Plume is available for anybody 18 years or older who desires gender-affirming care! This could include but is not limited to trans women and trans men, non binary and gender non-conforming people, intersex people, gender queer people, and more.

Plume is available in many states and expanding rapidly. See our coverage map for details and 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.

The Basics

Membership is $99 / month and includes:

• Digital video appointments with your trans-specialist medical provider.
• Collaborative treatment planning with your medical provider, based on your goals and their expert knowledge. 
• Ordering, analysis, and cost of all labs.
• A medical care team who specializes in gender-affirming care.
• 24/7 text access to your care team and response within an hour during business hours, Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time.
• Digital video appointments from anywhere.
• You and your medical provider will evaluate your goals and establish an appropriate hormone treatment program.
• Ongoing progress monitoring. Your care team will track your progress with quarterly evaluations and treatment adjustments 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.
• Connections to resources for primary care, mental health, and more.
• A trans and queer-led team cheering you on every step of the way.

We are cash-based, which means that insurance, Medicare, and Medicaid do not cover the cost of membership.

*The cost of medication is not covered by your membership. Gender-affirming medication ranges from $5 - 50 per month depending on medication. We recommend GoodRx 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.

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

First, determine if you are interested in a Plume membership for gender-affirming hormone therapy. (GAHT or “HRT”) or if you only need a one-time letter of support for surgery. Letters are included in membership. Next, scroll to the top of this page and select “Get Started” to download our app* and schedule your appointment with a Plume medical provider.

At your appointment, you and your provider will create an individualized treatment plan that works best for you. You can decide after your appointment if Plume membership is right for you. For gender-affirming hormone therapy (GAHT or “HRT”), your provider will send prescriptions to the pharmacy of your choice at the end of your first appointment. [Note: You must be a Plume member to receive a prescription.] For one-time letters, you will receive your letter within a week.

As a part of your membership, your care team will monitor your progress, check your hormone levels, and review 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 ensures our conversations are kept private on your phone. Through Spruce you can communicate with your provider by text, phone, or video chat.

Plume’s medical providers are here to discuss your goals, needs, desires, questions, and concerns regarding gender-affirming hormone therapy (GAHT or “HRT”).

• Tap “Get started” at the top of the page, and download our app
• Go through our medical intake process and schedule with one of our trans-specialist medical providers.
• See your provider via video visit!

Note: The average wait time for a visit is under two weeks, and our care team is available for questions leading up to your appointment.

Your first appointment fee is $99, which will be applied to your membership if you join. If membership is not right for you, you will not be charged further. You must be a Plume member to receive a prescription for gender-affirming medicines.

Your provider will start by reviewing your health history / intake forms and opening up a conversation about your goals and desires. You’ll work together to figure out a treatment plan that is right for you. Your provider can answer any and all questions about the medications, dosage, their effects, how to inject, take, or apply them, and what to expect as you go. Our providers are experts in gender-affirming care and no matter if this is your first time exploring hormone therapy or you’re a decade in, they are here for you with respect and wisdom. You can decide if a Plume membership is right for you, and, if you become a member, you’ll get a prescription for your medication, same day!

Your first appointment fee is $99, which will be applied to membership if you join. You must be a Plume member to receive a prescription for gender-affirming medicines.

This is a deeply personal process, and we are here to help! The best next step is to have an appointment with one of our trans-specialist medical providers. Scroll to the top of this page and select “Get Started” to download our app and schedule.

You can discuss all of your needs, desires, and concerns with your medical provider. The appointment fee is $99, and there is no obligation to start a membership after your appointment. If you become a member, your appointment fee will be applied to your subscription. You must be a Plume member to receive a prescription for gender-affirming medicines.

Plume will make it as easy as possible to transfer your prescription, progress monitoring, and labs to our care. Scroll to the top of this page and select “Get Started” to download our app and chat with our care team about the best solution for your current situation.

All routine testing, including hormone monitoring and other blood tests, recommended for gender-affirming care is covered by the monthly membership fee.* Nothing extra needed!

Without Plume, out-of-pocket labs can range from $150 – $500. You don’t have to worry about that with our membership.

We order labs through Quest Diagnostics. They have many lab draw sites throughout the country. We place the order, and you go to the nearest Quest lab site to get your blood drawn. We let you know the results with recommendations via our secure app as soon as they come in.

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

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. Insurance may be used to cover the cost of hormone medication. Check with your insurance provider regarding coverage.

We have partnered with several non-profits to provide need-based financial support for Plume members. Our HRT Access Fund provides 12 months of free gender-affirming hormone therapy and medications via Point of Pride. We will begin accepting applications for our next round of funding in 2021 (date TBD). Learn more at https://pointofpride.org/HRT-Access-Fund/

We made a cost comparison chart to help you determine if Plume is right for you.

Plume’s gender-affirming hormone therapy (GAHT or “HRT”) membership is a flat-rate of $99/month. 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 ~$20 a month on average with cost-saving coupons from Goodrx.

Your first appointment fee is $99, which will be applied to your membership, if you join. If you decide membership is not for you, you will not be charged further, and you may always cancel at any time. 

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 GoodRx for coupons.

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

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.

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 and Kentucky only. For more information about your specific restrictions, please contact your program directly.

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.

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 turnaround time to issue the letter. If you need a letter from a behavioral health professional, unfortunately we don’t provide those. 

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 to receive 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)

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. We have arranged a low rate with Quest labs where you pay out of pocket and we reimburse you for the cost by discounting your monthly membership.

Monthly membership for New York and New Jersey patients is $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. 

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

• A digital video appointment with your trans-specialist medical provider to get started.
• Collaborative treatment planning with your medical provider, based on your goals and their expert knowledge. 
• Ordering, analysis, and cost of all labs.
• A medical care team who specializes in gender-affirming care.
• 24/7 text access to your care team and response within an hour during business hours, Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time.
• Texts and calls with your provider, as needed.
• Ongoing progress monitoring, quarterly evaluations, and treatment adjustments, as needed.
• Prescriptions for gender-affirming medications sent to the pharmacy of your choice.
• Letters for name or gender marker change or surgery.
• Connections to resources for primary care, mental health, and more.
• A trans and queer-led team cheering you on every step of the way.

NOTE: 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 GoodRx.

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.

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.

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

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