Transgender and Gender Diverse Care

Gender Diverse Care Team

The Gender Diverse Care Team (GDCT) consists of medical providers, mental health providers, and case managers dedicated to supporting transgender and gender diverse students who are contemplating or pursuing gender-affirming care. The GDCT is a collaboration between Counseling and Psychological Services (CAPS) and University Health Services (UHS).

Any student who experiences incongruence between their current gender identity and gender/sex assigned at birth may benefit from working with the GDCT. Whether a student desires help exploring their gender identity, is ready to start gender-affirming hormones, or wishes to pursue surgical treatments, the GDCT can help.

Consultation

The GDCT helps students understand their goals and concerns with regard to gender affirmation. The team follows the World Professional Association for Transgender Health (WPATH) guidelines for practice and uses an informed consent model. To provide holistic support, a team-based approach is recommended, which can include collaboration with:

• A mental health provider to address emotional concerns and provide support around gender exploration and/or challenges unique to transitioning.
• A case manager to help with attaining past medical records, coordinating with any outside providers, and understanding insurance coverage.
• A medical provider for an evaluation of health status; support and assistance with medications, contraception, gender identification cards, and fertility preservation options; and potential prescription of gender-affirming hormones.
• In some situations, the GDCT may recommend a student also receive a psychiatry evaluation.

Collaboration

Students’ primary GDCT members regularly communicate with one another regarding ongoing questions and concerns.  This communication may be via phone or secure message or occur in-person at team meetings. The entire GDCT meets on a routine basis to discuss students’ treatment plans, consult, and offer one another suggestions for how to best support students. 

Mental Health Evaluation

At CAPS, evaluation starts with a 15-minute phone call.  Next, students meet with a CAPS clinician for a 45-50-minute initial consultation. During this consultation, the clinician will work to better understand the student, any mental health concerns the student may have, and, when relevant, the student’s gender-related concerns. Together the clinician and student will develop a treatment plan. This may involve group therapy, assessment for a letter for gender-affirming surgery, and/or short-term individual therapy at CAPS or a referral to a community provider for longer-term individual therapy. If needed, students can meet with a case manager at CAPS or UHS to explore which community providers best fit their needs and take their health insurance. In these instances, a student’s GDCT members at UHS and CAPS will involve their community-based therapist in treatment planning and care coordination.

• Read more about resources for gender diverse students at CAPS.

Medical Evaluation

Students work with a medical provider at UHS to develop a treatment plan based on the individual’s goals for treatment and any medical and mental health care needs. The intention of the initial medical evaluation is to understand the student’s past medical history and current health status so that their medical providers can assess and discuss the risks and benefits of gender-affirming hormone therapy.

At a typical medical evaluation, a nurse will check the student’s blood pressure, heart rate, and weight. The medical provider will ask questions about the student’s medical history, health habits, and any physical symptoms the student is having. The provider may also perform a physical exam and the student may be asked to get bloodwork. 

Prior to writing a prescription, the student’s provider will review the informed consent process, discuss the student’s gender identity development history, and explain effects and possible risk factors for hormone therapy. This process normally requires a second visit. If a student begins taking gender-affirming hormones, medical visits are generally every few months to review changes, side effects, and monitor hormone levels and other labs.  Once hormone levels are stable, bloodwork and medical visits are less frequent.

Hormones

UHS providers do not require a letter from a therapist before starting gender-affirming hormones, however, a student must be able to demonstrate an understanding of both the risks and benefits of hormone therapy.

If and when a medical provider decides to move forward with treatment is dependent upon student-specific situations and needs.

Cost

There are no extra fees for the team-based, coordinated care provided by the GDCT. The individual care students receive from their treatment team members may have associated fees, however:

• Most CAPS services are provided for free to full-time students. Fees are charged for certain services (e.g., psychiatry) and for individual therapy sessions after the 6th visit.
• UHS office visit fees vary depending on the medical issues addressed. There are additional charges for some procedures and all ancillary services, such as laboratory tests and pharmacy. A students’ insurance company may cover these charges. Students should check with their insurance company to determine their coverage. If a student is having trouble paying their bill, UHS’s Billing and Finance Office may be able to assist.
• Community mental health providers accept a range of fees and insurance plans.
• If a student does not have insurance, case managers at CAPS or UHS can help them explore their options. Learn more about health insurance at Penn State.

Confidentiality

Students’ privacy is important to the GDCT.  Information shared with the GDCT is held in the strictest confidence consistent with professional and ethical standards, and state and federal law.  GDCT members will not release information without signed consent except in rare instances where sharing is required by law, such as to save a human life, report child abuse, or comply with a court order.

Get Started

To start working with a member of the GDCT, students can call 814-865-4UHS (4847) or go online to myUHS to schedule an appointment with a UHS case manager.

Expectations

• Respect and compassion regarding students’ care
• Dedication and knowledge by the professionals serving students
• Communication and collaboration with students and among their team members
• Confidentiality and privacy concerning students’ treatment