We make healthcare delightful. For everyone.

Access gender-affirming care in a caring, emotionally safe environment.

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Hormone Therapy
Prescriptions sent
to your pharmacy
Telehealth visits
at home
Chat support 24/7
in a safe space

Care crafted for you.

Affirming environment

As allies and members of the LGBTQIA+ community, our physicians care about helping you feel your best.

Insurance accepted

We're in network with most PPO plans to keep things as affordable as possible for you.

Care from home

Enjoy the comfort of a 100% remote healthcare experience. Have appointments and chat with your care team from the app, then pick up your prescriptions nearby (or have them delivered).

Our providers deliver the latest in affirming and evidence-driven care.

All of our providers are vetted according to strict quality of care protocols determined by UCSF, our hospital affiliate.

LGBTQ+ certified
Sara Saginaw, D.O.

Board Certified, Family Medicine, 10 years of experience in hormone care and general family medicine

As a member of the LGBTQIA+ community, Dr. Sara Saginaw started her practice in a smaller Texas town with limited LGBTQ+ services and care.

She developed an interest in hormone treatments and gender affirming therapy for adults and teenagers at that time and grew her skills for multi modality hormone therapy.  She feels passionate about improving access to hormone care and improving quality of life for all people.

Last but not least, Dr. Saginaw is a self-proclaimed crazy cat lady - and you may see them make an appearance on camera if you are lucky!

LGBTQ+ certified
Theresa Duggan, N.P.

Board Certified, Family Medicine, 3+ years of experience providing LGBTQIA+ care

Theresa Duggan is a Nurse Practitioner at Circle who is passionate about providing healthcare to all, especially underserved populations.

She is a sex positive practitioner who feels that her role is to provide care for the entire person, because everyone deserves access to quality healthcare that meets their individual needs.

Theresa is an open-minded provider who actively listens. She is is humble about her own knowledge and expertise, and is always striving to learn to provide the best possible care.

LGBTQ+ certified
LGBTQ+ certified
Dana Mirza, M.D.

Board Certified, Family Medicine, 3 years of experience providing LGBTQIA+ care

Dr. Mirza is passionate about supporting the self-actualization of all of her patients in their gender, mind, body, and spirit!

She strives to promote the health and happiness of the LGBTQIA+ community and is a proud ally.

Dr. Mirza is experienced in providing gender-affirming hormone therapy, gender-affirming treatments, mental health care, PrEP treatment, STI/STD care, and preventive medicine.

What is gender-affirming hormone therapy?

Gender-affirming hormone therapy aims to align an individual’s characteristics with their gender identity with the use of hormones. 

Our practice provides both masculinizing and feminizing gender affirming care for adults 18+. Receiving gender-affirming hormone therapy is a personal decision.

Our goal is to make sure that all people 18+ who want to do so can access safe, gender-affirming care from experienced clinicians. 

If you decide that gender affirming hormone therapy is right for you, your provider would assist with:

Feminizing hormone therapy with estrogen, progesterone, or a hormone blocker (such as spironolactone or finasteride).

Masculinizing hormone therapy with the use of testosterone. These could be in the form of pills, topical creams, or a self injection. Your provider will assist you in deciding the right treatment for you.

How can I learn more?

Prescriptions for hormones (such as testosterone, estradiol, or progesterone), hormone blockers (such as spironolactone or finasteride), hair loss medications (such as finasteride), and erectile function medications are all available through our practice.

If you have questions and would like to learn more about your options, we recommend booking an intake appointment to speak with a provider. We accept most PPO insurance plans and do not require a membership, so that it's easier for you to meet with a provider.

As a patient, you will have unlimited access to message your provider and your care team through our secure in-app chat.

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What to expect.

Please read through the FAQ for more information, including information on cost, treatment plans, and more.


Comprehensive gender-affirming care & hormone therapy (masculinizing & feminizing) over video

STD/STI testing, PrEP treatment, hair loss medications, erectile function medications, and more

UCSF-affiliated Board-Certified providers specialized in gender-affirming care

Major insurance plans accepted

Same-day or next-day appointment availability

No membership fees

In network with most PPO insurance plans

The appointment timeline

2 min

Book an appointment online

Select your state of residence, pick a provider and time, and confirm your insurance coverage for your estimated costs before you finalize your appointment.

2-3 min

Download the app and prepare for your appointment

Download the app right after you book your appointment.

15-30 min

Complete your first appointment and start treatment

A few minutes before your scheduled appointment time, you will receive a link via the in-app chat to join the video call. Make sure that you are in an area with a strong cellular connection.

During your appointment, your provider will get to know you and create a treatment plan tailored for you.

Your provider will ask that you complete two things: getting labwork done and obtaining letter from a therapist indicating that you have spoken with them about gender dysphoria.

If you do not have labwork done already, your provider will order labs to a location near you (via Quest Diagnostics or LabCorp). Your labwork results will be automatically uploaded to the app.

Once the labwork and letter from therapist are received, you will be able to begin the hormone therapy. Your provider will send prescriptions to your preferred pharmacy, and we will alert you in the app when your prescription is ready for pick-up.

Mail-order prescription service is available in some states; please ask your provider.

Anytime after appointment

Continue care through Circle Medical

Manage your regular follow-ups by booking and rescheduling your appointments through the app. Depending on your treatment plan, you may have follow-ups every 1-3 months.

Your care team will message you when you have a prescription or refill ready for pick-up at the pharmacy.

You may be recommended lab work to monitor hormone levels or take routine blood tests. Your provider will be able to place the order at a lab near you, where you can go to get your blood drawn.

If you have any questions or need to contact your provider, use our in-app chat to message your care team.

Your care doesn't have to stop here.

As a fully-licensed primary care practice, we know that making someone truly heathy is about more than one type of care. Our 70+ providers offer annual checkups, on demand video appointments, specialist referrals, and more.

Get Care

Held to a higher standard of care by one of the top 10 hospitals in the country.

Our affiliation with UCSF is more than just a partnership. Our providers must hit specific patient care metrics and consistently deliver the highest possible level of care.

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Frequently Asked Questions

Gender-Affirming Hormone Therapy

Can anyone receive gender-affirming hormone therapy through Circle Medical?

Yes, anyone who is 18+ and permanently resides in a state that we service is eligible for gender-affirming hormone therapy through our practice.

How does the process work? Do I need to bring anything to my appointment?

Our providers look to the UCSF transgender care and treatment guidelines, which can be found here.

During your first appointment, your provider will establish your medical history and ask whether you have had labs done.

If you don't have labwork done yet, your provider will place a lab order in to a location near you. Your results will be uploaded to the app automatically.

Some providers may request that you obtain a letter from a therapist indicating that you have spoken with them about gender-affirming care. You can upload this letter via the app. Note that this letter request is at the provider's discretion.

You can use our in-app chat to message your care team and provider as you complete the labwork. Once you have the needed items indicated by your provider and a completed first appointment with Circle Medical, you are ready to begin hormone therapy.

Your prescription will be sent to a pharmacy near you (or you can ask your provider if mail-order prescriptions are available in your state).

You'll then keep messaging your provider and care team as you start hormone therapy. Your provider may establish a follow-up appointment to adjust dosage or discuss how things are going.

Am I required to have a letter from a therapist prior to beginning gender affirming hormone therapy?

Circle Medical practices care in alignment with the UCSF Transcare guidelines and WPATH (World Professional Association for Transgender Health) Standards of Care. A therapist letter is not always a requirement in order for patients to have access to gender affirming care.

Often, we will not require a letter from a therapist or mental health professional prior to beginning gender affirming care. However, there are select times in which we may ask for a letter from a therapist, or mental health professional. For example, we may ask for a letter if a patient is unsure of their gender affirming goals and/or is new to exploring gender affirming therapy and is unsure whether starting gender affirming care is right for them. 

Our goal is to improve access to high quality and delightful primary care. Gender affirming care is within the scope of primary care and we are focused on creating a safe environment for people to receive care.

What states do you operate in?

To see a list of states, please start booking an appointment. You will be able to select from a list of all of the states where we are currently practicing.

You must be currently residing in the state of treatment as well as have your primary pharmacy be in that same state in order to be a patient at our practice.

How do I know if hormone therapy is right for me?

The decision to start your transition is a deeply personal one. We recommend booking a video appointment to speak with one of our experienced clinicians to get your questions answered. All of our clinicians are primary care practitioners, which means that they are experienced in providing care beyond gender-affirming hormone therapy.

Your clinician will be able to discuss your treatment options with you and answer any questions you may have, about gender-affirming care or about any other health topic you may want to discuss in a safe environment.

How does lab testing work?

Your provider will be able to place a lab order to a lab near you to get bloodwork and hormone monitoring completed. Your results will be uploaded automatically to the app, where you can view and download them at any time.


What type of provider am I seeing through Circle Medical?

Our providers are primary care providers (MD's, DO's, NP's, and PA's) who have experience in providing gender-affirming care and behavioral health care. They are allies and proud members of the LGBTQIA+ community. We encourage you to read more about each provider on their profiles above!

Do I need to book my appointment with a doctor (MD or DO), or can I book my appointment with any provider (PA-C, NP, etc)?

You do not need to book your appointment with a doctor. You can book your appointment with any provider that we have available. Our providers all work closely together to make sure that we are providing the same excellent standard of care to all patients regardless of which provider you book your appointment with. The type of provider you book with will not limit the type of treatment or medications that you are able to be prescribed.

How long are the appointments?

The first intake appointment is 30 minutes. Follow-up appointments are 20 minutes each.


What is the total cost of gender-affirming care and my treatment plan?

We accept most major PPO plans and we do not have any membership fees or ongoing membership requirements. The only cost that you have from our practice is the cost per appointment (see below for appointment cost estimates).

Your other costs include the cost of the medication(s) at the pharmacy (we recommend using GoodRx coupons to lower this cost), and the cost of any lab work or hormone testing at the lab.

With Insurance

$5 - $50 average copay* 1st appointment
$5 - $50 average copay* 2nd appointment

$10 - $100* total, with $5 - $50* monthly follow-ups once stable.

*Note: Your specific copay is dependent on your health insurance coverage. We typically see patients with copays of around $0-$50 per appointment, but this can be higher if you have a high-deductible plan and have not yet hit your deductible this year. To confirm your specific copay estimate, you can click to book an appointment and you will be asked to input your insurance information so that you can receive your cost estimate before confirming the appointment.

Our ability to estimate your costs is dependent on your healthcare insurance's database, so we do not guarantee that the estimate you see is the exact amount you will be billed. For the most accurate estimate of your per-appointment costs, we recommend calling the phone number on the back of your insurance card to ask your insurance plan what your primary care appointment costs are.

Without Insurance (out of network or uninsured)

$100 per appointment

Your specific follow-up appointment timeline may vary depending on what your provider recommends.


What insurance do you accept?

We contract with most PPO insurance plans. If you are a California Bay Area resident, we also work with a small number of HMO plans.

To verify if we work with your insurance, simply start booking an appointment online. You will be prompted to enter your insurance details and will receive eligibility results instantly as well as an estimate of your appointment cost prior to confirming your appointment.

Some PPO plans that we currently work with are:

Anthem Blue Cross/Blue Shield, Aetna, Blue Shield of California, Cigna, Health Net, Humana, and United Healthcare.

Plans that we cannot work with are:

Unfortunately, we are unable to provide care for patients who have Medi-Cal or Medicaid insurance. This is because we are not licensed Medi-Cal or Medicaid providers, so we are not able to provide care, even if these patients choose to pay cash instead of use their insurance. If you have Medi-Cal or Medicaid, please do not book an appointment with us, as we will be unable to provide care even if you do not enter your insurance information. We apologize about this.


What do I need to do to prepare for my first appointment?

After booking your first appointment, download the app and make sure that you are able to sign in. Confirm your appointment start time in the app (all times are in your phone's local time). No other actions are needed.

You will receive an in-app chat message 1-2 minutes before your appointment start time with the link to join your video appointment.

What happens after I am prescribed?

After you are prescribed medications, we will coordinate sending these prescriptions to your preferred pharmacy. We may have a mail-order prescription delivery service available; please ask your provider about this.

We will contact you via the in-app chat regarding ongoing refills and follow-up appointments. Your specific follow-up appointment cadence will be determined by your provider.

If you have questions at any time, please feel free to chat with your provider and care team via our secure app.

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Appointment Summaries After Every Visit

Your provider will prepare a personalized plan for you after each visit including a diagnosis, recommendation, prescriptions and resources for additional reading.

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Have questions about your medical insurance? Notice new symptoms? Your Care Coordinator and doctor are available to talk using secure, HIPAA-compliant chat.

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Talk to a provider about Gender Affirming Hormone Therapy today.

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Speak to a care coordinator about Gender Affirming Hormone Therapy.