The national Gender Reassignment Committee was founded for the purpose of evaluating and approving gender affirming surgeries, specifically ones performed in public health centers, and funded by the person’s Kupat Holim (HMO) or the army as a part of the healthcare basket (Sal Habriut סל הבריאות); and for approving a change of the gender marker in the national population registry and in the person’s identifying documents such as I.D and passport.
Some gender reassignment procedures which can be accessed through the doctors and other members of the Committee can also be accessed through various doctors, the Kupat Holim, and hospitals and health centers. Some of these are fully publicly funded after getting the committee’s approval, some are included in secondary health insurance (ביטוח משלים), and some are a part of the healthcare basket and do not require the committee’s approval.


The Committee works in the Haim Sheba Hospital at Tel Hashomer.
The Committee functions in accordance with the Ministry of Health’s regulations in Healthcare Administration Circular no. 16/2014.

The Committee’s responsibilities

The Committee evaluates an applicant’s fitness for gender reassignment surgeries in two aspects:

• Medical – the Committee’s official purpose is to provide medical consultation and to make sure there are no medical reasons that would prevent the requested surgery or surgeries from being performed.
• Informed Consent – the Committee’s official purpose is to provide as much relevant information as possible, in order to allow informed consent for medical procedures.
  
  In situations where there is a lack of ability to give informed consent, the Committee process will resume once that ability returns.

The Committee works to provide each applicant with the medical and psychosocial information about gender reassignment procedures in a personalized manner. It offers emotional support and accompaniment throughout the process, and allows for conversations about gender and gender affirming care with professionals trained in these fields.

Core principles and rights

The Committee follows core principles which mandate that each person has the right to make decisions about their own body and about medical procedures, if they can give informed consent. Gender reassignment surgeries which the Committee authorizes are intended to allow each person to live in harmony with their gender identity.
This comes from the view that gender affirming procedures are varied, both medically and socially, and should be matched to each person’s wants and needs.

Understanding and expressing one’s gender is a basic right for every one of us, and there is a broad spectrum of experiences, identities and gender expressions, which can change over time.

Gender identification or expression are not dependent on sex hormones, secondary sex characteristics, genitals, or sexuality.

The Committee acts in accordance with the Patient’s Rights Act and the core principles at its heart. Each applicant has the right to receive respectful and equal treatment with respect to their chosen or preferred name, pronouns, and gender expression. They have the right to access their personal medical records which include documentation of the applicant’s progress in the Committee, and can ask questions and request clarifications about medical procedures. They can also bring an escort to accompany them to tests and to consultation and treatment appointments, and they can start, stop and resume the Committee process at any time.
All these rights are grounded in the Patient’s Rights Act and its core principles, in accordance with which the Committee works.
The Committee follows the professional standards accepted worldwide, first and foremost the Standards of Care (SOC 8) published by the World Professional Association for Transgender Health (WPATH).

The Committee’s guidelines:

• The beginning of the process is the date you first contact the Committee coordinator.
• You can apply to the Committee for approval for surgeries from age 18.
• The amount of time from the application until receiving the Committee’s approval for surgeries will not exceed 12 months.
• Receiving the Committee’s approval does not require getting any surgeries or other medical procedures done.
• You can apply to the Committee to change the gender marker on your I.D from age 16 with approval from all parents.
• Receiving the Committee’s approval for surgeries and receiving approval for the gender marker change do not depend on each other.
• The track for surgery approval includes approval for changing the gender marker, unless you have requested otherwise.
• Taking hormone replacement therapy (hormones and/or blockers) is not a requirement for the Committee’s approval.
• You can begin hormone replacement therapy (HRT) through the Committee endocrinologist, but Committee approval is not required to begin HRT elsewhere, through Kupat Holim doctors or hospitals.
• Carrying an infectious disease (such as HIV or Hepatitis B or C) does not revoke your right to surgeries.
• You can have some of the appointments with the social worker / psychologist by video call, using the hospital’s online technology and according to the guidelines for its use.
• The Committee appointments are recorded in your electronic medical records in accordance with the common regulations in the Israeli public health system and the medical privacy regulations.
  You can view the information in your medical records through the Sheba hospital website or app.

The Committee Process

1. The track for authorizing gender reassignment surgeries (funded by Kupat Holim/army).

A person can apply to this track from age 18. The process lasts about a year:

• An appointment with the committee psychiatrist, an appointment with the committee endocrinologist (or, alternatively, submitting a medical summary from the past half a year provided by another endocrinology clinic), and appointments with committee specialist doctors.
• About 3 appointments with a psychologist or social worker from the Committee (there’s also an option to extend their accompaniment for a longer time).
• After all the appointments have happened the Committee reaches a decision about authorizing surgeries, without the applicant’s presence being required. When an official approval is given by the Committee it is sent by email, signed by the Committee chair.
• Even before the process is done the applicant receives a document authorizing them to change their gender marker in the population registry and in their I.D. The appointments required for this approval are only the ones outlined in the next paragraph.

2. The track for authorizing gender marker changes in the population registry, I.D and passport,
   for those who have not had gender reassignment surgeries.
   A person can apply to this track from age 16 (with parental approval required under age 18). The process lasts several months:

• An appointment with a Committee psychologist or social worker, an appointment with the Committee psychiatrist, and an appointment with the Committee endocrinologist (or, alternatively, submitting a medical summary from the past half a year provided by another endocrinology clinic).

• Receiving a document which authorizes changing the gender marker in the population registry, I.D and passport. Changing the gender marker and receiving new identifying documents are done at branches of the Population Authority (רשות האוכלוסין).

3. The track for authorizing gender marker changes in the population registry, I.D and passport,
   for those who have had gender reassignment surgeries without Committee approval (through the public or private health systems or abroad).
   A person can apply to this track at any age.
   

You can receive a public document for a gender marker change by submitting the following documents:

• A written medical summary by the performing surgeon, in Hebrew or English. If the summary is in another language besides Hebrew or English you must add a certified translation to Hebrew or English as well as a signed affidavit affirming the translation’s accuracy.
• A signed confirmation from your family doctor that the gender reassignment surgery was performed.
• A signed personal testimony from you that the gender reassignment surgery was performed.

Beginning the Committee process

To start the Committee process you must contact the Committee coordinator by phone or email, and she can provide you with a general explanation about the Committee process and how to deal with your Kupat Holim and the hospital regarding administrative issues.

You must tell the coordinator the track you wish to take in the Committee, and add your full name, pronouns, phone number, I.D number, email, and address, as well as a photo of your I.D.

Right from the start you should send the coordinator a medical summary from an endocrinologist, if you have one from the last half a year.

After your initial application, you will be assigned an introductory appointment with a Committee social worker or psychologist, and a letter will be sent to your Kupat Holim or the army confirming the beginning of the Committee process and specifying the required approvals.

After the introductory appointment you will be scheduled for follow-up appointments with the social worker or psychologist, and for appointments with Committee specialist doctors depending on the medical procedures you have requested.

You can choose to delay or stop the Committee process at any time and for any reason, temporarily or forever. In addition, you can continue the Committee process at any time, after a short or long break, by contacting the Committee.

You should update the Committee coordinator or the social worker / psychologist about any change you decide to make.

You should contact the Committee coordinator, Ziva Margalit, for the following issues:

Scheduling an initial appointment, additional questions, information about scheduling appointments, getting financial coverage from your Kupat Holim for Committee appointments, getting Committee approvals, and communication with the Committee throughout the process.

Ziva.margalit@sheba.health.gov.il

03-5302677

Approvals you can receive from the Committee

• “Kupat Holim letter” – this is sent by email at the beginning of the process. It’s a confirmation that you’ve begun the Committee process, including a specification of the appointments you’ll be required to have with certain professionals. You can present this to your Kupat Holim or the army in order to receive financial coverage (Tofes 17 or army budget proofs).
• Approval of eligibility to get gender reassignment surgeries (this is given at the end of the Committee process).
• Approval of eligibility to change your gender marker in the public registry, I.D and passport (this is given at the end of the process required to receive it).

Which gender reassignment surgeries are included in the Committee’s approval, and can be done with public funding?

1. Genital surgeries – “bottom surgery”
   • For trans women and the MtF spectrum – the surgeries are done in Sheba (Tel Hashomer) hospital, and have also recently been started at the Galil Medical Center in Nahariya and at Rabin (Beilinson) hospital in Petah Tikva.
   • For trans men and the FtM spectrum – these surgeries are not performed in Israel at present, and can be done abroad with the Kupat Holim’s funding.

Further surgeries which are done at Sheba hospital and major medical centers across the country:

1. Chest surgeries – “top surgery”: flattening and reshaping of the chest (mastectomy), breast reduction, or breast enlargement.
2. Facial feminization surgeries.
3. Neck feminization surgeries – adam’s apple flattening.
4. Removal of internal reproductive organs – hysterectomy (with or without ovary removal).
5. Vocal cord feminization surgery – it is essential to combine this with voice therapist treatment.

Appointments with the Committee’s specialist doctors

פגישות עם רופאות ורופאים מומחים כחלק מהוועדה להתאמה מגדרית

These appointments during the Committee process will be decided on based on the applicant’s personal needs and requested surgeries, as well as Ministry of Health regulations. Therefore, some applicants will meet all of the Committee’s doctors and some won’t.

In accordance with the Ministry of Health’s regulations, each track through the Committee includes meeting the Committee psychiatrist. Usually there will be one appointment, the goals of which are:

• To make sure that the request matches the tracks through the Committee.
• To check the applicant’s ability to give informed consent to gender reassignment surgeries while understanding the meanings and consequences of the processes.

If any doubts rise about an applicant’s ability to give informed consent, a discussion will be held about this with the applicant in full transparency.

In certain cases the Committee members will ask for a professional opinion from a therapy or aid professional working in a mental health institution or in the community. If you have summaries of treatment or institutionalization, or psychological or psychiatric expert opinions, you should bring them to the Committee appointments. The opinions should address the gender identity and transition process, be up to date (no more than half a year prior to contacting the Committee), and be given by licensed mental health professionals.

The appointments with the psychiatrist take place in the general psychiatric clinic, separately from the appointments with the other doctors.

The next appointments will be with surgeons in the specialties that are relevant to the requested surgeries. All of the doctors are also a part of the Gender Reassignment Clinic at Sheba hospital. Some are members of the Gender Reassignment Committee and some are not. In cases where a doctor is not a member of the Committee, there will be an additional appointment with a surgeon who is a Committee member. For instance, an applicant requesting facial feminization surgery will meet with a senior surgeon from the mouth and jaw department who specializes in these surgeries, and with another surgeon (usually from the plastic surgery field) who is a Committee member.

Fields in which the doctors who perform gender reassignment procedures in Sheba hospital are also Committee members include:

• Psychiatry (for all Committee processes)
• Endocrinology (for all Committee processes)
• Plastic surgery (breast enlargement, chest flattening, and other surgeries)
• Urogynecology (genital surgery)
• Urology (genital surgery for trans women and the MtF spectrum)
• Gynecology (hysterectomy (with or without ovaries) for trans men and the FtM spectrum)

Fields in which the doctors who perform gender reassignment procedures in Sheba hospital are not Committee members include:

• Mouth and jaw surgery (facial feminization)
• Ear-nose-throat surgery (neck feminization, vocal feminization)

The goals of the appointments with the surgeons and with the endocrinologist are:

• Providing medical information about gender reassignment surgeries (each doctor in their field of expertise).
• Personal medical consultation (you should prepare any questions you have and information about your medical background, including the relevant medical summaries).
• Giving approval that there are no medical obstacles to continue the Committee process and perform the requested surgeries. The sum of these approvals from each doctor allows for the Committee’s final approval.

The appointments with the surgeons will be held at the Sheba hospital outpatient clinics, and they’ll be in a clinic format, that is, all of them in one day (as much as possible). The appointment days are on Wednesdays once every two weeks in the morning hours (keep in mind that there might be a waiting time for the concentrated appointment day).

Appointment forms for these meetings will show up in the Sheba website and app (which you should download in advance), and you can use them to receive the required financial coverage from your Kupat Holim / the army.

You should independently keep track of your appointments. You should update your Committee psychologist / social worker and the Committee coordinator about any problems or changes regarding your appointments.

Accompaniment by a Committee social worker / psychologist

• The accompaniment includes about three appointments, which take place once every few months until receiving the Committee’s decision. It’s possible to have some of these appointments by video (using the Sheba hospital online infrastructure).
• The first appointment is meant for meeting the social worker or psychologist, with focus placed on the gender reassignment process, information about the Committee procedure, and the social worker / psychologist’s assessment of the applicant’s ability to give informed consent.
• The second appointment is meant for the social worker / psychologist to get to know the applicant better, to check their progress in the Committee, and to talk about the needs that arise and whether any changes have come up which need to be assessed or addressed.
• The third appointment is meant for summing up the process and for emotional preparation for the surgeries. This appointment usually takes place after completing all the other appointments with the relevant Committee members.
• Depending on the applicant’s needs or preferences it’s possible to extend the accompaniment by about three more appointments.

The goal of this accompaniment is to provide support and aid in the process, to create a safe space to ask questions about the transition process and gender reassignment, and to give relevant psychosocial information. You should be in touch with the social worker / psychologist by email or phone. Regular communication can help advance the process and make sure that your needs are answered in the best possible way.

תיאום ומעקב אחר פגישות שנקבעות במסגרת הליך הוועדה

Appointments with Committee members

The Committee social worker / psychologist – the Committee coordinator schedules the first appointment with the social worker / psychologist. The appointment form for this appointment is sent in an email with all the relevant details, as well as a letter to your Kupat Holim confirming the beginning of the Committee process. The following appointments with the social worker / psychologist are scheduled between you and them during your meetings, and so will not appear in the online system; you should write them down in your calendar.

Committee doctors – after your first appointment with the social worker / psychologist, the appointments with the remaining Committee doctors will be scheduled by the Committee coordinator. The Sheba Connect call center sends an automatic SMS when the appointments are scheduled, which includes a link to the appointment forms. Using the appointment forms you can receive the relevant financial coverage you need.

Transgender community representative on the Committee – you can receive a consultation appointment with the community representative, Nina Halevy, about the Committee process or about bottom surgery for trans women and the MtF spectrum, at the Trans Center (Anilevich 62, Tel Aviv Yaffo). You can sign up at the link:

https://calmark.co.il/p/dwvwi.

Or you can get an appointment with Nina during one of the clinic days, which take place once every two weeks at Sheba hospital, with the help of your Committee social worker / psychologist.

Consultation appointments with other doctors who perform gender reassignment surgeries:

• Scheduling with Dr. Ran Yahalom of the mouth and jaw department (for facial feminization surgeries) is done by the Committee coordinator (an SMS from the hospital will be sent automatically once the appointment is scheduled).
• Scheduling with Dr. Adi Primov of the ear, nose and throat department (neck feminization and vocal feminization surgeries) can be done on your own by calling the number 03-5303988 (an SMS from the hospital will be sent automatically once the appointment is scheduled).

Remote / online appointments

Some of the appointments with the social worker / psychologist can be done remotely by video using the hospital’s Datos system. Shortly before the appointment a link will be sent to your email/phone, there’s no need to download any app or program for this.

The appointments with the doctors are only done face-to-face.

Tracking appointments

You can find information about upcoming appointments, delaying appointments or cancelling appointments at the hospital’s general appointments call center at 03-5305000.

Tracking the doctors’ appointments scheduled to take place in a single day (‘clinic format), and inquiring about delaying or cancelling one of them, can be done by calling the outpatient clinic secretary at 03-5303104, extension 8.

The locations of Gender Reassignment Committee appointments

The Committee is not situated in one place, and appointments with Committee members are held in different buildings and departments. To get to the right place on time you should pay close attention to the emails and messages you get from the Committee coordinator and from Sheba hospital (by SMS, email, and on the hospital website).

The appointments with the social worker / psychologist will be held in one of the following places (pay attention to the details in your appointment form as this may change):

• Hospitalization building, plastic surgery department (eastern elevators, second floor).
• Hospitalization building, outpatient clinics (the corridor near the information station, corridor 3, the room number will appear in your appointment form or you can ask at the reception desk before the corridor; or corridor 4 room 180).
• Psychiatry building (social worker – room 615; psychologist – room 626).

Appointments with the Committee psychiatrist:

• Psychiatry building (room 626).

Appointments with the Committee endocrinologist, Dr. Liana Tripto, will be held in the hospitalization building at one of the following two locations:

• Endocrinology and diabetes institute (main entrance, outpatient clinics wing all the way to the end, second floor).
• Outpatient clinics (main entrance, turn left after the information station to the outpatient clinics wing, corridor 3, the room number will appear in your appointment form or you can ask at the reception desk before the corridor).

Appointments with the Committee surgeons (Dr. Alon Liran, Dr. Revital Arbel, Dr. Noam Catri) will usually be held in a clinic format (one day for all of the appointments) on Wednesdays once every two weeks, at the following location:

• Outpatient clinics (main entrance, turn left after the information station to the outpatient clinics wing, corridor 3, the room number will appear in your appointment form or you can ask at the reception desk before the corridor).

Appointments with an additional Committee surgeon (Dr. Yael Harel):

• Will be decided after the Committee’s approval.

Appointments with surgeons who are not Committee members for consultation leading up to surgeries:

• Dr. Adi Primov – The building of the ear, nose and throat department and head-neck surgeries.
• Dr. Ran Yahalom – outpatient clinics (main entrance, turn left after the information station to the outpatient clinics wing, corridor 3, the room number will appear in your appointment form or you can ask at the reception desk before the corridor).

Bureaucracy and financial coverage

What should you bring to appointments:

• For the appointment with the Committee endocrinologist you need to bring an endocrinology summary from the past half a year and a financial coverage approval from your Kupat Holim / the army.
  You should bring the summary to your first appointment with the Committee (with the social worker / psychologist), but you can also give it at any point later on in the process.
  If you don’t have an endocrinology summary, you will have a meeting with the Committee endocrinologist.
  If you have an endocrinology summary, you should forward it to the Committee coordinator or to the Committee social worker / psychologist, by email or paper copy. If you’ve already provided this summary and the financial coverage approval you won’t need to come to your meeting with the Committee endocrinologist, as she’ll be able to approve your continued progress through the committee based on your medical summary.
• For an appointment with the social worker / psychologist it’s important to bring a professional opinion from an accompanying mental health professional (therapist, social worker, psychiatrist) from the past half a year.

This opinion can help move things forward towards the Committee’s approval, so if you have one you should already bring it to your first appointment.

If you don’t have a professional opinion of this type, you might need to have several appointments with the Committee social worker / psychologist.

• For every appointment with Committee members and Sheba hospital doctors, you must bring a financial coverage approval from your Kupat Holim (Tofes 17) or from the army (budget proofs).
  For appointments with the endocrinologist and surgeons you need to bring a separate financial coverage approval for each appointment.
  
  For appointments with the psychiatrist, psychologist or social worker you need to bring the relevant coverage ‘subscription’, or מנוי (for appointments with mental health professionals each financial coverage is valid for several appointments – more details further down). The appointment cannot take place without financial coverage.
  
  If you do not have a financial coverage approval you can pay for your appointment on the spot in the clinic.
  
  Those in military service cannot give a payment or deposit for appointments.
  
  You need to forward your coverage approval to the professional you are meeting (doctor, social worker/psychologist) or to the Committee coordinator, by email or by paper copy, and you need to bring the coverage approval to every appointment.
  
• You need to bring medical documents which include the relevant medical and diagnostic information, so that the Committee members can give you medical advisement that’s based on your medical history; and as preparation for the Committee’s approval.
  You should forward these documents to the Committee doctors or to the social worker / psychologist or to the Committee coordinator, by email or paper copy, at the appointment or leading up to it.
  

An explanation of the types of financial coverage and how to obtain them

After contacting the Committee by email, you will get a return email from the Committee coordinator with an appointment form for an appointment with a Committee social worker / psychologist, and a request for financial coverage for this and other appointments.

Financial coverage from your Kupat Holim is called Tofes 17 (Form 17), financial coverage from the army is called אסמכתא תקציבית (‘budget proofs’).

During the weeks following your first appointment you will get an SMS from Sheba hospital with a link to the Sheba website. There you will find the appointment forms for appointments with various medical professionals as part of the Committee process (you can download the Sheba Connect app for convenient tracking and management of your appointments and your personal file in the hospital system).

You must submit these appointment forms and the request letter to your Kupat Holim or the army in order to receive your financial coverage, and you must make sure to bring the relevant coverage approval to every appointment.

Please note:

• For appointments with one of the Committee doctors (endocrinologist and surgeons) you must bring a financial coverage approval to every appointment.
• For appointments with the psychiatrist and with the social worker / psychologist, you’ll need to ask the Kupat Holim/army for financial coverage subscriptions (מנוי), with each covering several appointments. There are three kinds of subscriptions:

1. First you will need a ‘diagnostic subscription’ (מנוי אבחוני), code L0771, which covers 2 appointments.
2. After completing these appointments you will need a ‘short treatment subscription’ (מנוי טיפולי קצר), code L0773, which covers 6 appointments.
3. After completing the second set of appointments, in order to continue you will need a ‘long treatment subscription’ (מנוי טיפולי ארוך), code L0775, which covers 30 appointments. Usually this won’t be needed, and it’s only used for continued accompaniment for those who want or need it.

Kupat Holim representatives in Sheba (Tel Hashomer) hospital: you can get help from the Kupat Holim desks on the ground floor of the hospitalization building to print any Tofes 17 that has already been approved for you by your Kupat Holim.

Assistance from Sheba hospital in getting financial coverage from your Kupat Holim: assistance reaching out to the Kupat Holim to get financial coverage (Tofes 17) for tests, treatments and other medical procedures, and more. This service is intended for Sheba patients who have asked their Kupat Holim for a Tofes 17 and been refused. The service is free.

Contact:
03-5307000
zchuyot@sheba.gov.il
For more information online (in Hebrew)

The end of the process and receiving the Committee’s approval for surgeries

After completing all of the relevant appointments with Committee members, the Committee must make a decision about approving surgeries in the following manner:

• Once a month the Committee makes a decision regarding a final approval for those who have finished the required appointments. Situations where there are medical problems or where there is a lack of ability to give informed consent, are brought to a discussion. An invitation to the discussion will be sent to the applicant by the Committee coordinator; participating in the discussion is not mandatory.
• After the Committee gives a positive answer, an official approval for gender reassignment surgeries, signed by the Committee chair, will be sent to you by the Committee coordinator through email.
• If the Committee approval is delayed or prevented by one of the Committee members’ medical opinions, or if there’s concern about a lack of ability to give informed consent to surgeries at the present time, a discussion will be held on the matter. This discussion will be in the presence of the Committee members and the applicant, and it will include an explanation of what else is required to receive the approval and how the applicant should proceed, including how they may appeal the Committee’s decision.
• If it’s decided that treatment of some kind is required to give a final determination of medical fitness for a particular surgery, you can receive an approval from the Committee that’s contingent on having another appointment with a relevant Committee expert after completing the required treatment. In this case, the Committee can give its approval for other surgeries and for changing the gender marker on your I.D and passport, and the contingent approval will only be for the surgery that has raised medical concerns.

Appealing the Committee’s decision

• You can appeal the Committee’s decisions by submitting an appeal in writing to the Committee chair. You should add documents from professionals which support your appeal.
• After submitting the appeal the Committee will have a new deliberation, and will reach a decision that will be documented in your medical record and delivered within 60 days of the appeal’s submission.

Good practices for proper organization

• The most efficient way to communicate with the Committee is by emailing the Committee coordinator, and the Committee social worker or psychologist who accompanies your process.
• Appointment forms to appointments with doctors will be sent by an SMS from Sheba hospital and will appear in the Sheba website or app inside the Sheba Connect system. We highly recommend that you download the Sheba app to help manage your appointments.
• All the information about your appointments appears in the appointment forms – we encourage you to read them closely and to keep them until the appointment.
• The meetings with the social worker / psychologist will not appear on the website or app and reminders about them will not always be sent by SMS. This is because the Committee coordinator only schedules the first of these, and the social worker / psychologist will schedule the remaining ones with you in person during your appointments with them.
• For every appointment with a professional you should bring the relevant financial coverage form (full details will be given at the beginning of the Committee process).
• You should track the appointment forms for your appointments, update the Committee if you have not received them and ask for help with this if you need it.
• You should organize all of the relevant documents and save them until the process is done.
• The service is given at a public hospital, which has long waiting times. You should prepare yourself for the possibility of a long waiting time.
• If you have questions about scheduling appointments, financial coverage for Committee appointments or receiving the Committee’s approvals you can contact the Committee coordinator.

Contact information: Ziva.margalit@sheba.health.gov.il, 03-5302677

• If you have questions about anything in the Committee process you can contact the social worker or psychologist accompanying you (for whom you were given your first appointment). Their job is to manage your process through the Committee from its start until the final approval.
• For help with the clinic days (when you get all of the appointments with Committee doctors in one day; held on Wednesdays once every two weeks), you can contact the coordinators of the LGBTQ health service at Sheba hospital, the nurses Nissim Ovadia Tzaig and Salem Abu Zalef, through the email: lgbtqservice@sheba.health.gov.il
• If necessary you can reach out using the Committee’s main email address: Gender.ReassignmentComitee@sheba.health.gov.il
• To make an appointment for consultation about neck feminization (adam’s apple flattening) and voice feminization you can directly contact the secretary of Dr. Adi Primov of the ear, nose and throat department, at 03-5303988.
  The general phone number of the ear, nose and throat department: 03-5302440.

Continued contact with the Committee after receiving its approval

Reaching out with another request

After completing the entire Committee process, you can reach out to it again at any time. You’ll be able to do whatever additional procedures are necessary for the new approval you are asking for, without needing to start the entire Committee process from the beginning.

Asking for ongoing accompaniment after receiving the Committee’s approval

Some people wish to continue receiving emotional accompaniment even after getting the Committee’s approval, while waiting for surgeries, recovering, and going through the rehabilitation process (which can take weeks, months, or longer).

As part of the emotional service the Committee provides there’s an option for an additional three appointments with a Committee social worker / psychologist (usually the same one you already met), after getting the Committee’s approval. This can allow for additional preparation for surgery, support, consultation, and more. You can also receive limited accompaniment after surgery, including follow-up talks and help getting in touch with relevant psychosocial and community support systems.

It’s important to get as wide a base of support as possible during this complicated time. If you need closer and more intensive aid, you should reach out to the accompaniment, advice and therapy services in the community, including the transgender community organizations.

The Gender Reassignment Clinic at Sheba hospital

Alongside the Gender Reassignment Committee, which functions at the Ministry of Health’s direction, there is a Gender Reassignment Clinic at Sheba hospital which is open to the general public. The clinic’s services are a part of the outpatient clinics and do not depend on the Committee process, aside from those surgeries which require Committee approval.

Services you can receive at the clinic:

• Hormone replacement therapy (HRT) and supervision, at the institute of endocrinology (also called the endocrinology clinic).
• Inspection and supervision at the plastic surgery clinic (through the outpatient clinics) following gender reassignment surgeries done at Sheba hospital (post-op).
• Consultation and surgery at the plastic surgery clinic (through the outpatient clinics), following complications in surgeries done abroad or through private medical services.
• Supervision at the plastic surgery and gynecology clinics (through the outpatient clinics), following surgeries done abroad or through private medical services.
• Several appointments with a social worker or psychologist from the Gender Reassignment Clinic leading up to or following gender reassignment surgeries (while waiting for the surgery, during pre-surgery hospitalization, during post-surgery hospitalization, and in the supervision stage in the clinic). This is dependent on the necessity of this aid and on the clinic’s available resources.
• Accompaniment by the coordinators of the LGBTQ service at Sheba hospital, the qualified nurses Salem Abu Zalef and Nissim Ovadia Tzaig. This includes advice and assistance in communicating with the hospital on anything related to the Gender Reassignment Committee and the Gender Reassignment Clinic.

Additional services you can receive at the Sheba (Tel Hashomer) hospital

• Fertility preservation for trans people who wish to retain their fertility.
• Shesek – the center for sexual health led by Dr. Noam Catri. It includes a sexual and couples clinic led by Dr. Oriel Cohen-Arkin.
• The HIV AIDS, PREP, PEP and sexually transmitted diseases clinic led by Dr. Itzik Levi.
• Accompaniment by the coordinators of the LGBTQ service at Sheba hospital, the qualified nurses Salem Abu Zalef and Nissim Ovadia Tzaig, who are responsible for improving the experience of LGBTQ patients and who provide assistance in communicating with the hospital during visits to the outpatient clinics and hospitalization in various departments.

For any further questions, communication with the Committee and individual questions you can contact:

• The Committee coordinator at Ziva.margalit@sheba.health.gov.il.
• The social worker / psychologist who begins accompanying you in the Committee (their contact information will be in the appointment form sent by email).
• The Gender Reassignment Committee email:
  

Gender.ReassignmentComitee@sheba.health.gov.il

• The Gender Reassignment Committee at the Sheba hospital website

The Committee members

• Committee chair and psychiatrist – Dr. Raz Gross
• Committee coordinator – Ziva Margalit
• Transgender community representative – Nina Halevy
• Endocrinologist – Dr. Liana Shkolnik-Tripto
• Plastic surgeon (top surgery, MtF bottom surgery and more) – Dr. Alon Liran
• Urogynecologist surgeon (MtF bottom surgery, treatment and supervision post-op) – Dr. Revital Arbel
• Urologist surgeon – Dr. Noam Kitrei
• Gynecologist surgeon (hysterectomy and oophorectomy) – Dr. Yael Harel
• Psychologist – Anat Koziol-Bodik
• Social worker – Maya Payes
• Psychologist – Ira Kontorovsky

Regulations and government circulars which regulate various procedures related to the Committee:

• 12.05.2014 – Health Administration Circular no. 16/2014. General guidelines on gender reassignment surgeries and on the Committee.
• 24.03.2014 – Guidelines on gender reassignment surgeries abroad.. Mainly refers to FtM bottom surgery.
• 29.01.2018 – Changing/correcting the gender marker in the public registry (of the Ministry of the Interior).
• 11.12.2019 – Ministry of Health – surgeries supplementary to gender reassignment in the healthcare basket
• 5.2.2020 – Health Administration circular – approving change of sex marker in I.D without surgery