Gender Affirmation
We provide gender affirmation services to offer comprehensive support for individuals experiencing gender incongruence (GI).
We participate in the Kansai GIC Network NPO and the Gender Change Review Conference. By collaborating with psychiatrists, obstetricians and other specialists within this network, we provide consultations based on the “Guidelines for the Diagnosis and Treatment of Gender Incongruence.” Our gender affirmation specialist doctors will conduct consultations, discuss appropriate hormone therapy and determine future plans with patients. Please rest assured that you are in capable hands.
We offer generic Nebido, the long-acting male hormone injection at nearly half the price of its original.
Feel free to LINE us as we also stock all other kinds of hormone therapy medications.
Whether the consultation is conducted face-to-face or online, you can undergo hormone therapy and/or testing immediately after the consultation at the day of your visit.
We offer initial gender affirmation consultations in person on the dates below. Underlined dates indicate consultations with Dr. Singh IKEBUKURO.
9 (Tue), 29 (Mon)
In September, initial gender affirmation consultations are available on all dates
except September 6 (Sat), 7 (Sun), 26 (Fri), 27 (Sat), 28 (Sun), 29 (Mon) and 30 (Tue), when we will be closed.
7 (Tue), 20 (Mon)
In October, initial gender affirmation consultations are available on all dates
except October 1 (Wed), 4 (Sat), 5 (Sun), 14 (Tue), 17 (Fri), 24 (Fri), 25 (Sut) and 26 (Sun), when we will be closed.
5 (Wed), 18 (Tue)
In November, initial gender affirmation consultations are available on all dates
except November 28 (Fri), 29 (Sut) and 30 (Sun), when we will be closed.
If you have any questions regarding the gender affirmation, contact us via our official LINE.
Please select the section to jump to.
Note that the prices indicated in this page are all inclusive of tax.
About Gender Affirmation
The tests and treatments we can perform are as follows:
Our counseling and hormone therapy are not covered by Japanese national health insurance.
Counseling
For those with GD, we initially ask to your concerns, provide advice on what can be done and suggest what to begin with.
We offer consultations on GI/GD, hormone therapy, and potential surgeries (for surgeries, we will provide referrals).
We also provide advice for those wishing to undergo gender transition and support for preparations for a gender affirming surgery. Note that the procedures for gender change are carried out at the court.
While we offer consultations on treatment policies, we do not diagnose GI/GD.
Hormone Therapy
Treatment for individuals with GD or GD includes “hormone therapy” and “gender-related surgeries”.
We ensure safe hormone therapy while conducting thorough medical consultations and examinations.
If you are considering a mastectomy or gender-affirming surgery, we offer assistance in selecting the appropriate hospital and provide necessary referrals.
Those who have undergone a gender affirming surgery will become able to apply for a “change of gender in the family register” at the family court.
We offer hormone administration for FTM (Female to Male) to transition from female to male and MTF (Male to Female) to transition from male to female.
Administering hormones helps individuals get closer to their desired physical appearance, but it may also lead to changes from their original healthy state.
It is crucial to consult with a doctor in advance; self-administering hormones without medical guidance can be hazardous.
Regular Examinations
Starting hormone replacement therapy can increase the risk of various diseases such as liver dysfunction, kidney dysfunction, lipid metabolism disorders, diabetes, polycythemia, thrombosis and osteoporosis.
The following examinations may be eligible for coverage under the Japanese national health insurance.
We investigate liver and kidney functions, lipid metabolism disorders, uric acid levels, hormone levels, etc. Based on these results, hormone dosage will be adjusted as necessary.
There is a risk of thrombosis as a complication associated with hormone therapy.
We provide not only blood tests but also comprehensive medical care whenever necessary. This includes lower limb ultrasound, cardiac echography and neck echography to evaluate the risk of cerebral infarction and myocardial infarction.
Hormone Therapy
Here is an overview of the available options and possible side effects of hormone therapy.
Hormone Therapy Options
Main Indications:
Individuals who are AFAB (Assigned Female at Birth), transgender men (FTM) and non-binary individuals
Medication Options:
Injectables: Short-acting testosterone (Testoviron), long-acting testosterone (Nebido generic)
Topicals: Cernos Gel, Glomin, 1UP Formula
Orals: Cernos Capsules
Main Effects:
Fat redistribution, increased muscle mass, increased facial and body hair, deepening of the voice, cessation of menstruation, clitoral enlargement, vaginal atrophy, oily skin and acne, androgenetic alopecia (AGA)
Common Side Effects:
Polycythemia, liver function abnormalities, cardiovascular disease, hypertension and others
Testoviron, a short-acting testosterone preparation, contains the same active ingredients as Enarmon Depot and Testinon Depot.
Main Indications:
Individuals who are AMAB (Assigned Male at Birth), transgender women (MTF) and non-binary individuals
Medication Options:
Injectables: Progynon Depot
Topicals: Le Estrogel
Orals: Progynova
Main Effects:
Breast development, changes in body shape due to fat redistribution, reduced muscle mass, softer skin and reduced sebum production, decreased libido and erectile function, testicular atrophy and loss of spermatogenesis
Common Side Effects:
Thrombosis, cardiovascular disease, gallstones, hyperprolactinemia, lipid disorders, breast cancer and others
Main Indications:
Individuals who are AMAB (Assigned Male at Birth), transgender women (MTF) and non-binary individuals
Medication Options:
Orals: Spironolactone
Main Effects:
Reduction in testosterone levels, breast development and tenderness, decreased erectile function and libido, reduction in body hair
Common Side Effects:
Frequent urination, low blood pressure, mood decline, arrhythmias, general fatigue and muscle weakness due to electrolyte imbalances such as hyperkalemia or hyponatremia
Required Examinations
During hormone therapy, there’s an increased risk of various diseases such as liver dysfunction, kidney dysfunction, lipid metabolism disorders, diabetes, polycythemia, thrombosis and osteoporosis.
Additionally, it’s essential to periodically measure hormone levels because excessive hormone replacement therapy could potentially lead to lethal complications.
We recommend blood testing and hormone measurement in starting and continuing hormone replacement therapy.
Blood count, liver function, kidney function, electrolytes, uric acid, CK, TG, LDL, HDL, blood sugar, HbA1c
In addition to the above, the following hormone tests can be conducted.
Before oophorectomy: Estrogen, Testosterone
After oophorectomy: Testosterone
* Oophorectomy refers to the surgical removal of one or both ovaries.
In addition to the above, the following hormone tests can be conducted.
Before orchiectomy: Estrogen, Testosterone
After orchiectomy: Estrogen, (Testosterone)
* Orchiectomy refers to the surgical removal of one or both testicles.
* The level of prolactin will be measured annually.
The gender affirmation will primarily not be covered by Japanese national health insurance. However, depending on the patient’s underlying conditions, blood tests and other examinations may be covered by insurance.
For more details, please consult with our doctor.
Prices
The gender affirmation will primarily not be covered by Japanese national health insurance.
But, periodic examinations associated with hormone therapy may be covered by insurance, so please consult the doctor.
The price of medical care without insurance will be calculated based on the following pricing system.
[Total Price] = [Consultation Fee] + [Test Fee] + [Medication Fee]
Consultation Fee
The consultation fee varies depending on whether it’s your initial visit or a follow-up visit.
Irrespective of insurance coverage, a follow-up consultation fee applies for all subsequent visits.
Please refer to the top of this page to see whether your preferred consultation date falls on an face-to-face consultation day or an online consultation via video call.
Initial fee: 2,500 JPY
Follow-up fee: 1,000 JPY
Test Fee
The prices for the tests are as follows:
| Type of Test | Price (JPY) | Results* |
|---|---|---|
| Hormone Therapy Blood Test Package | 3,000 | 2-3 days |
| Testosterone + Estrogen | 2,000 | 4-5 days |
| Testosterone | 1,500 | 4-5 days |
| Free Testosterone | 1,500 | 4-5 days |
| Estrogen | 1,500 | 4-5 days |
| D-dimer (Thrombosis Risk Assessment) | 1,500 | 2-3 days |
| LH | 1,500 | 4-5 days |
| FSH | 1,500 | 4-5 days |
| Prolactin | 1,500 | 4-5 days |
| Chromosome Test** | 33,000 | 4-6 weeks |
*The number of days for test results is counted from the “start of testing.” For specimens collected in the evening, on Sundays, holidays or during the New Year holidays, the next business day will be considered the “start of testing.” For not covered by Japanese national insurance services, results are available by email.
**Advance appointment required. Please contact us via Official LINE.
Treatment Prices
The prices for hormone therapy are as follows:
We provide a generic version of long-acting testosterone (Nebido).
It is approximately half the price of the brand-name medication, making it more affordable. Please consider it as an option.
| Type | Formulation | Price (JPY) |
|---|---|---|
| Short-acting Testosterone | Testoviron 100mg | 2,500 |
| Testoviron 250mg | 3,500 | |
| Long-acting Testosterone | Nebido Generic (Cernos Injection) |
18,000* |
| Nebido Generic Oral (Cernos Capsule) |
1 box: 5,000 / 30 capsules 3 boxes: 14,000 / 90 capsules 6 boxes: 27,000 / 180 capsules |
|
| Testosterone Cream | Cernos Gel (1% Testosterone Undecanoate Topical) |
4,000-9,000/month** |
| Glomin (1% Testosterone Topical) |
4,100 | |
| 1UP Formula (5% Testosterone Topical) |
Prescription Fee: 2,200 (+ medication cost)*** |
|
| Short-acting Estrogen | Progynon Depot 10mg | 2,000 |
| Progynon Depot 20mg | 3,000 | |
| Estrogen Gel | Le Estrogel | 1 bottle: 4,300 2 bottles: 6,200 3 bottles: 8,100 |
| Anti-Androgen Agent | Spironolactone | 50mg: 2,500 / 30 tablets 100mg: 5,000 / 30 tablets 150mg: 7,500 / 30 tablets 200mg: 10,000 / 30 tablets |
| Estrogen Oral | Progynova (2mg) | 4,000 / 28 tablets 10,500 / 84 tablets 18,000 / 168 tablets |
*Includes the cost of hormone level testing.
**Dosage and amount may vary depending on each patient’s individual condition. Please consult your doctor during your visit.
***For 1UP Formula, you will pay a prescription fee of 2,200 at our clinic and purchase the medication separately at a specialized pharmacy (approx. 12,100).
Testoviron, a short-acting testosterone preparation, contains the same active ingredients as Enarmon Depot and Testinon Depot.
Consultation Flow
First-time visitors, as well as those who wish to have counseling or other consultations, are required to visit on the days when our gender affirmation specialist doctors are available.
The gender affirmation operates on our appointment-priority system just like our other departments. And, walk-ins may result in extended wait times, so we kindly ask you to make an appointment and fill out the questionnaire in advance.
Appointment
Please make an appointment through the “Gender Affirmation” section of our website.
“Initial Gender Affirmation Consultation” is conducted by a specialist doctor for all patients.
We only accept appointments for initial consultations on designated “Initial Gender Affirmation Consultation” dates.
Hormone treatments for follow-up visits are available regardless of the designated dates. Please make an appointment through the “Gender Affirmation (Follow-Up Consultation)” section of the reservation site.
Fill Out the Questionnaire
After completing your appointment, click the link provided in the confirmation email to fill out the questionnaire.
Filling Out the Questionnaire
After completing the appointment, please click on the link in the appointment confirmation email or the button below to fill out the questionnaire.
Visit On the Day
Please visit us at your appointed time. We will provide you with a number at the reception, and you will be called by that number for testing, billing, etc.
Doctor’s Interview & Consultation
The doctor will conduct a consultation based on the questionnaire, provide appropriate advice, conduct tests, and administer treatment as required.
Residents of Hokkaido, Tohoku and Kanto region can access the generic Nebido at our partnered Personal Health Clinic in Tokyo.
Obstetrics and Gynecology Specialist. Certified by Japanese Society of Gender Dysphoria.
Handles transgender consultations at Yokohama Motomachi LUNA Clinic and gender consultations at Idaten Clinic and Personal Health Clinic.