Gender-affirming surgical care is coming to SLO County with new partnership
Gender-affirming surgical care for transgender individuals will soon be available in San Luis Obispo County through a local collaboration with a Bay Area surgical team.
Starting early this year, the Gender Confirmation Center — a San Francisco-based surgical center that works with transgender and non-binary clients — will start offering its services in San Luis Obispo County, with the clinic’s first surgeries in the area planned for late February and early March.
Founded in 2013 by Dr. Scott Mosser, the Gender Confirmation Center is one of the largest providers of surgical care for transgender individuals in California, offering a wide range of gender-affirming procedures.
Dr. Mosser said the GCC’s expansion into San Luis Obispo County has been in the works for more than two years, when Community Action Partnership of San Luis Obispo Center for Health and Prevention clinic director Kayla Wilburn reached out to the GCC and asked if the surgical center’s team would be able to provide its care in the region.
Now, the GCC is preparing to make its services available in a region that has been largely without access to gender-affirming surgery.
Landon St. James, chair of local advocacy organization Tranz Central Coast, said he’s closely familiar with the challenges posed by a lack of access to surgical care as a transgender man.
St. James has firsthand experience with the GCC, having received his top surgery through the clinic six years ago, and said he’s excited to see more trans people in San Luis Obispo County gain access to the same care with fewer barriers.
He recalled the first in-person meeting between local medical and mental health providers and the GCC, which was held earlier this week at the GALA Pride and Diversity Center, and the feeling the joy spreading between people who have only been able to tell their clients “no” when they ask for local care options.
“I want to shout it from the rooftops, because it is going to change people’s lives,” he said. “We’re gonna see the light come into people’s eyes when they find out.”
Few options for transgender care available in SLO County
Prior to the GCC’s expansion into San Luis Obispo County, few options for gender-affirming surgical care were available in the area.
While access to hormone replacement therapy is available in San Luis Obispo County via providers such as Planned Parenthood, surgical care is scarce, St. James said.
Outside of Planned Parenthood, only a handful of primary care providers in a county already bereft of adequate medical professionals have the training and willingness to provide hormone replacement therapy to transgender clients — a number that has only shrunk as some health companies have quietly rolled back their care options for transgender people in anticipatory compliance with the Trump administration’s edicts on transgender rights, he said.
Issues finding a trans-friendly doctor can extend beyond the world of gender-affirming care, as there’s no guarantee that a doctor will be willing to work with a transgender client, St. James said.
“Trans healthcare is so much more than hormone therapy or surgery,” St. James said. “Trans people get ear infections, we get common colds, we hurt our knees, and we have the same medical needs as everyone else, and our transness is in the room with us in any medical setting.”
As is, just one San Luis Obispo County clinic, Chalekson Plastic Surgery + Med Spa, advertises its ability to provide gender-affirming surgery, and it only offers top surgeries — breast augmentations and mastectomies — for transgender and non-binary clients.
Being able to work with clients with more expediency was a substantial driver behind the GCC’s new expansion, as extensive travel for surgery can lead to higher costs for clients, Dr. Mosser said.
St. James said for transgender San Luis Obispo County residents, that often means lengthy travel to larger cities such as Los Angeles, San Francisco, Seattle or even out of the country to find a clinic for their needs — and, critically, accepts their insurance.
“It’s not just finding a surgeon that does health care for trans people, it’s then finding a surgeon that will take your insurance, and then it’s coordinating time off work if you’re employed to travel, any recovery time that’s required,” St. James said. “I think something else that people forget to talk about is that often, you can’t take yourself to these procedures, and you can’t take yourself home from procedure, so do you have somebody else that’s in the position to take time off work and to travel with you?”
Coming from a background in cosmetic plastic surgery, Dr. Mosser said he was drawn to the field of gender-affirming surgery after performing his first top surgery for a transgender man in 2009.
Noticing that there was a growing demand for his services — along with plenty of misinformation and gaps in care — Dr. Mosser started a website to provide more standardized information on gender-affirming surgery, which eventually led to the founding of the Gender Confirmation Center.
By 2016, Dr. Mosser was exclusively working with transgender clients, and quickly grew his practice to include a team of around half a dozen other surgeons and experts in transgender medicine.
“When somebody is on a gender journey and a physician is talking to them, they’re really deeply connected to that conversation,” Dr. Mosser said. “It is the most important thing in the universe to them. ”
Gender Confirmation Center to serve clients starting in early 2026
The GCC’s expansion of services into San Luis Obispo County was not its first; in September, the GCC also opened a comprehensive care center in Pasadena that offers mental health care, hormonal therapy and eventually surgical care, Dr. Mosser said.
“We’re working as quickly as we can to get started, and we’re working as safely as we can to ramp up in a very coordinated way so that we’re not taking any chances,” Dr. Mosser said. “Hopefully, in the future, we’ll be at a point where we have less than three months wait times for surgery to be completed.”
The San Luis Obispo County expansion will focus only on surgical care, collaborating with local health agencies to bring its services to the area, he said.
GCC chief operating officer Julianne Shirey said clients can initiate the care process by getting on the San Luis Obispo waitlist, which started onboarding clients late last year.
Providers will meet with patients virtually to start to make the initial introduction, and will have follow-up meetings with clients in person at CAPSLO’s Center for Health and Prevention once a course of care has been determined, Shirey said.
Dr. Mosser said while some insurers such as United Healthcare and Cigna generally cover fewer aspects of gender-affirming surgery than other providers, the GCC’s insurance team has a strong history of working with clients’ health coverage to get some or all of their costs covered — a prevalent issue in the world of transgender medicine.
Any client regardless of location can get on the waitlist to have their operation performed in San Luis Obispo County, with the goal of offering more flexibility of location, Dr. Mosser said.
Surgeries will be performed at Posada Surgery Center in Templeton by Dr. Alexander Facque and Dr. Efstathios Karamanos, Shirey said.
The GCC’s team is anticipating to spend one day each week seeing patients for intakes and evaluations and one day performing operations, she said.
Though the GCC offers a wide range of surgical procedures through its San Francisco office — including top and bottom surgeries, facial feminization and facial masculinization surgeries and body contouring to fit the needs of transgender men, women and nonbinary people — the San Luis Obispo County expansion will start with a narrow scope, Dr. Mosser said.
“It will initially start with just top surgery, and from there we’ll get our feet on the ground and really make sure that we’ve got systems that are sensible and provide the service level that we want, and then eventually, depending on need, we could maybe eventually have somebody who’s there full-time and who’s experienced in all aspects of gender surgery,” Dr. Mosser said. “This is really just kind of the first foray into SLO, and we’re really happy to be there.”
This story was originally published February 9, 2026 at 10:00 AM.
