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Gender Affirming Care

Transgender, genderqueer, gender fluid, gender expansive, or people outside of the gender binary identity routinely face discrimination and misunderstanding from health care providers, which prevents many of them from getting the care they need. We are committed to providing comfortable, affirming, and accessible care to our trans and genderqueer community at Macalester College. We strive to create an environment that is gender affirming and inclusive so that you feel safe in order to get the care you need. We approach gender affirming care from a culturally responsive, non-judgmental, holistic perspective, and our providers center their care around meeting you where you are at with respect, kindness, and compassion.

Using an informed consent approach, our gender affirming care is designed to reduce barriers to accessing care. Like all medical and mental health visits at the Hamre Center, there is no cost for appointments with providers. Costs only occur if medical labs, prescriptions, and/or procedures are recommended by your provider and will be discussed with you before any action is taken.

Our goal is to provide gender affirming care in a way that is as transparent and accessible as possible so that you feel safe, seen, and respected. We want to help you connect with the resources you need to be healthy and well.

If you would like to schedule a medical or mental health appointment, you can contact the clinic at 651-696-6275.

Have questions? Check out our FAQs!

Information about Gender Affirming Insurance Coverage

At the Hamre Center, there is no cost for medical visits, talking with providers, and/or getting physical exams (with your consent). When medical labs or prescriptions are agreed upon by you and your provider, we will discuss anticipated costs or options with you. See Hamre Center list of charges document. If you are seeking gender affirming services outside of the Hamre Center, please review your insurance benefits.

In our experience, gender affirming care has been covered at the same rate as other medical services on the UnitedHealthcare insurance plan. Since we cannot guarantee coverage, we recommend contacting the Help Line customer care service for Gallegher via phone, live chat, or email form to ask specific questions regarding your coverage and approximate costs. If you do not have UnitedHealthcare, you can follow the same process by contacting the customer service phone number on the back of your insurance card. For assistance calling your insurance company and/or to be directed to the right person to answer your insurance questions, contact our Insurance and Referral Specialist, Nicola Michael-Tsai (she/they) at [email protected].

Here is the medical policy for Gender Affirming Care with UnitedHealthCare. Please note: this document has medical terminology that can be difficult to interpret and understand. We are providing this document because some medical clinics may request to see it. We recognize there is language in this document that is clinical and pathologizing in nature. Take care in how you utilize this document because it may not be helpful for you in your journey.

Additional Resources

Hamre Center’s goal is to make you aware of possible resources in the community that may be helpful. These lists are not comprehensive of all available resources, and we do not endorse any of the following services as the right option for any specific individual. This list includes information about local medical clinics, mental health agencies, legal processes, and books/graphic novels to support you in your journey.

Queer / Trans Campus and Community Resource List

Gender Affirming Care FAQ

  • Q: What is informed consent?

    A: In the context of health care, “informed consent” means that we will present you with all of the information and knowledge you need to make a decision so you understand the impact it may have on the biological, psychological, and social domains of your life. This includes, but not limited to sharing risks and benefits, potential positive and negative outcomes, offering you resources and support for continued understanding, allowing space for questions, and giving you opportunity to communicate your choice and decide if you want to move forward.

    We are very committed to providing you with lots of education and information so that you can make the best decisions about your own body and health care. We trust that you know yourself better than anyone. We fiercely acknowledge that trans, genderqueer, and non-binary gender identities are not a mental illness or a disorder.

    We also encourage you to continue connecting with community and accessing many of the resources and knowledge outside of our walls, so that support and information continues to be accessible to you with or without seeking medical or mental health services from our office.

  • Q: Are you currently taking on new medical and/or therapeutic students?

    A: Yes, call our front office at 651-696-6275 to schedule an appointment. Depending on the time of year, first-time medical appointments may have a 1-4 week wait and first-time mental health appointments may have a 2-3 week wait from the time of your call.

  • Q: I am interested in seeking surgical interventions. Can you write gender affirming surgery letters?

    A: Yes. Our process is informed by the  World Professional Association for Transgender Health Version 8 (WPATH) standards and seeks to be collaborative, based on your needs, and to improve access rather than gatekeep your medically necessary care. We are working on having all of our providers trained in the updated WPATH 8.0 requirements necessary to write this letter. At this time, some of our providers are trained and prepared to assist you. Call our front office at 651-696-6275 to schedule an appointment with one of our experienced counselors, or you can reach out directly to counselor/care coordinator Jen Moore at [email protected] for them to help coordinate access to this service.

  • Q: I identify as non-binary. How are you prepared to support me?

    A: We strive to honor all your identities, provide an inclusive space, and use inclusive language in our office. Sometimes a medical records system and other health records systems from other places may enforce binary categories. If and when that arises, we will do our best to be transparent and open with you about what is happening.

    We recognize that everyone has unique support needs. While we will seek to be responsive to expressed needs, you are always welcome and encouraged to correct us, tell us if/when things change regarding how you experience support, and request specific providers from our offices.

  • Q: How can I give feedback about my experience at the Hamre Center?

    A: Your feedback is very important to us. We encourage and invite feedback about our work with you, successes, and areas for improvement. If we make a mistake, you do not feel safe and respected in our care, and/or there is something about your care that you’d like to offer feedback on, below are several options to do so. 

    1. Anonymous Feedback Form
    2. Direct email to Jen Jacobsen, Hamre Center Executive Director
    3. Direct email to Hanin Harb, Hamre Center Mental Health Counselor / DEI Program Manager

    We acknowledge the emotional labor that goes into offering feedback, especially after experiencing harm. If you do not have capacity to offer us your emotional labor with feedback, we understand. If you have limited capacity, please be sure to prioritize your care first and foremost. If you do choose to contact us, please know it is our hope to not only deeply hear what you offer, but also give options to you about what we can do to repair and/or correct what went wrong in a way that feels centered on the impacts you experienced.

Hormone Care FAQ

  • Q: Am I guaranteed to get hormones if I come to the Hamre Center?

    A: No. Like any medication we prescribe for any reason, we will utilize the informed consent process (explained above) and make sure that hormones are safe for your body and your health.

    If you and your provider find that you have any health conditions or concerns that require attention before you can start on hormones, they will help connect you to a provider that would be a good fit for you. In some cases, we may refer you to another hormone provider if we feel we can’t meet your needs.

  • Q: Does everyone get the same dose of hormones?

    A: No. The medications you are prescribed will depend on your goals, how you tolerate the medications, and what the mix of desired effects and side effects are. Some patients call their desire for lower hormone doses “microdosing,” and our gender care has always included prescribing hormones at as low a dose as the patient desires or as high a dose as is safe for them. Gender exists on a spectrum and not everyone who is trans-identified has the same vision or goals for their bodies or their transition. Like all medical interventions, gender care should meet your goals for change or treatment. Our providers will talk with you about your identity and the hopes you have for taking hormones then personalize your care plan to help meet your needs as much as possible. We tailor our work to meet your unique needs as an individual.

  • Q: What if I have already taken hormones?

    A: Great! We’d love to help you continue taking hormones. You can contact the clinic to make an appointment. Please have your medical records from any previous hormone provider(s) sent to the Hamre Center. Please bring any hormone medications you are currently taking with you to your first appointment as well.

  • Q: I want to reduce or stop taking hormones. Can you help?

    A: Yes, we can absolutely help you. Please reach out to our office so we can help you reduce or stop medication to help better align with your needs and goals.

  • Q: How do I get started?

    A: Call the front desk at 651-696-6275 to make an appointment to ask us more in person or to start the process of receiving prescribed hormones.

  • Q: How much will this cost?

    A: It depends. Our goal is to make hormone care as affordable as possible. There is no cost for medical visits, talking with providers, and/or getting physical exams (with your consent). When medical labs or prescriptions are agreed upon by you and your provider, we will discuss anticipated costs or options with you. See Hamre Center list of charges document.

  • Q: Do I have to go to therapy to get hormones?

    A: No. We encourage you to seek support during your transition journey and trust that you will know best what support, if any, is needed. We know that being trans, genderqueer, or non-binary is not a mental illness. We also know that because of persistent cisgenderism and restrictive gender binaries within the world that are deeply tied to white supremacy and colonialism, it can be hard to explore and expand gender both internally and externally. If you want support that Hamre Center cannot offer or would prefer to access support outside of our office, we will partner with you to find those resources.

  • Q: I think I might want more than hormones for my gender care – perhaps surgery or hair treatments or dermatological interventions. Do you offer that?

    A: No. We can partner with you to refer you to larger gender care clinics that offer mental health services, hormone care, surgery, voice and communication therapy, dermatological procedures, hair removal, reproductive and sexual health, and more. We are actively trying to grow our list of places that Macalester students have had success receiving gender affirming care in our local community. 

Mental Health FAQ

  • Q: Does the Hamre Center offer gender affirming mental health care?

    A: Our goal is to offer gender affirming mental health care. We recognize that each person has unique needs and defines what is “gender affirming” specific to themselves. Read on to hear how we define it… We provide individual counseling for students who are seeking therapeutic support related to gender identity and expression from the stages of questioning their gender identities through whatever part of the transition process – social, medical, legal, navigating systems, intrapersonal work, etc– that feels important to them. Gender affirming means you’ll never have to prove your identity, though you might wish to explore it, and we can help with that. Choosing counseling can be related or unrelated to mental health concerns directly tied to gender identity. We’ll affirm who you are while also listening to your needs around how big gender is related to the support you’re seeking. Generally, the goal of individual counseling is to talk through concerns and help you heal, grow, and move towards a more satisfying and meaningful life. It is an opportunity to explore feelings, thoughts, behaviors, beliefs and build self-awareness, to receive support and guidance, to consider solutions to life’s challenges, and to set personal goals to work toward change. You will work with a trained mental health counselor in a safe, caring, and confidential environment.

  • Q: How do I schedule a mental health appointment?

    A: To schedule a one-on-one individual counseling appointment, you can: 1. Fill out the Request an Initial Individual Counseling Appointment form, 2. Call our front desk at 651-696-6275. 3. Stop by our office in the Leonard Center to schedule,  4. Email us at [email protected], or 5. Contact a counselor via email or phone directly.

  • Q: What can I expect from my first appointment?

    A: At your initial meeting, you will meet with your counselor for 45 minutes to discuss your current concerns and relevant history. Together, you will come up with next steps for your care based on your needs and available resources (i.e. short-term individual counseling, group counseling, off campus support, other recommendations, or you may decide no further care is needed). If the next step is short-term individual therapy at the Hamre Center, a follow-up meeting will be scheduled (usually in 2 – 3 weeks). If the next step is off campus counseling, then your counselor or the Hamre Center Care Coordinator will work with you to find resources and support in the local community. 

    We also always invite you to “interview” your counselor, whether that be at Hamre Center or in the community. You can ask your counselor questions about their approach to counseling, their values, their education, and their experiences that are important for you to know about. If the counselor you’re first with at Hamre Center isn’t a good fit, you can switch to a different provider. And same goes with providers out in the local community. Here is a guide about what to expect and how to prepare for a first appointment and/or counseling consultation.