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And across the administration we have been working very, very hard to get as much scientific we can publicly usablele and into a format for folks who need that. The National Climate assessment is a great example of that kind tool. Its also a great example of the actionable Climate Science that president obama talked about climatelaunched the action plan last summer. Since the president announced greatan we have made progress on a variety of fronts and im really happy today to pleasure of introducing somebody who has really been driving so much of that thatss, and dr. Sullivan, the undersecreta...

As i mentioned, we have a 180 site network in the commonwealth of virginia and with technology it doesnt have to be a traditional referra referral arh is than the western half of the commonwealth of virginia. Ibos who with her preponderance of sites in Far Southwest virginia primarily because thats, lisa we start that was a rural area and a lot of the Grant Funding and our legislative partners were in southwest virginia. We have sites in the middle of the Chesapeake Bay and on easteron theeastern shore of vis well. So technology while this is not about technology it is really important to choo...

And i think that that is something that as a city and we as a Health Department with be proud of because we are leading the way for good and really appropriate transgender healthcare and with that i actually have a question. And it is really about the role map that that you have mentioned at the end. And the providers of the surgeries and i believe that there are some conversations happening before, and at ucsf which is teaching institute. And so, creating a center of excellence through this partnership. I think that is a great question and i think that the workers working on this, and include...

And i think that that is something that as a city and we as a Health Department with be proud of because we are leading the way for good and really appropriate transgender healthcare and with that i actually have a question. And it is really about the role map that that you have mentioned at the end. And the providers of the surgeries and i believe that there are some conversations happening before, and at ucsf which is teaching institute. And so, creating a center of excellence through this partnership. I think that is a great question and i think that the workers working on this, and include...

You have obviously the costly it is. So i would encourage you to really think this true, and possibly under the umbrella of the department. And i greatly appreciate that is in the alignment on it and it is in alignment with the chiefs that i have spoken to at San Francisco general great. Commissioner taylormcghee . Thank you. And clearly there was a paradigm shift in 2010 when medical cited that transgender surgery or sexual reassignment surgeries were medically necessary. So obviously that obviously helps to pave the way particularly that it relevant you lated the insurance commissioner and t...