Trans Resource Navigator

Gender-affirming care in Puerto Rico

Care for adults
Limited
Care for people under 18
Banned
Plan Vital pays for hormones
Unclear
Plan Vital pays for surgery
Unclear
Private plans must cover care
Yes, by law

Hormone therapy and surgery are legal for adults 21 and older in Puerto Rico. Ley 63-2025 bans puberty blockers, hormones, and gender-affirming surgery for anyone under 21, with a 15-year prison term for providers, and bars public funds from paying for that care. No shield law exists. Informed-consent style care is available in San Juan from community clinics; the main US telehealth services do not currently serve Puerto Rico.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. If you are under 18, or a parent
  2. Rules for adults
  3. Health centers near you
  4. Clinics, programs, and funds
  5. Paying for care
  6. Laws and court cases
  7. Sources

If you are under 18, or a parent

Ley 63-2025 ("Ley para la protección de la salud y el bienestar de los menores de edad en Puerto Rico", Senate Bill 350), signed July 16, 2025 and in effect immediately:

  • Who: anyone under 21 (Art. 3).
  • What: puberty blockers, sex hormones (including androgen blockers, estrogen, progesterone, testosterone), and surgeries used for gender transition or to treat gender dysphoria (Arts. 3 and 4). Public and publicly funded institutions may not spend funds on these treatments.
  • Exceptions: intersex conditions and other genetic or hormonal disorders certified by a pediatric endocrinologist or pediatrician, and treatment of unrelated conditions.
  • Penalties: a fixed 15-year prison term for anyone who violates the law, plus revocation of a health professional's license. Organizations face a $50,000 fine per violation and loss of all licenses and operating permits (Art. 6). The Department of Justice enforces it.
  • Not banned: mental health care and counseling.
  • Status: in effect. We found no court order blocking it.
[1][2][3]

Rules for adults

Age 21 and older: no law limits your care. Clinics in San Juan such as TransSalud and Centro Ararat offer hormone therapy, and many community health centers (330 clinics) charge on a sliding scale.

Ages 18 to 20: in Puerto Rico you are legally a minor until 21, and Ley 63-2025 bans hormones and gender-affirming surgery for you. Mental health care is not banned. Some people this age get care outside Puerto Rico; the Campaign for Southern Equality can connect trans people aged 18 to 21 in Puerto Rico with travel and care navigation.

If you have little money:

  1. Ask about Plan Vital (Puerto Rico's Medicaid). Coverage of hormones for adults is not published; ask your plan or clinic.
  2. Community health centers: find one at findahealthcenter.hrsa.gov.
  3. TransSalud posts its cash prices (about $80 for a first virtual visit and $99 for basic hormone labs).
  4. Point of Pride's HRT Access Fund (applications each May).
[1][2][7][9]

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Clinics, programs, and funds

  • Clínica TransSalud[7]

    San Juan clinic for LGBTQ+ people. Hormone therapy for adults, primary care, PrEP and free HIV testing, and virtual follow-up visits. Publishes cash prices and a membership plan for people without insurance.

    • Paid
    • Telehealth
    • Sees uninsured patients
    Carr. 21 U3-2, Las Lomas, San Juan, PR 00921Languages: Español

  • Centro Ararat[8]

    Nonprofit primary care clinics in San Juan, Ponce, Juana Díaz, and Arecibo focused on HIV, sexual health, and PrEP, with integrated mental health. Its San Juan annex in Edificio Europa is listed in directories as "Clínica Translucent", a trans care clinic; call to confirm hormone services.

    • Cost varies
    • Community reported
    787-296-8888Languages: Español, English

  • HRSA Find a Health Center[9]

    Federal locator for community health centers (330 clinics) in Puerto Rico. They charge on a sliding scale and serve people without insurance.

    • Sliding scale
    • Sees uninsured patients

  • Campaign for Southern Equality, Trans Youth Emergency Project[2]

    Does not operate in Puerto Rico directly, but connects trans people aged 18 to 21 in Puerto Rico, and parents of younger youth, with an organization that helps find care outside Puerto Rico and pay for travel.

    • Free

  • Point of Pride HRT Access Fund[10]

    National fund that pays for a period of telehealth hormone care; applications open each May. Check whether the partner telehealth service can serve Puerto Rico.

    • Free
    • Unverified

  • True Self Foundation[11][12]

    Puerto Rico nonprofit that has offered partial grants for gender-affirming surgery for trans adults, among other programs.

    • Free
    • Community reported

  • Departamento de Salud, línea de VIH y enfermedades de transmisión sexual[13]

    Department of Health information line for HIV and STI testing, treatment, and prevention services, (787) 765-1010.

    • Free
    787-765-1010Languages: Español

  • Línea PAS (ASSMCA)[13]

    Puerto Rico's 24-hour crisis and mental health line, 1-800-981-0023 (TDD 1-888-672-7622). You can also call or text 988.

    • Free
    1-800-981-0023Languages: Español, English

  • Trans Health Project (A4TE)[14]

    Guides and templates for appealing insurance denials of gender-affirming care.

    • Free
    • Unverified

Paying for care

Medicaid (Plan Vital)[1][4]

Puerto Rico's Medicaid program, Plan Vital, is run by ASES (Administración de Seguros de Salud) through private managed care plans. We could not find a published policy on gender-affirming care for adults. Ley 63-2025 bars public funds from paying for this care for anyone under 21. If you are 21 or older, ask your Plan Vital plan in writing whether hormones and labs are covered, and appeal any denial. Apply for Medicaid through the Programa Medicaid of the Department of Health.

Apply for coverage

Private insurance[5][6]

The Movement Advancement Project lists Puerto Rico as having a law or policy against transgender exclusions in private insurance, but we could not find the rule itself on the Insurance Commissioner's site, so treat this as unconfirmed. If a plan denies care, first file an internal appeal. Then file a complaint with the Oficina del Comisionado de Seguros (OCS). Employer self-funded plans are federally regulated. A4TE's Trans Health Project has appeal templates.

File an insurance complaint

The rules in detail

Laws and court cases1 law

Sources

14 sources. Numbers in the text, like [1], point here.Show all
  1. Ley Núm. 63 de 2025, Ley para la protección de la salud y el bienestar de los menores de edad en Puerto RicoLexJuris de Puerto Rico, Law. accessed
    “Niño o menor de edad - Toda persona menor de 21 años... será sancionada con pena de reclusión por un término fijo de quince (15) años.”
  2. Resources for Trans Youth & Their Families in Puerto RicoCampaign for Southern Equality, Organization. accessed
    “Transgender young people in Puerto Rico can still access mental health care, which is not restricted or banned by this law.”
  3. Derechos de las personas transgéneroACLU de Puerto Rico, Organization. accessed
  4. Programa Medicaid de Puerto RicoDepartamento de Salud de Puerto Rico, Official page. accessed
  5. Puerto Rico's equality profileMovement Advancement Project, Organization. accessed
  6. Sistema de querellasOficina del Comisionado de Seguros de Puerto Rico, Official page. accessed
  7. TransSalud Puerto RicoOrganization. accessed
    “Consulta con el proveedor (visita inicial virtual) $80 ... Laboratorios (Terapia hormonal básica de afirmación de género) $99”
  8. Centro Ararat ClinicsCentro Ararat, Organization. accessed
  9. Find a Health CenterHRSA, Official page. accessed
  10. Point of PrideOrganization. accessed
  11. True Self FoundationOrganization. accessed
  12. Contactos, Puerto RicoRecursos Trans, Community. accessed
  13. Programas de SaludDepartamento de Salud de Puerto Rico, Official page. accessed
    “VIH/Enfermedades de transmisión sexual (787) 765-1010 ... Línea PAS 1-800-981-0023 1-888-672-7622 TDD”
  14. Advocates for Trans EqualityOrganization. accessed