Gender services

What can I expect as a standard of care in accessing services at CrescentCare?

CrescentCare adheres to the evidence-based standards of care that have been established by clinicians and expert professional organizations after decades of clinical experience and research. The standards include a comprehensive, nonjudgemental individualized care from appropriately trained professionals. CrescentCare follows guidelines and recommendations from World Professional Association for Transgender Health (“WPATH”), the Endocrine Society, the Academy of Pediatrics, the American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry, and the U.S. Department of Health and Human Services Office of Population Affairs.  

CrescentCare follows all  State and Federal laws. When you access care with us, we will see you as you want us to see you. Thank you for trusting us with your care.

What name and gender marker will be used in CrescentCare systems?

The name and gender marker associated with your insurance (or ID documents if you are uninsured) will show up in our system. This means you may see your legal name or gender marker show up in writing on your patient portal or medical record. However, we only ever use the name and pronouns you ask us to use while you receive care here. If you do experience any misgendering or misnaming during your visit, we encourage you to notify your provider or to reach out to our gender navigator team. 

My GAHT prescription is not covered by my insurance, and I cannot afford it. What do I do now?

If your hormone prescription is not covered by your insurance or you are uninsured, talk to your provider about this issue during your visit. We may be able to help you access discounted prescriptions via our partner pharmacies.

Visit our list of partner pharmacies, many of whom can ship your meds to you if needed.

We utilize an informed consent model for gender-affirming hormone therapy (GAHT).   We recognize that everyone’s goals and journey are unique. Your provider team will have an in-depth conversation with you about your health history, your personal needs and goals, your experience, and any questions you may have. Risks and benefits for any treatment will be thoroughly discussed. From there you will work together to develop an individualized care plan using shared decision-making and based on the latest evidence-based standards of care. Our medical providers may request further assessments and labs based on your individual health history. We deliver care using a team approach, where multiple members of our gender care team are there to support you in meeting your individual needs.

Everyone deserves access to safe, affirming, trauma-informed care and compassionate mental health practitioners. We acknowledge that many people of trans experience have had complex experiences with the medical system, so we want to ensure gender-affirming behavioral health care is  accessible.For more information about behavioral health care at CrescentCare, please visit Behavioral Health.

 This tool will help you understand if you are eligible to change your name and what steps are required to complete the process.

Here are the structural basics to know:

• You will pay a fee and file a Petition for Name Change along with copies of your identification at the clerk of court in either the parish where you live, the parish you were born in, or in Orleans Parish. The petition will be sent to the District Attorney’s office where they will run a background check on you. Once the DA approves your background check, they relay this information to the Clerk of Court, who then gives you an official Certified Name Change document. You will bring this document to most places where you will be changing your name. Since this document is so important for accessing the next steps, we strongly recommend asking for multiple “certified copies” (usually costs a few dollars each) of this Certified Name Change document to have as backups as some government offices require keeping a certified copy.
• If you want to change your gender marker you should ask your medical provider for a gender marker change letter. You will bring this document to places where you will be changing your gender marker.
• Once you have your Certified Name Change document and your gender marker change letter, if updating your gender marker, you will then gather other ID documents to prove who you are and go to offices like the Birth and Vital Records Office, Social Security Office, OMV, and Passport Office to update your information. From there, most people use their corrected ID documents to update their bank, doctor, employer, school, utility companies, voter registrar, insurance company, military/VA record, attorney, will, library, professional licenses, car title, etc.

Best practices for completing the process:

• Call the agency or office before you go.  Make sure you bring everything you need with you including the appropriate identifying documents and  payment in acceptable format. Most places you need to change your name already have information on how to navigate that system. When in doubt, look it up or call ahead!
• Here are some helpful tips if you have a challenging experience: 

1. 1. Bring an advocate.
   2. Ask to speak to a manager.
   3. Ask to work with a different person in that office.
   4. Go back on a different day of the week.
   5. Document the name of the person and call the office to report your experience to management.
   6. Remember, you are undertaking a long and expensive process. You deserve care, support, and rest, especially while you navigate these systems.

Name-Change FAQ:

Who is ineligible to change their name?

Unfortunately, anyone convicted of a violent felony, people who have outstanding warrants for their arrest or pending felony charges, and people who are currently on parole or probation cannot legally change their names.

I am under 18 years old. Can I change my name? 

Changing your name as a minor in the state of Louisiana is complicated but not impossible. This process requires support from both parents if they are alive and you are legally in their custody. Talk to your provider if you are a minor initiating the name change process to get connected to resources.

I’m nonbinary or gender nonconforming. Can I change my gender marker on my Louisiana documents to an option like “X”?

Unfortunately, the state of Louisiana does not currently offer a nonbinary gender marker option on our state-specific identification documents. 

Currently, it is an option to change your gender marker to “X” on your U.S. Passport and Passport Card. You can find information about changing your Passport on the State Department website.

What should I know when trying to change my gender marker on my birth certificate?

Changing gender markers on birth certificates is dependent on rules of the state and parish/county in which you were born.  The current legislation in the state of Louisiana  only allows gender marker change after successful completion of vaginoplasty or phalloplasty. We recommend that people who were born out of state contact the office of birth and vital records of their home county/parish to find out the rules for their region.

What should I know when considering if I will change my gender marker with my health insurance?

Most insurance companies maintain a binary understanding of gender.  For billing purposes, the companies code  certain types of care, such as reproductive care, according to the listed gender. For example, people who have ovaries and cervixes require routine medical screening and many  insurance companies deny coverage for pap-smears, hysterectomies and cervical care for people who are listed as male in their system.  Many people assigned female at birth opt to change their gender marker on most ID documents but keep an “F” with their insurance company to ensure coverage of organ-specific care. If you have a prostate and a family history of prostate cancer, it is worth considering if you would prefer to keep an “M” gender marker for coverage of prostate screening. Similarly, if you are a person planning to have an orchiectomy and wanting to change your gender marker to female with insurance company, you may want to wait to update your gender marker until after your surgery.

Your state identification card and insurance can have different gender markers.

We do not provide any surgical procedures at CrescentCare. WPATH Standards only recommend surgery after in-depth counseling session about the risks and benefits has taken place.  If a gender-affirming surgery (GAS) procedure is something you are considering, talk to your medical provider about your goals and needs.  

Gender-Affirming Surgery FAQ

Can my therapist who does not work at CrescentCare write my behavioral health letter?

We have examples of sample letters that we can send to your behavioral health provider, if they are unfamiliar with writing letters of support for gender affirming surgeries. Once your therapist completes your letter, they may either send it directly to the surgeon’s office or to a gender clinic patient navigator at CrescentCare for submission to the surgeon’s office with your other letters.

My insurance denied my claim. Now what do I do? 

As with any denial of services, you need to work quickly to appeal the denial. You should get a letter in the mail outlining how to appeal your denial, usually within a specific number of days. Please keep a copy of your denial letter and share it with your surgeon and your gender care provider.

I am not eligible for insurance in the US, but I want to access a GAS. 

We keep a list of organizations who support trans people in paying for surgery out of pocket when they are ineligible for insurance, or their surgery is not covered by their healthcare plan.  Many of these funds have tight application windows and sometimes are only available to people from certain backgrounds or geographic areas. Please ask us during your next visit. 

What might prevent me from accessing a GAS? 

Unfortunately, some surgeons utilize BMI, or body-mass-index, a value derived from the weight and height of a person, to determine if they will operate on someone. Another factor that may affect your ability to access surgery is your age. Smoking may also affect your ability to access surgery. As smoking tobacco affects our lungs, heart, and blood flow, stopping smoking will help you both get through surgery and anesthesia as well as heal properly. 

The last thing we see get in the way of accessing surgery includes issues that may impact your ability to successfully recover such as your housing or substance use or other medical problems. Please tell your care team about what you are experiencing so we can support you.  Many of these roadblocks can be worked through but we need to know about them to support you in meeting your goals.

Accessing surgery sounds hard. How will you help me make this happen? 

CrescentCare staff can support you through the process. 

CrescentCare staff stay as up to date as possible with the gender-specific resources available for our communities. Please ask during your next visit. 

Visit the Community Resource Guide, a comprehensive list of resources in the city, updated yearly by a dedicated group of volunteers from Anti