The Comprehensive Gender Services Program (CGSP) at University of Michigan Health helps transgender, gender nonconforming, and nonbinary adults access and obtain the highest quality gender affirming medical care.
Our team of medical providers includes physicians from the following areas:
- Dermatology
- Endocrinology
- Family Medicine
- OB/GYN
- Otolaryngology
- Plastic Surgery
- Speech and Language Pathology
- Urology
In addition, our team of mental health clinicians includes clinical social workers who have many years of experience working with people of diverse gender identities.
Our team believes that identifying with a gender that is different from one’s sex is a normal part of the human experience, and that people with all gender identities, including agender, non-binary and gender queer identities, deserve equal access to the highest quality care.
CGSP providers at University of Michigan Health are members of the World Professional Association for Transgender Health (WPATH), and medical and mental health services are provided consistent with the WPATH Standards of Care.
Follow this link for Child & Adolescent Gender Services
How CGSP Supports Patients
CGSP acts as a central hub for gender affirming care at University of Michigan Health. Patients in our program can contact us directly to ask questions, check in on where they’re at in process for receiving care, or to get information on specific services offered by University of Michigan Health. CGSP also accepts and reviews letters of support that patients may need for clinical services.
How to Get Started with CGSP
You do not need to have a doctor's referral to get started with CGSP. You can call or email us to request a Service Inquiry Form (SIQ). This will be used to either create a chart for you or update an existing one. CGSP will also send you information packets based on the services you’re interested in.
All gender affirming surgeries require one or two support letters from a licensed provider (depending on your insurance and the surgery desired). If you need assistance finding a letter writer, please contact our office.
General Process for Having a Gender Affirming Surgery
This is a general list of steps that happen before having a gender affirming surgery at University of Michigan Health. This might be slightly different for different procedures, but they all generally follow the same process.
For more specific information you can submit a Service Inquiry Form (SIQ) to CGSP to receive information packets. If you have already filled out that form you can call CGSP.
Wait times can vary depending on the service you are interested in and our providers' capacity. If you would like an estimate, please call CGSP. You can generally expect the whole process from submitting your support letter to surgery to take 8 months to over a year depending on the procedure. If you are requesting multiple procedures those processes can be happening at the same time.
- Submit a Service Inquiry Form (SIQ) to CGSP. After you submit the form, you will hear back from CGSP in the method you requested in 1 to 2 weeks. You will be provided with a list of your next steps and information packets for each of the services you requested. If you requested information be sent through email, make sure that CGSP’s email address is not being filtered into your spam email box. If you requested information to be sent back through the mail add an extra 1 to 2 weeks to the time for it to be processed by CGSP and moved through the mail system.
- Submit your letter of support from a mental health provider. The information packet you received from CGSP will include a checklist of what must be included in that letter. Depending on your insurance provider and surgery you may need two letters of support. Letters of support must be dated within a year of your surgery date. Please make sure your letter lists all the services you're interested in. You do not need an individual letter for each service if you are requesting multiple consultations. If you need assistance finding a letter writer, you can contact CGSP for resources. If you want to call CGSP to confirm we received your letter, please wait a week to do so. That will give your letter time to move through our system to a point where we can confirm we received it.
- CGSP reviews your letter of support to make sure it includes all of the required information being requested by surgeons and insurance providers. Once CGSP has your letter, it will go through an internal review process to prepare it for insurance prior authorization.[HA3] CGSP wants to make sure your letter includes all the required information. If your letter needs revisions, CGSP will contact your letter writer directly for the revisions. This process can take up to a month depending on CGSP’s capacity and the volume of letters we receive.
- Once your letter of support is reviewed and marked as ready, CGSP will contact you about scheduling a consultation. CGSP’s first preference for contact is through your patient portal. CGSP will send you a registration email for the patient portal during your intake. If you need a new registration email sent to you, please contact CGSP. Be sure to have notifications turned on for your portal account so you do not miss a message from CGSP. If you do not have your patient portal set up, CGSP will reach out by phone using the number listed on your Service Inquiry Form.
- After hearing from CGSP about your letter of support, call CGSP to schedule your consultation. Your wait time for consultation will depend on the specific doctor’s schedule.
After your consultation, the rest of the process will be handled by departments outside of CGSP. Your main point of contact will be the department performing the surgery. If you need the contact information for that department you can contact CGSP for the number. - After your consultation appointment, your support letter will be submitted to your insurance provider for prior authorization. The length of time it takes for prior authorization to be approved varies by insurance provider.
- Once prior authorization is approved, a surgery scheduler will contact you to schedule your surgery. You can generally expect to have your surgery 3 to 6 months after your consultation.
Insurance Information
CGSP is not able to recommend particular insurers or plans. If you have questions about your insurance coverage for gender affirming medical care, please contact your insurance company directly.
While we can inform people about the insurance plans that are accepted for payment at University of Michigan Health (and most plans are accepted) just because this plan is accepted, doesn't mean that this plan covers all gender affirming medical services. In order to know what your insurance plan will cover, it is necessary to call the insurer and ask them directly. In order to ensure accurate information from the insurer, it is sometimes advisable to obtain a copy of the Plan Documents and/or Summary of Benefits and Coverage.
Contact Information
Comprehensive Gender Services Program
4250 Plymouth Rd
Ann Arbor, MI 48109
Phone: 734-998-2150
Fax: 734-998-2152