Gender-affirming surgery refers to any surgical procedure which may be used to make someone feel more comfortable with their body in a way that affirms their gender. Gender-affirming surgeries are not limited to the trans* community, nor are they a requirement of transition. Some trans* people do not seek surgery while others may undergo a number of gender-affirming surgeries over the course of their life. There is no one right way to use surgery in your gender transition!

Gender Affirming Surgery with UC SHIP

If you’re interested in getting a gender-affirming surgery using UC SHIP insurance, here are some steps to take.


Check if your procedure is covered

  1. Most gender-affirming procedures are covered under UC SHIP. You can find information about what gender-affirming surgeries are covered by UC SHIP on the 2023-24 UC SHIP Transgender Benefits Flyer. Find more resources on Student Health’s Trans Health Care page.
  2. Non-surgical procedures such as electrolysis or laser hair removal are eligible for reimbursement rather than direct insurance coverage.


Get a referral

You must get a referral from your Student Health primary care physician before receiving any services outside of Student Health, including gender-affirming surgeries.


Acquire a letter of readiness

Your insurance and/or surgeon may require one or two letters from certified mental health professionals to approve your gender-affirming surgery. Under UC SHIP, gender-affirming surgeries require one letter for precertification. Please check with your surgeon’s office about letter requirements before committing to a surgery date. Check out the Letters of Readiness section below for more details on how to get your letter(s) written.


Find a surgeon/provider:

  1. If you want insurance to cover your procedure, it is important to select a surgeon that is in-network with UC SHIP. If your surgeon is an Anthem Blue Cross in-network provider, then your insurance will cover 80% after you have met your annual deductible. There are currently no in-network surgeons who offer gender-affirming surgeries in the Santa Barbara area which means you will likely have to travel. Here are a few ways to find an in-network surgeon:
    1. Meet with a social worker at student health who can give you a list of providers, walk you through the approval process, and answer most insurance-related questions. 
    2. Refer to UC SHIP’s Transgender Provider list which can be found on this page. Access the 2023-24 version here!
    3. Use your UC SHIP information to login to Anthem’s website and use the provider search option to find possible surgeons. 
  2. Consider booking consultations with multiple surgeons to make sure you find the right fit. Once you find a surgeon that you trust and feel comfortable booking with, the surgeon’s office will collect any necessary paperwork and help you select a surgery date.


Cost and Payment:

  1. Costs for gender-affirming surgeries vary widely by procedure, location, provider, and insurance coverage. It is difficult to get an accurate estimate of costs before surgery. Talking to your surgeon’s office and the hospital/surgery center about estimated costs will help you prepare. If you anticipate difficulty paying for your procedure, refer to our Medical Financial Help page.
  2. Many surgeons/hospitals will require you to pay the estimated cost a few days before the surgery. Ask about a payment plan if needed. After surgery, your insurance may update the cost based on how the procedure went (complications, anesthesia, nausea medication, etc.) and any discounts you might qualify for. You could receive a partial refund or be asked to pay the difference depending on what adjustments are made.



Hospitals and surgery centers require you to have a designated driver before going through with surgery. This person will need to check you in, pick you up, and drive you home from surgery. Many hospitals will refuse your operation if you do not have a designated care person and will refuse to let you leave the hospital after surgery without that person present. Public transportation or rideshare services will not fill this requirement. If you can’t find reliable transportation, consider reaching out to the Trans@UCSB group chat.


Time off work or school:

  1. If you can, plan your surgery during a school break or holiday. If you can’t, consider asking for remote work/school options or giving a time frame for when you can return. You should acquire a doctor’s note to prove medical need which your primary care physician or surgeon’s office should be able to provide. While surgery does not qualify for temporary disability, DSP's Temporary Disability page has some helpful resources and recommendations.
  2. Time frames will vary but you can expect to return to light work after…
    1. 6-8 weeks for bottom surgeries
    2. 2-4 weeks for top surgeries
    3. 2-3 weeks for facial surgeries

Gender Affirming Surgery with Other Insurances

Covered procedures and approval processes may vary by insurance, but most of the above steps should still apply. To see what is covered, look for your insurance plan’s benefits catalog or call the phone number on your insurance card and ask about gender-affirming services. If you have a non-UC SHIP health insurance and would like help navigating gender-affirming surgery, please reach out to a UCSB social worker or our Health Equity Advocate.

If you have more than one insurance, you may be eligible for double coverage on your gender-affirming surgery. If you have UC SHIP and another insurance, please note that UC SHIP will default to your secondary insurance anywhere outside of Student Health. If you pursue gender-affirming surgery with two insurances, your other insurance will be billed first with the remaining bill sent to UC SHIP. If you share insurance with your parents or family, they will likely be able to see that you are pursuing gender-affirming surgery. If you would like UC SHIP to be your primary insurance coverage, you will have to remove yourself from any other health insurance plans, including your parents’. To learn more about the details of double coverage involving UC SHIP, please email the health insurance team through your Student Health portal.

Letters of Readiness for Surgery

Insurance companies and surgeons often require one or two letters from a mental health professional to prove the medical necessity of a gender-affirming procedure. These letters certify that the patient has been diagnosed with gender dysphoria by a licensed clinician. We acknowledge that this system is an act of gatekeeping and can be invalidating for many trans* people. Until systemic change can be made regarding this requirement, we try to ease the burden by providing easy and affirming channels for students to request these letters.

If you would like a consultation for a letter of readiness, please call CAPS at (805) 893-4411 and tell them you are seeking a letter for a gender-confirming surgery or procedure. You will be scheduled for a Brief Assessment phone call (10-15 min) with one of their clinicians, during which you can specify your wish for a letter consult. You will then meet with one of CAPS’s letter-writing clinicians, who will follow WPATH Version 8 Guidelines for Surgery Readiness (the legal and ethical standard used by UCSB CAPS and other UC campuses). The letter-writing process typically involves two meetings with a clinician which will involve a structured clinical interview and at least one follow-up appointment. Once letters are written, they are the property of the student and typically considered valid for one year by most physicians (duration time can vary). CAPS has multiple clinicians equipped to write gender-confirmation letters, meaning they can provide more than one letter if need be.

If you are seeking a letter for gender-affirming surgery and already have a therapist or psychologist who is supportive of your transition, you may ask them to write your letter. If they don’t know what to write, please refer to this guide.

Informational Resources

This informational guide provides a general overview of gender-affirming chest surgeries including mastectomy, breast reduction, and breast augmentation. If you are considering undergoing one of these surgeries or just want to learn more, this is a great place to start! 

Chest Surgery Info Guide

We are working on adding info sheets on other surgery types including Facial Feminization Surgery (FFS) and bottom surgeries!