HRT@Home: Gender-Affirming Care Across State Lines When Your State Won't Provide It
Transnational Health's HRT@Home program provides transgender hormone therapy by telehealth to patients in states that restrict gender-affirming care. Here's how it works and how CE Repro Fund supports their patients.
If you're transgender or nonbinary and live in a state that restricts gender-affirming care, you already know the fear: losing access to the hormones that allow you to live as yourself. As state-level bans and federal policy changes make HRT harder to access, telehealth providers operating under shield law protections have become a lifeline.
HRT@Home, a program of Transnational Health Corp, is one of those lifelines. And CE Repro Fund is here to make sure cost never stands between you and your care.
What HRT@Home provides
HRT@Home offers gender-affirming hormone therapy via telehealth, providing both feminizing HRT (estrogen and anti-androgens) and masculinizing HRT (testosterone) through video telemedicine appointments.
The program uses an informed consent model — meaning you don't need a letter from a mental health provider or any form of gatekeeping to access hormones. You meet with your provider, discuss your goals and medical history, and begin treatment based on your informed decisions about your own body.
Appointments are available evenings and weekends, reflecting the reality that many patients are working multiple jobs or navigating complicated schedules. Medications are shipped via mail-order pharmacy in unmarked, discreet packaging, with local pharmacy pickup also available in the DC and Maryland area.
Who HRT@Home serves
HRT@Home serves patients in 48 states, with a particular focus on reaching transgender and nonbinary people in states where gender-affirming care has been restricted or made difficult to access. Their providers are licensed and located in shield law jurisdictions — including DC and Maryland — which protect them from legal retaliation by states that restrict gender-affirming care.
Maryland's Trans Shield Act, which took effect on October 1, 2024, specifically added gender-affirming care to the state's definition of legally protected healthcare. This creates a protected corridor in the DC metro area for providers serving transgender patients across the country. Visit hrtathome.org to check availability in your state.
How the process works
Getting started with HRT@Home follows a simple path. You book a consultation through their website. You meet your provider via a secure video call. Together, you discuss your health history, your transition goals, and develop a treatment plan. Your provider writes your prescription, which is filled through a mail-order pharmacy and shipped to your door. Ongoing care — including lab work monitoring and dose adjustments — happens from home via follow-up telehealth visits.
Making care affordable
HRT@Home is a cash-pay practice and does not currently accept insurance. However, they offer two sliding-scale programs and partner with community organizations to subsidize care. Their stated policy is that no one is turned away for inability to pay.
CE Repro Fund provides direct financial assistance to patients who need help affording HRT@Home's services. If you need gender-affirming hormone therapy and can't cover the cost, contact us about patient funding assistance.
For donors, this is one of the most direct ways your money makes a difference. $50 covers a month of HRT medication. $100 covers a telehealth provider visit. $1,000 can fund a full year of hormone therapy including medications, visits, and lab work.
Why this matters
Twenty-seven states have enacted bans on gender-affirming care for minors, and several states have extended restrictions to affect adult access as well. The Supreme Court's Skrmetti ruling in June 2025 upheld these bans, and federal executive action has further threatened institutional support for gender-affirming care.
For transgender adults in restrictive states, the options are stark: find a way to access care through telehealth, travel to a state where care is available, turn to unregulated hormone sources, or go without treatment entirely. Research consistently shows that hormone therapy improves mental health outcomes, quality of life, and overall wellbeing for transgender people. Losing access to monitored medical care carries real health risks.
HRT@Home exists to ensure that no transgender person has to make those impossible choices simply because of where they live.
For patients seeking HRT
If you need gender-affirming hormone therapy, visit hrtathome.org to check availability in your state and book a consultation.
For additional resources, visit our Resources page for information about other transgender healthcare organizations and support services.
If you need financial help paying for HRT, CE Repro Fund may be able to assist. Visit our Join Us page to contact us.
For donors who want to help
HRT@Home, like Southern Woven, cannot advertise through Google due to platform restrictions. Organic search is one of the only ways patients in restrictive states can discover these services. By sharing this post and supporting CE Repro Fund, you're helping transgender people find the care they need.
Your donation to support Transnational Health directly funds HRT for transgender patients who cannot afford care. You're not funding a marketing budget or an overhead line item — you're funding someone's hormones, their provider visit, their lab work. The care that lets them be who they are.