Our continued commitment to providing safe access to health care
In light of the recent decision by the U.S. Department of Health and Human Services to roll back gender-based discrimination protections in the Affordable Care Act, University Health Service (UHS) affirms our position that health care services should not discriminate in any way, whether this be on age; race/ethnicity, sex; sexual orientation; gender (including gender identity); marital status; physical size; religious, spiritual or cultural identity; psychological/physical/learning disability; socioeconomic status; or veteran status. This is consistent with the long-held values of cultural inclusion, respect, and equality that UHS holds.
UHS and the University of Michigan remain committed to our non-discrimination policy, which outlines that patients and employees cannot be discriminated against based on sex, sexual orientation, gender identity or expression. UHS will continue to provide safe access to affirming, inclusive, quality health care for our University of Michigan campus, including all LGBTQ+ students, faculty, and staff.
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 and non-binary patients below.
The Gender Affirming Care team
The Gender Affirming 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 goals for affirmation, to initiate or continue hormone therapy, and/or to receive referrals for gender-affirming services outside of UHS (e.g. surgery, voice coaching).
We know that supporting trans and non-binary health means so much more than gender-affirming care, and you are invited to schedule with these or other UHS providers for your general primary health care needs.
- Rachelle Wilcox
- Monique Steel
- Aimee Maslach
- Tatyana Guifarro (Psychiatry Physician Assistant)
- Fatima Nasir (Social Worker)
- DeLynn Howe (Registered Nurse)
Gender Affirming 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 Gender Affirming Care team member?
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:
- 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. Any of our UHS Clinical Social Workers can 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.
- Schedule a first appointment with a Gender Affirming Care clinician. During this first appointment, you will discuss your medical history and transition goals.
- 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.
- 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, Gender Affirming Care member and Psychiatric Physician Assistant, is available by referral for evaluations to obtain a letter of support. You can obtain a referral by contacting UHS Social Workers (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. More information about CAPS services for trans and non-binary students is available here.
- 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. UHS Clinical Social Workers 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 U-M Community Provider Database.
How do I submit my letter of support to UHS?
Why isn’t UHS using the informed consent model?
I am already receiving hormone therapy. Can UHS help me continue this care?
Yes! Any Gender Affirming Care provider can take over management of hormone therapy if you are on a stable dose of hormones. We will review any records available, but if possible, it's best to send the following from your current provider: Initial visit summary, most recent visit summary, and most recent lab results. Records can be sent in advance to UHS Health Information Management. If that's not possible, you can bring them with you to your appointment. You do not need to provide a letter of support from a mental health professional to continue hormone therapy at UHS.
If you are not yet on a stable dose, we may be able to take over management of hormone therapy pending review of previous records. Send records to UHS Health Information Management to the attention of our UHS Social Workers, who will work with a Gender Affirming Care provider to review. We will work together to make a plan for how UHS can help!
What are my other options for accessing hormone therapy outside of UHS?
How can I access other gender-affirming services such as surgery?
What fees are associated with hormone therapy at UHS? How about gender-affirming surgery? Does my insurance cover this process?
Most currently enrolled students on the Ann Arbor campus pay the health service fee as part of tuition, which funds clinical services at UHS, as well as well-being services to improve campus health and wellness.
See Costs for Non-students 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.
UHS Clinical Social Workers 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.
U-M faculty, staff, and dependents (as well as students enrolled in GradCare) with questions about coverage can contact Kate Van Valkenburgh, Benefits Compliance Administrator, at email@example.com or (734) 647-4021.
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.
UHS Clinical Social Workers are 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 Gender Affirming Care 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 Gender Affirming Care services at UHS?
UHS Clinical Social Workers are 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 5-hour training series focused on providing affirming care and service to lesbian, gay, bisexual, queer, trans and non-binary patients. Most 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. We require all UHS staff members to have continuing education about inclusive care, specifically to patients who are trans or gender-nonconforming.
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.
Gender Affirming Services for Trans/Non-binary Students at Counseling and Psychological Services
Comprehensive Gender Services Program at Michigan Medicine
U-M Spectrum Center
OutList is a directory of LGBTQ-affirming health care providers