Transgender, Gender Non-Conforming, Non-Binary and Gender Expansive Health

Transgender, gender non-conforming and non-binary people may have unique health needs. They should receive care that is affirming, respectful and considerate of their health concerns and goals.

In New York City, it is illegal to discriminate on the basis of a person’s sexual orientation, gender identity or gender expression in public accommodations, including in health care settings.

You have the right to advocate for your health needs and ensure that you are receiving the care that is most appropriate for you.

Defining Gender Terms

Gender identity is different from sexual orientation, such as straight, gay or asexual. The following terms are popular but not the only ones that are used. A person's identity may reflect one or more of the following terms, or none at all.

  • Transgender: A person whose gender identity differs from their sex assigned at birth.
    • Trans Woman: A person whose sex was assigned as male at birth but identifies as a girl or woman. May use female pronouns and titles, such as "she" and "Ms."
    • Trans Man: A person whose sex was assigned as female at birth but identifies as a boy or man. May use male pronouns and titles, such as "he" and "Mr."

  • Gender Non-Conforming: A person whose gender expression does not reflect conventional expectations of a man or woman.

  • Non-Binary: A person who does not identify as a boy/man or girl/woman.

  • Two Spirit: A term used by some Indigenous people to refer to a person who identifies as having both a masculine and a feminine spirit. It can be used to describe sexual, gender or spiritual identity.

  • Cisgender: A person whose gender identity aligns with their sex assigned at birth.

For more information, see Trans Student Educational Resources: The Gender Unicorn. This infographic illustrates the differences among gender identity, gender expression, sex assigned at birth and sexual orientation.

Mental Health

Due to stigma, discrimination and abuse experienced by transgender, gender non-conforming, non-binary and other gender expansive people, these groups are more likely to have depression, anxiety, suicidal thoughts and trauma.

There are services available to help New Yorkers:

  • NYC Well: Free, confidential support, crisis intervention and referral service for anyone seeking help for mental health or substance misuse concerns. NYC Well is available 24/7, 365 days a year.

  • Trans Lifeline: A trans-led hotline that connects trans people to the community support and resource needed to survive and thrive. The hotline is available 24/7.

  • The Trevor Project: Provides free crisis intervention and suicide prevention services to LGBTQ+ teens and young adults.

  • NYC Anti-Violence Project: Help for survivors of intimate partner violence, domestic violence, abuse or other crimes.

Community Support Resources

In addition to the local services listed below, you can find affirming care by visiting the NYC Health Map.

Affirming Legal Services (serving all boroughs)

Bronx

Community Support

Housing

Brooklyn

Community Support

Manhattan

Community Support

Queens

Community Support

Staten Island

Community Support

Gender Affirming Surgery and Procedures

For transgender, gender non-conforming and non-binary people who decide to medically transition, gender-affirming procedures may be part of the process. For those who decide to pursue such procedures, there are options to support their gender expression and transition-related goals. Not all transgender, gender non-conforming and non-binary people choose to undergo gender-affirming procedures as part of a medical transition.

There are procedures to reconstruct external genitals, such as vaginoplasty, orchiectomy, phalloplasty and metaoidioplasty.

You can also get procedures to increase or reduce the size of your breasts or chest, reconstruct your face, reduce an Adam's apple or change the pitch and resonance of your vocal chords.

Some transgender, gender non-conforming and non-binary people may seek illegal or medically unsupervised gender-affirming procedures and products. These procedures may be illegally performed by someone who is not licensed to practice medicine. This can be dangerous, as it can lead to poor or adverse outcomes, both short and long term, and even death.

For the best possible outcome and for your safety, visit a board-certified plastic, reconstructive or cosmetic surgeon. Any medical intervention should be supervised by a licensed practitioner to ensure appropriate follow-up and care. Speak to your provider about options that may be available to you and for help navigating the process.

If you do not have a provider or insurance, visit the NYC Health Map for health insurance enrollment assistance or to find an affirming provider.

For more information, visit Johns Hopkins Medicine: Gender Affirming Surgery FAQs.


Sexual Health

The key to sexual health for people of any gender expression is open and honest communication with your partner and health care provider.

Learn more about how you can have a safe and pleasurable sex life with your partner(s):

The following sexual health tips are specifically for transgender, gender non-conforming and non-binary people.

Safety, Pleasure and Comfort

Transgender Men and Transmasculine People

  • For some transgender men who engage in receptive frontal sex, taking testosterone may affect natural lubrication, so be sure to use water-based lubricant to increase comfort and pleasure and minimize the risk of injury.

  • Transgender men should get regular chest exams, internal pelvic exams and pap smears.

  • Douching is discouraged for people who have vaginas that were not constructed by vaginoplasty. It can disturb the natural bacteria there and possibly cause bacterial vaginosis.
  • If you have frontal sex with cisgender men without a condom, you can become pregnant, despite taking testosterone. Discuss your contraception options with your provider and your partner(s). You can also consider using condoms.

Transgender Women and Transfeminine People

  • Transgender women who have had a vaginoplasty should use a water-based lubricant for receptive frontal sex.

  • After vaginoplasty, dilation is an important part of the immediate and long-term care. It can also make vaginal/frontal sex more comfortable and lessen the chance of injury.

  • For people who have undergone vaginoplasty, when screening for sexually transmitted infections, be sure to self-collect or have your provider collect swabs of the vagina.

  • People who have had a vaginoplasty may still need to have prostate exams.

  • Transgender women who have not had bottom surgery and who have cisgender female partner(s) may still get their partner(s) pregnant. Discuss contraception options with your provider and your partner(s). You can also consider using condoms.

Transmasculine, Transfeminine, Non-Binary and Other Gender Expansive People

  • Transmasculine, transfeminine, non-binary and other gender expansive people who engage in receptive frontal sex are susceptible to yeast infections.

  • For people who have had a vaginoplasty, periodic vaginal douching is recommended during the immediate post-op period. It may also be helpful in the long term. Talk to your provider about what works for you.

Additional Resources

More Information