Resources

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.

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.

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 consultation 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.

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.

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.

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.  

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.

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

Transgender Services at OutReach Community Center
OutReach LGBTQ+ Community Center provides social and support to the Madison and South Central Wisconsin Trans* and Non-Binary Community in a variety of ways, helping gender diverse people develop healthy lives.