University of Wisconsin–Madison

TGQ

Trans health

University Health Services and Mental Health Services collaborate with each other and the GSCC on a social transition model with the goal of offering straightforward and supportive transition care.

UHS offers hormone replacement therapy (HRT) in an Informed Consent model. This means that they do not require you to get a letter from a mental health provider in support of hormones as long as you can provide informed consent for care. A person can provide informed consent if they:

  1. Have correct information about HRT
  2. Are able to understand the information about HRT that has been provided, including risks and benefits, as well as reversible and irreversible effects
  3. Are able to use this information to make a decision (definition from Howard Brown Health)

The Informed Consent model is consistent with WPATH Standards of Care and reduces barriers to accessing medically necessary treatment. In this model you will be given accurate and comprehensive information about HRT, and will be supported in making the decision that is the right for you. Please note that providing care in an informed consent model does not mean that hormones are available on demand. In the rare case (e.g. acute psychosis) that a medical provider determines that you seem unable to provide informed consent, you may be referred to mental health services for further evaluation.

As of early 2018, five medical providers at UHS have been trained to provide care related to gender affirming hormones, including initiation and maintenance. In addition to medical training involving case studies, these providers have participated in a 12-hour training facilitated by the UHS Trans Health Specialist and GSCC staff. See their names and positions below.

See below for relevant documents, including informed consent documents on physical changes. We are always happy to talk you through it as well!

GSCC pro staff liaison: Katherine Charek Briggs
GSCC grad student liaison: Cecil Leigh Wilson

You can offer feedback to UHS at Tell Us How We’re Doing.

Currently enrolled students can use the Preferred Name System to designate the name reflected in your UHS health records. See the Navigate Campus page for more on Preferred Name.

UHS health records

Non-students can designate a preferred name, which will be reflected in UHS health records:

  1. Log into MyUHS.
  2. Click on “Go to messages.”
  3. Click on “New message.”
  4. Select “I want to designate my preferred name in my UHS record (non-students)
  5. Enter your preferred name and click “Send.”

Students and non-students can designate their gender identity and whether their sex assigned at birth differs from their legal sex, which will be reflected in UHS health records:

  1. Log into MyUHS.
  2. Click on “Go to messages.”
  3. Click on “New message.”
  4. Select “I want to designate my preferred gender identity and/or sex assigned at birth in my UHS record.”
  5. Enter your gender identity and/or sex assigned at birth and click “Send.”

For questions regarding UHS medical records, students can contact Nancy Ranum at naranum@uhs.wisc.edu or (608) 262-1894.

All students may access University Health Services, including Mental Health Services, without cost, by virtue of paying your student segregated fees. This covers limited individual counseling, group counseling, clinic visits, and more.

Medical transition services

Medical transition services are covered by the Student Health Insurance Program, a supplemental insurance beyond services provided through segregated fees. SHIP covers up to $25,000 of transition care, including hormone prescriptions, surgical procedures, electrolysis, and other transition-related medications or procedures. This dollar amount is a lifetime cap.

SHIP Gender affirming surgery benefit overview

If hormones and related supplies are your primary need, it is more cost-effective to pay out of pocket than to buy SHIP. For surgical procedures, we recommend getting your letters, appointments, and arrangements in place, and then purchasing SHIP for the semester of your surgery. Surgical care is covered at 60% for out-of-network providers and 80% for in-network providers.

Most people find SHIP easiest to use for top surgery (for trans men, transmasculine, and masc of center folx). If you’re looking to use it for bottom surgery, you may want to check in with Katherine at the CC, who is on the trans health work group. We are currently finding out the best way to help you access in- and out-of-network surgeries.

Grad students, faculty, and staff: Your state health insurance will begin covering transition care on January 1, 2019. See Grad students or Fac/staff for more.

Transition care FAQ

See below for common questions around accessing transition care and identity document support. What other questions do you have? Contact us and we’ll find an answer!

  • I want to begin or continue the process to start hormones.
    1. Call UHS primary care at 608-265-5600, option 1, and ask to be scheduled for an appointment to begin or continue hormones
    2. Attend your medical appointment: have your questions answered by a medical provider, create a roadmap for your care with your provider and discuss your medical goals, provide informed consent and complete labs as directed by your provider
    3. Attend follow up medical appointment your provider: review results of labs, discuss any potential medical contraindications, and receive prescription for HRT if appropriate
    4. Ongoing work with you medical provider to participate in follow up care. Follow up appointments are routinely scheduled at 1 month, 3 months, 6 months, and 12 months.

    Providers who are currently offering care related to HRT are:

    We know that stress related to discrimination has an impact on your wellbeing and can exacerbate anxious and depressive symptoms. If you are experiencing distress, we encourage you to talk with your medical provider to learn about options for gaining additional support. UHS offers individual and group counseling with a number of providers who have extensive experience working with TGNC students, can prescribe psychotropic medication if appropriate, and has many wellness and stress reduction offerings.  Transitions can be stressful and having support will be important. In addition to the groups offered at UHS, students also have access to many community-based supports including discussion and peer facilitated support groups at the GSCC and OutReach LGBT Community Center.

  • I need a letter for surgery.

    UHS follow the WPATH SOC v 7 recommended guidelines for letters in support of surgery. Surgeons who follow WPATH standards require one letter from a mental health provider in support of top surgery and two letters from two different mental health providers in support of bottom surgery. For some surgeries, you may need to undergo permanent hair removal processes for 6+ months and be on HRT for 12+ months. Even if you haven’t done those things yet, you can still be seen for a letter!

    To meet with a mental health provider to talk about getting a letter in support of surgery, schedule an Access Consultation. During your consultation, let the access specialist know you would like to be scheduled for a gender identity consultation (GIC) for a surgical letter.

    During your appointment, your mental health provider will conduct a psychosocial assessment to gather information that is needed for the letter of support, including:

    1. The results of the psychosocial assessment, including any diagnoses
    2. Information about how long you have worked with your mental health provider and the type of evaluation and counseling you’ve participated in
    3. An explanation that the rationale for surgery has been met, and a brief description of the clinical rationale for supporting your request for surgery
    4. A statement about your ability to provide informed consent for surgery
    5. A statement inviting the surgeon to contact your mental health provider/s for coordination of care

    Many bottom surgeries require a lengthy recovery period and may require numerous procedures, and it is not uncommon for complications to occur. UHS mental health providers will work with you to help build and support your resilience in preparing for any post-surgical needs you may have.

  • I want to talk to a mental health provider who has training and experience working with TGQ people.

    UHS knows that many TGQ students want to work with mental health providers who have experience and training in gender identity and expression. Whether you are wanting support in your exploration of gender identity, are experiencing symptoms of anxiety or depression, or have other concerns, mental health services has providers who offer care in an affirming way.

    As of early 2018, a majority of mental health providers have participated in at least one 12 hour gender identity training facilitated by the trans health specialist (below) and staff from the GSCC. This training included information about campus climate for TGQ students, language commonly used to by trans, gender non-conforming, and gender expansive students to talk about identity, information about bias and the impact of discrimination on wellness, strategies to support students in their exploration of gender identity and expression, and training in writing letters of support for HRT and gender affirming surgery.

    UHS also has providers who have a designated focus and in-depth experience working with TGQ students & LGBTQ students:

    • Shannon Juniper Neimeko is an associate counselor who has a focus on trans health & is mental health service’s LGBTQ Health Ambassador.
    • UHS is also currently hiring an additional associate counselor who has a focus on LGBTQ mental health.

    To meet with a mental health provider at UHS, begin by scheduling an Access Consultation. During your consultation, let the access specialist know you would like to receive care from a provider who has experience with TGQ students. You may also request to work with a LGBQ or TGQ identified mental health provider.

  • I need a doctor’s note to change my name/gender markers on identity documents, and I’m already receiving my HRT from a UHS provider.

    You can schedule a follow up appointment or login to “MyUHS” and send a new message directly to your current HRT provider.   Tell your provider what type of document and what state (if applicable) you need.

    Completed letters are signed, placed in sealed envelopes, labeled with your name in use and date of birth, and available for pick up with a 5th floor receptionist during business hours (your provider will specify whether it’s the Blue or Green desk when they message you to let you know the letter(s) are ready).  Signed letters can be scanned into the medical record and then shared electronically in “MyUHS.” Some students use this option if they are off campus.

    Keep in mind your provider may be out of the office for vacation or away during breaks.   If that is the case and you are facing a deadline to complete a letter, please schedule a visit with another HRT provider at UHS.   They can review your records at the appointment and typically create the required letter(s).

    Please note some letters require a doctor’s signature.   If you see a physician’s assistant or nurse practitioner for your HRT, they will consult one of the licensed physicians who provide HRT to review your medical records and co-sign the documents.  

  • I need a doctor’s note to change my name/gender markers on identity documents, but I haven’t seen a UHS provider for my gender care.

    Certain identity documents require a letter from a physician to certify a change in gender or name.  If your previous HRT-provider is not able to provide documentation for you, this is a service we can provide without fee for registered students.*  You will need to establish care with one of the medical providers in primary care that provide HRT. The provider will need information regarding your “transition-related treatment.”**  Usually 1-2 office visits and a review of outside medical records from your past HRT provider will satisfy this requirement.

    Outside medical records can typically be obtained for free when they are transferred directly to our clinic.   You can start this process online prior to your first appointment:

    1. Log into the “MyUHS” portal on our website.
    2. Click on “Messages” on the left-hand side.
    3. Click of “New Message.”
    4. Check “I am a UW student or domestic partner”.
    5. Check “I want to authorize RELEASE OF MY HEALTH INFORMATION”.
    6. Complete the remainder of the form, electronically “sign” the form and click “Send.”

    *If you are not registered for classes over summer break, you will need to pay the one-time $103 summer fee to access UHS care and services during the summer.   
    **Wording per the National Center for Transgender Equality (NCTE) nationwide database for identity documents. See the NCTE ID Documents Center for more.

UHS trans health documents

Online health resources

WPATH Standards of Care
The clinical guidelines of care set by the World Professional Association for Transgender Health, used by most healthcare providers

The Center of Excellence for Transgender Health Learning Center
A collection of health guides, fact sheets, and brochures for transgender health

GenderWellness
A project of OutReach LGBT Community Center, GW collects information and resources to help trans, gender non-conforming, and gender diverse people develop healthy lives

Support others supporting you

In the classroom

Want to connect with your professor, instructor, or TA about your name or pronouns? We have some template emails for you:

Semester introduction: name/pronoun

Responding to incident in class

We are also happy to talk you through strategies for intervention and taking care of yourself in challenging or triggering situations.

Groups for supporters

Partners of Transgender People
A peer support group for partners/spouses of transgender people. It meets every 4th Friday of the month from 7-9pm at OutReach.

TransParent
A group that supports parents of trans and gender non-conforming children and youth. It meets every 2nd Monday of the month from 6-8pm at 545 W Dayton St.

Local & regional orgs

WI Transgender Health Coalition

A group dedicated to improving the lives of transgender and gender non-conforming individuals in south-central Wisconsin and promoting quality treatment and access to care.

OutReach

An LGBT community center offering meeting space, advocacy, peer counseling, numerous support groups, an extensive LGBT lending library, volunteer opportunities, and more.

GSAFE

An organization that increases the capacity of LGBTQ students, educators, and families to create schools in Wisconsin where all youth can thrive by developing leadership of LGBTQ students, supporting Gay-Straight Alliances, training educational staff, advancing educational justice, and deepening racial, gender, and trans social justice.

Diverse & Resilient

A Milwaukee-based organization that aims to eliminate disparities in health between LGBT people and the general population, focusing on mental health, sexual health, partner and community violence, and substance use.