University Health Service

UHS Wants to Serve You

Our goal is to provide high-quality, affirming, accessible care to trans and non-binary patients in a comfortable, inclusive environment. Learn more about our specialized services for trans patients below.

 

The Trans Care Team

The Trans Care Team is a group of health care providers at UHS specifically trained in providing affirming care to trans and non-binary patients. You can schedule with one of these providers for a general health care visit, to discuss transition goals, to initiate or continue hormone therapy, and/or to receive referrals for gender-related services outside of UHS (surgery, voice coaching, etc.)

We know that supporting trans health means so much more than transition-related care, and you are invited to schedule with these or other UHS providers for your general primary health care needs.

Team Members:
Tatyana Guifarro (Psychiatry Physician Assistant)
Diana Parrish (Social Worker)
DeLynn Howe (Registered Nurse)
 

Trans Care Team Services

Well-person visits (aka Physicals, Annuals, or Health Maintenance Exams)
General primary care (for urgent and non-urgent health concerns)
Initiation of hormone therapy
Sexually Transmitted Infection (STI) testing and treatment
PrEP and PEP
Pelvic exam and cervical cancer screening
Pregnancy prevention
 

Frequently Asked Questions

How can I schedule a visit with a Trans Care Team member?

Visit Scheduling to see your options. You can specify if you would like a visit to initiate hormone therapy, a visit to continue hormone therapy that was initiated elsewhere, or an appointment unrelated to hormone therapy. You can also specify if you’d like to be seen in the Medical Clinic or the Women’s Health Clinic. Currently, Rachelle Wilcox and Monique Steel are the Trans Care Team providers who are able to initiate hormone therapy. All other Trans Care Team providers can continue hormones initiated elsewhere. Being specific about the kind of visit you’d like will ensure that you are scheduled with the correct provider and that enough time is scheduled.

What is the process for initiating hormone therapy at UHS?

UHS follows the World Professional Association for Transgender Health (WPATH) Standards of Care (Version 7). Steps for initiating hormone therapy are below:

  1. Obtain a letter of support from a licensed mental health provider (see below). Mental health providers are able to provide letters of support after gathering psychosocial information related to your gender identity and providing informed consent about the effects and outcomes of hormone therapy. See question below for information about how to obtain this letter of support. Trans Care Team Social Worker Diana Parrish will review the letter within 2 business days of receipt to confirm that it meets WPATH Standards of Care, and will notify you and your mental health provider directly as soon as this process is complete. The letter of support should be received by UHS before your second appointment.
  2. Schedule a first appointment with a Trans Care Team clinician. During this first appointment, you will discuss your medical history and transition goals.
  3. Before your second appointment, you will need to complete lab tests (which requires taking a blood sample) in the lab on the 2nd floor of UHS.
  4. A prescription for hormones will likely be provided during the second appointment if the letter of support has been received and there are no outstanding medical concerns to further evaluate.

How can I get a letter in support of hormone therapy and/or surgery?

  • To obtain a letter of support from UHS: Tatyana Guifarro, Trans Care Team member and Psychiatric Physician Assistant, is available by referral for evaluations to obtain a letter of support. You can obtain a referral by contacting Trans Care Team Social Worker Diana Parrish (no appointment necessary). You can also ask your existing UHS provider to give you a referral, if applicable.
  • To obtain a letter of support from Counseling and Psychological Services (CAPS): Schedule an initial consultation appointment at CAPS. During this consultation, inform the clinician that you would like to meet with a CAPS clinician in order to obtain a letter of support regarding hormone therapy and/or surgery. Like all CAPS services, appointments for letters of support are free. CAPS is only available to students who are currently enrolled in classes.
  • To obtain a letter of support from an off-campus mental health provider: You do not need to see a UHS or CAPS clinician to obtain a letter of support. Trans Care Team Social Worker Diana Parrish can refer you to off-campus therapists who specialize in providing affirming services, including letters of support, to trans and non-binary clients. You can also use online therapist directories like the UM Community Provider Database.

How do I submit my letter of support to UHS?

You can email, fax, or drop off your letter of support to UHS Health Information Management. Be sure to direct it to the attention of Diana Parrish.

Why isn’t UHS using the informed consent model?

We acknowledge and affirm that you are the expert on your own body, identity, and experience. As the initiation of hormone therapy is a new service at UHS, for now, we are following the WPATH Standards of Care to ensure that you receive the high-quality care you deserve. Corner Health Center in Ypsilanti (serves patients ages 12-25) provides hormone therapy using an informed consent model.

I am already receiving hormone therapy. Can UHS help me continue this care?

Yes! Schedule an appointment with any Trans Care Team provider to discuss your needs. If possible, it’s best to send a summary of your current hormone therapy regimen to UHS Health Information Management or bring it with you to your appointment.

What are my other options for accessing hormone therapy outside of UHS?

The Comprehensive Gender Services Program at Michigan Medicine offers gender-affirming services including hormone therapy. Another popular choice is Corner Health Center in Ypsilanti (serves patients ages 12-25).

How can I access other gender-affirming services such as surgery?

The Comprehensive Gender Services Program at Michigan Medicine offers a range of gender-affirming surgeries as well as other services to meet your individual needs. Please note that all services obtained outside of UHS are not included in the Health Service Fee.

What fees are associated with hormone therapy at UHS? How about gender-affirming surgery? Does my insurance cover this process?

All visits at UHS, including those with Trans Care Team providers, are free for currently enrolled students. See Fees for Others for information for non-student patients and students who are not currently enrolled. The cost of hormones and gender-affirming services like surgery is dependent on one’s health insurance coverage and varies widely. You can contact your insurance company directly for more information. Trans Care Team Social Worker Diana Parrish can assist with navigating your health insurance benefits and finding alternative resources for those individuals who do not have access to health insurance. The UHS Managed Care and Student Insurance Office has certified Health Care Navigators who have received training in affirming care for lesbian, gay, bisexual, queer, trans and non-binary patients, and can help you enroll in health insurance if you do not currently have coverage. They can also answer questions about coverage under the Domestic and International Student Health Insurance Plans. UM Faculty, Staff, and Dependents (as well as Students enrolled in GradCare) with questions about coverage can contact Kate Van Valkenburgh, Benefits Compliance Administrator, at katevv@umich.edu or (734) 647-4021.

How can I give UHS feedback about my visit?

We welcome your feedback so we can continue improving our services. Visit Feedback for online, in-person, or phone-based options.

How do I change my name and/or gender markers?

To provide UHS with your name, pronouns, sexual orientation identity and/or gender identity, log on to your patient portal and navigate to Health Questionnaires → Sexual Orientation and Gender Identity Form. If you do not yet have access to the patient portal, you can call 734-764-8320, visit UHS Registration in person, or ask any UHS provider to update this information during a visit. Once your health record is updated with this information, it will be used in all future communications and visits. We affirm that this information may change over time and are happy to update your record as needed. We also have the ability to change your gender marker in our medical record system. If your gender marker in our system is not consistent with the gender marker on record with your health insurance, claims for some services such as cancer screenings may be denied. You can file an appeal if this occurs. Please note that UHS shares a medical record system with Michigan Medicine.

Information about updating campus records is provided by Spectrum Center here.

Information about changing name and/or gender marker on state ID and federal documents can be found here.

Washtenaw County residents can obtain a free Washtenaw County ID card, which does not have a gender marker and has the option of adding a preferred name.

Diana Parrish is available to assist with name and/or gender marker change processes.

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

If your previous provider(s) are not able to provide documentation for you, this is a service we can provide. You will need to establish care with one of the Trans Care Team providers. The provider will need information regarding your “transition-related treatment” (see National Center for Transgender Equality for details). Usually 1-2 visits and a review of outside medical records from your past provider(s) will satisfy this requirement. You can send your medical records to UHS Health Information Management or bring them with you to your appointment.

Who can I contact if I have questions about Trans Care services at UHS?

Trans Care Team Social Worker Diana Parrish is available by email or appointment to discuss both on-campus and off-campus resources.

What is UHS doing to create an inclusive, affirming environment?

This summer, UHS clinical and clerical staff participated in a training series focused on providing affirming care and service to lesbian, gay, bisexual, queer, trans and non-binary patients. All but one of the bathrooms in the building are gender-inclusive. We have created new workflows to provide multiple avenues for sharing pronouns, name, and gender identity with staff and taken steps to ensure they are easily visible to all staff.

How can I give UHS feedback about my visit?

We welcome your feedback so we can continue improving our services. Visit Feedback for online, in-person, or phone-based options.

Additional Resources