Live your authentic life.

Gender-affirming hormone therapy from anywhere.

Why We’re Different

Expert

Expert

First-in-class, evidence-based medical care.
Convenient

Convenient

Virtual care from your smartphone.
Secure

Secure

Confidential experience at every touchpoint.
Affirmative

Affirming

Our trans and queer led team is here to support you.

Redefining Healthcare

We believe healthcare should be easy, convenient, and center the unique needs of the trans community. If you are trans, it doesn’t always mean you need or desire gender-affirming hormone therapy (HRT), but if you do, we are here to help. You are our priority. 

Xochitl

Direct Access

Plume’s trans-specialist medical providers are available for questions, appointments, and information from the convenience of your smartphone. No phone trees. No leaving messages with the front desk. We promise!

Services & Pricing

Membership provides everything you need to begin your journey or maintain your routine. There are never hidden fees or unexpected costs.

Message

Initial Evaluation

Labs

Labs

Rx

Rx + Supplies

Progress Monitoring

Progress Monitoring

Video

Virtual access to care

 *Membership includes issuing the prescription to your local pharmacy, but does not cover the cost of medication. Out-of-pocket cost of medication varies from $5 – 50. Insurance can cover the cost of medication, but not the cost of membership.

One-Time Letter Writing Service Now Available!

We’re excited to announce a new service to the trans community for non-members of Plume seeking a medical letter of support for surgery.

One-time Letter of Support

$150

Message

Initial medical evaluation

Letters

Letter of support

Video

Virtual access to care team

Meet Your Care Team

“We work to provide the highest quality gender-affirming care and truly meet patients where they are by dismantling barriers that keep gender-diverse people from living their fullest life.”

Jerrica Kirkley, MD

she/her

Dr. Kirkley is a trans woman and board certified in Family Medicine. She has provided gender-affirming care (GAC) in various clinical settings and is the author of a GAC protocol implemented by health systems across multiple states.

Alann

Alann Weissman-Ward, MD

he/him

Dr. Alann is a Jamaican and Jewish trans man who is board certified in Family Medicine and Addiction Medicine. He has been providing gender affirming care since 2009.

Get Started With Plume Today!

Schedule your first appointment in as little as 25 minutes during business hours, M – F  9AM – 5PM MST.

Membership is $99 per month, which includes labs!

1

Download the app

Download Spruce, our communication app. You have direct access to our care team to talk through your needs before you become a member.

2

Video
consult

Meet with one of Plume’s trans-specialist medical providers to discuss your needs and goals.

3

Make
a plan

You and your medical provider will develop an individualized health and lab-monitoring plan based on your goals. 

4

Rx
delivered

Prescriptions and supplies sent to your local pharmacy to pick up.

Testimonials

4 years on HRT

“My care team was wonderful,  I had never been seen by a transgender medical provider before, a very uplifting and empowering experience, I had no doubt that she would be able to provide exactly what I needed.”

Kai Hill

Just started HRT

“Plume made a big difference, I got first blood work, since I’ve been off medicare it has been hard to get blood work.  Other services they offer are amazing. The only of its kind.”

Zoey Brown

1 year on HRT

“I had 90-day gap, between when my job would start insurance. Since I am not a policy-maker it was easy to misunderstand the plan. Plume made it simple, HRT was covered and I could get on with my life. “

Altia Cruz

Pay it Forward: The HRT Access Fund

We have teamed up with Point of Pride, a trans-led nonprofit, and YouAreEssential, a black trans-led organization, to create access to free care through our service to underserved trans individuals. The HRT Access Fund provides 12 months of free medical care, including the cost of medications, for trans folks seeking gender-affirming hormone therapy (GAHT). Funds raised through the Plume x YouAreEssential campaign will be the first to be distributed to Black trans folks in need of hormone therapy. We are working to increase access to as many trans people as possible. With your help, we can provide free care to our community when they need it most. Every dollar contributed goes directly to a trans person’s care. Donate below.

FAQs

Where is Plume Available?

We are available in Arkansas, California, Colorado, Florida, Maine, Massachusetts, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Texas, Virginia, and expanding rapidly. Sign up for our waitlist by tapping “Get Started” at the top of the page. We’ll let you know when we are active in your state.

Who is Plume for?

Plume is available for anybody 18 years or older who desires gender-affirming care.
This could include but is not limited to:

  • Trans women
  • Trans feminine
  • Trans men
  • Trans masculine
  • Intersex
  • Gender non-binary
  • Gender non-conforming
  • Gender fluid
  • Gender queer
  • Agender
  • Whatever your gender!

How do I get an HRT (hormone therapy) prescription?

Well, you came to the right place! Plume specializes in gender-affirming care, including HRT. 

  1. Tap “Get started” at the top of the page.
  2. Go through our medical intake process and schedule with one of our trans-specialist medical providers.
  3. Your appointment takes place digitally from your smartphone. 
  4. You and your provider will determine the best treatment plan to meet your goals.
  5. Sign up for Plume membership ($99/month) and your provider will issue a prescription the day of your appointment. There is no gatekeeping, however, health concerns may affect the providers recommendations.

Membership is a recurring monthly investment of $99 which includes:

  • Ongoing issuing of your prescriptions.
  • Ongoing evaluation of progress toward your goals.
  • Quarterly bloodwork to monitor hormone levels. This is essential for tracking your health.
  • Convenient messaging with your care team from your smartphone.
  • Talk with your provider via text. No phone trees or long appointment wait times.
  • Letters of support for surgery, name change, or gender marker change.
  • Rx sent to the pharmacy of your choice. 
  • Access to resources and referrals for surgery and behavioral health.

How do I make an appt with a Plume medical provider?

Plume’s medical providers are here to discuss your goals, needs, desires, questions, and concerns regarding HRT (hormone therapy). 

  1. Tap “Get started” at the top of the page.
  2. Go through our medical intake process and schedule with one of our trans-specialist medical providers.
  3. Your appointment takes place digitally from your smartphone. 
  4. You and your provider will determine the best treatment plan to meet your goals.
  5. Sign up for Plume membership ($99/month) and your provider will issue a prescription the day of your appointment. There is no gatekeeping, however, health concerns may affect the providers recommendations.

There is no obligation to start a membership with Plume after your appointment. If membership is not right for you, you will be charged a $25 appointment fee. You must be a Plume member to receive a prescription for gender-affirming medicines.

 

What if I am not sure if HRT or the Plume membership are right for me?

This is a deeply personal process, and we are here to help! Scroll to the top of this page and select “Get Started Today” to download our communication app and schedule an appointment with one of Plume’s trans-specialist medical providers. 

 You can discuss all of your needs, desires, and concerns with your medical provider. There is no obligation to start a membership. If you decide that HRT or Plume are not right for you, you only pay a $25 appointment fee for your time with the provider. If you do not become a member, you will not be issued a prescription for gender-affirming medicines.

If you become a member, we will apply the $25 toward your first month of membership, which is $99/month.

What services are included in membership?

Everything to start, continue, and maintain your gender-affirming hormone treatment.

  • Ordering, analysis, and cost of all labs.
  • Direct access to your medical care team who specialize in gender-affirming care.
  • 24/7 text access to your care team and response within an hour during business hours, M – F 9AM – 5PM MST.
  • Digital video appointments from anywhere.
  • You and your medical provider will evaluate your goals and establish an appropriate hormone treatment program.
  • Your care team will track your progress with quarterly evaluations and adjust treatment as needed.
  • Prescriptions for gender-affirming medications as needed sent to the pharmacy of your choice.
  • Letters for name or gender marker change or surgery.
  • Connection to resources for primary care, mental health, and more.

IMPORTANT: The cost of hormone medication is not covered by your membership. Hormone medication ranges from $5 – 50 per month depending on medication. Coupons are often available; we recommend Good RX.

Is the cost of medication included in my membership?

The cost of medication is not covered by your membership. Out of pocket, gender-affirming medication ranges from $5 – 50 per month depending on medication. We recommend Good RX for coupons.

Insurance may be used to cover the cost of hormone medication, but not the Plume service. Check with your insurance provider regarding coverage.

Can Plume be my primary medical care provider?

Plume is not a primary care provider; all treatments specifically focus on gender affirmation. Your Plume medical provider will evaluate your goals and establish an appropriate hormone treatment program, track your progress with quarterly evaluations and adjust treatment as needed; order and analyze all labs; write the prescriptions and send them to your local pharmacy; connect you to resources, and provide letters for name change or surgery. 

Plume strongly recommends that any patient has a primary care provider to attend to other medical conditions and routine care. We are happy to offer suggestions for a primary care provider that is sensitive to gender diversity/queer identity if needed.

What if I have an emergency?

Plume does not provide emergency medical services. Those experiencing crises or emergencies should call 911 or go to the nearest emergency room.

What if I’m having a mental health crisis?

While Plume facilitates access to behavioral health resources, we do not offer urgent or emergent support for behavioral health emergencies.

Those experiencing a mental health crisis should call the Trans Lifeline at 877-565-8860 or the National Suicide Prevention hotline at 1-800-273-8255.

LGBTQ+ youth should call The Trevor Project lifeline at 1-866-488-7386 or visit https://www.thetrevorproject.org/ for additional resources.

What gender-affirming medications does Plume prescribe?

We prescribe testosterone, estrogen, and testosterone blockers. Your medical provider will create a customized treatment plan, which includes prescriptions to help align your physical body with your gender.

How do I cancel my membership?

There’s no contract with Plume membership. It’s easy to cancel, just message your care team from within the Spruce app. If you have active Rx refills, they will be cancelled.

How does Plume work?

The Basics

Membership is $99 / month and includes:

  • Ongoing issuing of your prescriptions.*
  • Initial evaluation of your goals.
  • Ongoing evaluation of progress toward your goals.
  • Quarterly blood work to monitor hormone levels. This is essential for tracking your health. We partner with your local Quest lab to conduct blood work.
  • Convenient messaging with your care team from your smartphone.
  • Talk with your provider via text. No phone trees or long appointment wait times.
  • Letters of support for surgery, name change, or gender marker change.
  • Rx sent to the pharmacy of your choice. 
  • Access to resources and referrals for surgery and behavioral health.
  • No gatekeeping.

*The cost of medication is not covered by your membership. Out of pocket, gender-affirming medication ranges from $5 – 50 per month depending on medication. We recommend Good RX for coupons. Insurance may be used to cover the cost of hormone medication, but not the Plume service. Check with your insurance provider regarding coverage.

Schedule an Appointment

There are two reasons to schedule an appointment: To sign up for a Plume membership or to discuss with a medical provider if HRT or Plume are right for you. Scheduling is easy! Just tap “get started” at the top of the webpage and download our secure communication app.

Your First Appointment

Your first appointment is a video call from the convenience of our secure communication app. When you schedule your appointment you will be guided through our medical intake process that helps prepare your medical provider with important information about who you are, your health, and goals. Your appointment will focus on your needs and developing a treatment plan with your provider.

Future Appointments

No more lengthy office visits! Instead of waiting for appointments, you can message your care team and medical provider instantly using our secure communication app. Seriously, send us a message ANYTIME with your questions, concerns, or needs. Your care team will get back to you ASAP during business hours.  

Your Care Team

Your care team is composed of your medical provider, care coordinators, clinical manager, and the product team who is always working to incorporate your feedback to improve your patient experience. 

Plume’s medical providers are all trans-specialists, allies, and many are trans themselves. 

Your care coordinators, clinical manager, and product designer are all trans. They are your community and show up and support you 7 days a week.

The Chief Medical Officer is Dr. Jerrica Kirkley (she/her), a trans woman and board certified in Family Medicine. She has provided gender-affirming care (GAC) in various clinical settings and is the author of a GAC protocol implemented by health systems across multiple states

Ongoing Care 

Our goal is convenience and affirmation. 

  • Whenever you have a question, concern, or need, simply message your care team.
  • Blood work is essential to track your health. The cost of labs are covered by your membership. We partner with your local Quest lab to conduct quarterly blood work.
  • Your medical provider reviews your labs and communicates the results and any recommendations to align with your goals. 
  • If your goals shift at any time, message your care team and your treatment plan will be reevaluated. 
  • If you need letters of medical support for name change, gender marker change, or surgery, just ask and we’ll have it for you within a week.
  • Your team will work to connect you to referrals and resources for surgery and behavioral health.
  • Live your best life.

Does Plume provide letters for name or gender marker changes?

Yes! To change the name or gender marker on your identification documents (driver’s license, social security card, passport, birth certificate), you often need a letter from your treating medical provider or a form signed by them. You must be a member with Plume specifically for name and gender marker letters, we do not provide one-time letters for name or gender marker change.

Here are some great resources:

http://www.namechangeproject.org (Colorado only)

https://transequality.org/documents (national database)

https://transgenderlawcenter.org/resources/id (national database)

Does Plume provide letters of support for gender-affirming surgery?

Yes! We provide letters for both Plume members and non-members. If you are a Plume member, letters are included in your membership. If you are not a member, you can pay a one-time fee of $150 for an appointment with one of Plume’s medical providers, access to our care team for resources and support, and a guaranteed one week turn-around time to issue the letter. If you need a letter from a behavioral health professional, unfortunately, we don’t provide those. 

Does Plume provide gender-affirming surgery?

We do not provide gender-affirming surgery, but we do provide letters of support for surgery for both members and non-members. Letters of support are included in the price of membership or as a one-time service. We will also help navigate the process by providing a list of surgeons, referral if necessary, and guidance from our care team.

Does Plume provide behavioral health?

No, but we do encourage a relationship with a behavioral health provider for continued support as we believe this is a valuable resource for all people. 

If needed, we will help find a local therapist in your area that is competent in gender-affirming care or help connect you with a remote therapist who can be seen from the comfort of your own home via video, text or phone such as:

https://www.pridecounseling.com – queer/trans specific

https://www.betterhelp.com – not queer/trans specific but sensitive

https://www.marigoldhealth.com – not queer/trans specific but sensitive

How do I start with Plume?

Plume makes it easy to get expert, safe, and confidential gender-affirming care from the privacy of your home.

  1. Determine if you are interested in a Plume membership for HRT and gender-affirming care or if you only need a one-time letter of support for surgery. Letters are included in membership.
  2. Scroll to the top of this page and select “Get Started Today” to download our communication app* and schedule your appointment with a Plume medical provider.
  3. Together, you and your provider will create an individualized treatment plan that works best for you.
  4. For HRT, your provider will send prescriptions to the pharmacy of your choice at the end of your first appointment. For one-time letters, you will receive your letter within a week.

As a Plume member, your care team will continue to monitor your progress, check your hormone levels, and other blood tests as needed to make sure your journey is going smoothly. You can contact your care team directly anytime you need.

What is the Spruce communication app and why do you use it?

Spruce is a HIPAA compliant (Health Insurance Portability and Accountability Act) communications app made specifically for innovative medical practices. Our highest priority is confidentiality and Spruce allows us to keep your sensitive medical information private and secure. It also makes sure that our conversations are kept private on your phone. Through Spruce you can communicate with your doctor by text, phone, or video chat.

How much does Plume cost?

Plume offers two services.

Plume’s GAHT (gender-affirming hormone therapy) membership is a flat-monthly rate of $99. Membership includes your recurring prescription for gender-affirming medicines; a customized treatment plan designed with your medical provider; bloodwork at a local Quest lab; instant text message access to your care team; ongoing evaluation and adjustment of treatment; and letters of support for surgery, name change, and gender marker change. The cost of medicines is not included in membership. Medicines cost about $20 a month on average with cost saving coupons from Goodrx. There is no obligation to join. If after your first appointment, you decide membership is not for you, we will only charge you a $25 appointment fee.

Plume’s letter writing service offers a one-time letter of support for surgery for $150. This includes a medical evaluation; a letter issued within one week of your appointment; and access to your care team for resources and recommendations. This service does not include gender-affirming hormone therapy. Plume’s GAHT membership includes letters at no cost.

How does the cost of Plume compare to out-of-pocket or insurance?

We made a cost comparison chart to be transparent about pricing and to help you determine if Plume is right for you. 

What if I already have a gender-affirming medication prescription?

Plume will make it as easy as possible to transfer your prescription, progress monitoring, and labs to our care. Download the free Spruce app to talk with our team about the best solution for your current situation.

Is financial support available?

Our “Pay it Forward”’ initiative donates directly to the Transformative Freedom Fund. Colorado residents can apply for financial support for medications and surgeries through the Transformative Freedom Fund, https://transformativefreedomfund.org.

For surgery-specific financial support around the country, you can apply to Point of Pride’s annual transgender surgery fund, https://pointofpride.org/annual-transgender-surgery-fund/https://pointofpride.org/annual-transgender-surgery-fund/.

How does lab testing work through Plume?

All routine testing recommended for gender-affirming care is covered by the monthly membership fee.* Nothing extra needed!

Out-of-pocket labs can range from $150 – $500. You don’t have to worry about that with the Plume membership.

All labs are through Quest Diagnostics for monitoring hormones and other blood tests. They have many lab draw sites throughout the country. We simply place the order and you go to the nearest Quest lab site to get your blood drawn and then we will let you know the results with recommendations via our secure messaging app as soon as they come in.

*New York residents are subject to a law that requires the patient to pay for labs out-of-pocket. To off-set this, we have negotiated with Quest labs for reduced cost blood work. Plume will then reimburse New York patients by reducing their membership from $99 to $90.  The reduction in membership will cover the cost of labs with Quest. 

Can I use insurance to pay for my Plume membership?

We do not accept insurance for our monthly fees. Remaining a cash-only practice allows us to be innovative and cost-effective in providing the care that folks want in the most convenient way possible.  Our service is eligible for Health Savings Accounts (HSA) and we can provide guidance on how to use funds appropriately.

Do Medicaid or Medicare cover Plume services?

Unfortunately, they do not. Remaining a cash-only practice allows us to be innovative and cost-effective in providing the care that folks want in the most convenient way possible. Depending on your program, you may pay for Plume out-of-pocket with no consequences.

Restrictions are based on the state you live in and the program you are enrolled in. Plume is not available for recipients of Medicare in any state or Medicaid in Colorado only. For more information about your specific restrictions, please contact your program directly.

New York and New Jersey residents have a different membership, here’s how.

New York and New Jersey are beautiful states, but have strange laws about paying for laboratory services.  

Your Plume membership includes the cost of labs. Patients in New York and New Jersey are legally required to pay for lab services out-of-pocket. So, we have arranged a low rate with Quest labs where you can pay out of pocket and we will reimburse you for the cost by discounting your monthly membership.

Monthly membership for New York and New Jersey patients will cost $90, for all other states it is $99. This way Plume members in NY and NJ will pay the same average of $99 per month as all other members.