Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington.

Background: Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization.

Material And Methods: We collected routine program data from three SSPs in King County, Washington.

Barriers to Gender-Affirming Care for Transgender and Gender Nonconforming Individuals.

Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.