAPS), both of which are housed at the University of California San Francisco, one of the top five medical research and educational institutions in the United States. The mission of the CoE is to increase access to comprehensive, effective, and affirming health care services for our trans communities.

The efforts of the CoE are directed toward improving the overall health and well-being of transgender individuals by developing and implementing programs in response to community identified needs. CoE projects include community perspectives by actively engaging a national advisory body (NAB) of 14 transgender identified leaders from throughout the country. The collective experience of our diverse and talented NAB assures that our programs address issues that are timely and relevant to the community. To learn more about specific programs, please follow the CoE Programs link.

Needs assessment studies conducted in major cities across the United States since the late 1990s have shown that access to primary health care is highly problematic for many transgender and transsexual people. (See Bockting and Avery, Eds. [2005])

This protocol was created within the Department of Family and Community Medicine at the University of California San Francisco. It remains a work in progress, and will be annotated and/or updated when new data is available and validated. This protocol is intended to serve two purposes:

  • Provide accurate, peer-reviewed medical guidance. This protocol was developed under the supervision of eight physicians with extensive experience in treating transgender patients.
  • Provide a resource. This protocol contains references to additional materials that may be accessed for further study and shared with other provider colleagues and support staff to improve treatment capabilities as well as access to care for transgender patients.

Many physicians can learn a great deal about transgender care directly from their patients; however, patients may receive inaccurate information through community grapevines or other non-medical sources. Physicians are encouraged to review the existing medical research and clinical practice guidelines developed by a small number of treatment centers, and to be alert to new developments in this emerging field. (See section References)

Professional associations such as the World Professional Association for Transgender Health,, and the Gay and Lesbian Medical Association,, both of which hold biennial or annual symposia, and provider networks, which are informal and newly developing, are recommended sources for professional development in this field. It should be noted that this protocol is not a substitute for the WPATH Standards of Care (SOC), which describe diagnostic criteria and minimal, flexible guidelines concerning eligibility for certain transition-related treatments. Providers treating trans people who are undergoing or have undergone transition-related treatments should become familiar with the WPATH SOC, which is currently in its 6th edition, with edition 7 (a significant revision) anticipated to be released in the fall of 2011.