Trans Health on Campus

By: Jess Kung

The opportunity to reinvent yourself is exciting. You have a cool new haircut for your first day at a new school. You’ve put on your nice new professional clothes for your first day on the job. For trans students, especially those living on their own, college can be an opportunity to pursue transition without worrying about a family who may or may not be supportive of them.

And luckily for us, Long Beach State’s Student Health Center has started taking steps to make medical transition easier for students.

Gender transition is not a single process or moment — it’s an amalgamation of changes that include names and pronouns, grooming and dress, and literal bodies. It’s become pretty easy for people to experiment with names and pronouns, especially with supportive friend groups and internet personas.

What’s much less accessible is hormone replacement therapy (HRT) and gender confirmation surgeries. It requires the navigation of scary things like insurance and trusting a healthcare provider to not misgender you. It’s a concrete step towards owning your body, and usually comes with the kinds of changes that people start to notice.

This year, Student Health Services has started rolling out services to support trans healthcare. Right now, the most forward facing thing they’re offering is that they can fill existing hormone prescriptions.

So if you’re an enrolled students who has been on HRT for more than six months, you can transfer your subscription to SHS and pick it up at-cost, which is a good deal (but not necessarily much cheaper than other pharmacies). For transfeminine people they currently offer estradiol and the androgen blocker spironolactone, both in pill form. For transmasculine people they offer injectable testosterone, but they don’t offer needles to inject with yet.

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By the way, something that it can be hard to convince people of, trans or not, is that some trans people don’t experience a lot of gender dysphoria (the distress that comes from feeling like your body doesn’t match your gender identity). Dysphoria also manifests differently for different people. For some it’s concentrated on the way their clothes fit, for others it’s tied to their height or their voice. It can be really difficult to go to a healthcare provider if you’re not sure they’d able to learn these nuances.

So while they work on building an informed consent program that would allow them to initiate HRT prescriptions for people without needing a diagnosis (they hope to have that running in the next year), SHS is making an effort to train their staff and providers to be aware of trans students’ comfort and safety.

For instance, last year, a group of trans students combed the SHS website to make sure that the language was inclusive. They’re considering a rework of the name “women’s health” to reflect that not everyone with a vagina is a woman.

“I hope that transgender students feel comfortable going to Student Health Services, whether it’s for trans health or not. All students should feel welcome here,” said Dr. Michael Carbuto, the only provider trained to prescribe HRT.

It was a long process to start this new service, at least three years. Providers have to do extra training to understand the bloodwork and differences in medication. Usually, SHS keeps their services broad and applicable to most of the student population, because it makes it easier to handle the thousands of students coming in and out. It’s a bit of a departure to cater to the minority, but trans healthcare is expanding across the board.

Long Beach State is now one of nine schools of the 23 CSU campuses that offers HRT continuation. There are currently no CSU campuses that can easily initiate people.

However, there are many services becoming more common throughout the system: lab results that don’t restrict a person to one sex option, name and pronoun changes within the campus system and counselors trained to address trans and nonbinary gender identity with appropriate language. More counselors are also able to give HRT referrals to students who can’t initiate through informed consent.