Gender Affirming Medical Care
In the current political climate, accessing gender affirming medical services is increasingly difficult. Embedding services within college health settings is imperative. Gender affirming care not only serves trans and gender diverse students, it is also serves cisgender students and therefore must be available for the inclusion of all students. Explore the services below to learn more.
Medical Services
Below are resources to increase inclusivity and best practices for college health clinics. Each section links to brief information followed by resources commonly used by current practitioners who have been providing gender affirming care for years. Click here for recommendations about Gender Affirming Care in College Health Centers.
Helping clients find the right dose of gender affirming hormone therapy (GAHT) for their embodiment goals is important. Click here for dosage guides for estrogen hormone provisions.
Prescribing gender affirming hormone therapy to help patients achieve their desired aesthetic is crucial. Click here for guidance on gender affirming hormone treatment (GAHT) for testosterone.
Surgical interventions for trans and gender expansive people include many procedures. To learn more about the medical implications, see UCSF's guidelines for medical practitioners.
If you are providing gender affirming medical care, it is crucial to connect with other professionals. Click here to see how to join the Collegiate Gender Affirming Care (CGAC) Listserv.
Radical Informed Consent
What is radical informed consent?
Radical informed consent is an evolution of informed consent that moves beyond traditional definitions to ensure bodily autonomy for oppressed groups. According to the World Professional Association of Transgender Health, a patient can provide informed consent if they are able to understand risks, benefits, alternatives, unknowns, limitations, and risks of no treatment. Often providers are hesitant to provide gender affirming care due to misunderstandings and scare tactics in the current socio-political landscape. It is important to note that the rates of regret for gender affirming medical care is less than 1%.
Therefore, providers must be extremely careful to not withhold life-saving care for TGD patients. See the resources below to learn more:
Hormone
Therapy
Hormone Basics
Some transgender and gender diverse students seek a prescription for gender affirming hormone treatment (GAHT) to achieve a more affirming appearance. Not everyone has the same transition goals, so it's important to discuss embodiment goals with each patient. Some TGD students may want to achieve a feminine or masculine look, while others may hope to achieve an androgynous look and many other options.
TGD patients know best what they want for their transitions. As a healthcare provider, your goal is to ensure they have all the information needed to make an informed decision about their hormone provision.
Important Resources:
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Some questions to discuss with your patients:
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What physical changes you are looking for?
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Are you aware of the irreversible changes versus the reversible ones?
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How comfortable are you with needles and self-administered injections?
Surgical
Procedures
Photo credit: Silver Thumb Photography
*Note: not all TGD patients will experience dysphoria and meet criteria for the clinical diagnosis. Yet, as long as they are able to provide informed consent and understand the procedure and its implications, this diagnosis will be given to meet the needs of insurance or surgeon's office.
Gender Affirming Surgery
Sometimes TGD patients need surgical interventions to affirm their gender. This means medical providers within college health centers may be asked for a letter of support. A letter of support is designed to state the following information:
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The patient is able to provide informed consent.
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The patient has had a persistent and stable gender identity and meets criteria for Gender Dysphoria (ICD-10 F64.0).*
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This procedure is medically necessary (i.e., to not undergo surgery will lead to immense distress and negative physical and mental health outcomes).
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In college health centers, medical providers are often asked to write these letters. Though it may seem overwhelming to need to write a letter, it is a life-saving aspect of gender affirming care. For more information on surgical letters, please see this guide from Folx Health.
Sexual & Reproductive
Health
Gender Affirming Sexual Health
When working with TGD patients, it is important to assess for relevant screenings and procedures. Providers must learn how to ask patients about their sexual practices in a way that conveys no judgment and is affirming or gender neutral. Be mindful of automated prompts in medical records that may not be relevant for TGD patients (i.e., pap smears for transwomen).
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Here are some resources to use when counseling and treating TGD patients on their sexual and reproductive health:
Provider to Provider
Are you interested in offering gender affirming medical care but don't know where to begin? Watch the following videos of medical providers who offer clinical pearls based on their decades of experience providing medical care to the transgender community.
Understanding Gender
The image below is a visual guide to help explain gender and some of the components that contribute to gender identity. Click on the image for an educational guide from GLSEN.
