For transgender college students looking to live according to their gender identity, rather than the one they were assigned to at birth, it may be hard to receive health care.
Many clinics require letters and referrals from other doctors to start receiving hormone therapy, according to 21-year-old USC student and Annenberg Media reporter Val Diaz.
For Diaz, though, this is not the case.
“USC doesn’t do that,” she said. “As long as you go, you say that you want to get [hormone treatment], you sign some stuff–you’re good to go.”
Diaz started her transition two years ago and takes the female hormones estradiol and spironolactone, prescribed to her by USC. These hormones lower testosterone, make skin softer, develop wider hips and more.
Unlike many other schools, USC offers a robust amount of health services for the transgender community.
Diaz receives her hormones from Student Health, which offers services ranging from physical health to mental health services for transgender people.
She says her student health insurance covers 80% of her hormone therapy. Unlike other clinics across the country, all USC Student Health requires is informed consent, or the communication between a patient and health care provider leading to an authorization for care.
Diaz was surprised at how easy it was to get hormone pills through Student Health.
“I got there and the doctor was like, ‘OK, so do you want to start writing the prescription now?’ And I was like, ‘I still have to talk with my parents!’”
USC Student Health offers gender affirming health care, a practice that is starting to be introduced across college campuses nationwide. According to their pamphlet, Student Health “offers services ranging from primary care (including cancer and sexually transmitted infection screening) to hormone therapy.”
“USC health services has helped me get my hormones and also from them I’ve gotten a couple of referrals for trying to schedule [gender reconstructive] surgery,” Diaz said. “They’ve also helped me with blood tests that I have to get every three months to check my hormone levels and basic metabolic tests.”
Dr. Patty Pinanong, the gender-affirming care team lead physician, said she is devoted to ensuring patients like Val receive the care they need. Pinanong started USC’s Gender Affirming Care Team in 2013.
“We know that mental health concerns are a very big risk within our transgender gender diverse communities,” Pinanong said. “I think it’s one thing to hear the numbers [the number of trans kids who suffer from negative mental health]…but I think it’s another thing to really make an impact on someone’s life.”
The number of transgender people experiencing mental health issues is not limited to Pinanong’s patients. The U.S. Trans Survey found that 39% of its transgender respondents experienced “serious psychological distress.”
Over three-quarters of transgender and nonbinary youth have experienced symptoms of generalized anxiety disorder and 70% have reported experiencing a major depressive episode, according to the 2021 National Survey on LGTBQ+ Youth by the Trevor Project.
“We just want to make sure that people feel very supported with the services that we offer,” Pinanong said.
Asher Proctor-Jasper, a trans male USC student, said that he is a patient of Pinanong.
When they first met, he was surprised at how caring and in-depth the care he received was.
“She was sending me resources for things that weren’t even medical related,” he said. “My doctor was sending me resources for how to legally change my name in California. [She] just went above and beyond.”
At USC, The Gender Affirming Care Team also provides referrals for gender affirming services and surgeries, such as gender reconstructive surgery, facial feminization or masculinization, and vocal therapy.
Reconstructive surgery is a common procedure done for transgender people. Proctor-Jasper received reconstructive chest surgery, also known as top surgery, through USC. He got his surgery at Keck Medicine of USC in Pasadena by Dr. Regina Baker, a plastic and reconstructive surgeon.
“I’ve never felt more cared for by a community of medical professionals than I have with USC,” he said.
Proctor-Jasper said he has been misgendered in the doctor’s waiting room in the past and has felt very uncomfortable. However, USC made sure that everything from the waiting room to the surgery itself was gender affirming, according to Proctor-Jasper.
“I actually had this huge anxiety because I had a lot of different medical providers in the past misgender me and call me by my legal name, which is a feminine name,” he said.
“I’m a big dude and it was the most uncomfortable thing ever and people would always look at me.”
However, at USC, he was pleasantly surprised at the treatment he received.
“At USC, they called my last name and I went back to the room,” Proctor-Jasper said. “[The doctor] asked me, ‘I see on here that you’re transitioning, what should we call you?’”
Proctor-Jasper recalled one time he had to make a crucial post-op appointment, just as his insurance was set to expire.
He was worried that due to the busy nature of Student Health, he would not be able to see them before his insurance coverage ran out.
However, the doctors made sure that they could squeeze him in.
“They were like, ‘No, we want to make sure that you’re taken care [of],’” he said. “It was absolutely surprising.”
USC Student Health also offers gender affirming mental health services and works with the LGBTQ+ Student Center to offer services including individual therapy as well as group therapy.
There are also two embedded mental health counselors, Dr. Matthew Brinlely and Riley Davis, within the USC LGBTQ+ Student Center. They provide therapy and counseling for those in the center.
One resource also available to transgender USC students is Gender Spectrum, a group therapy for students exploring their sexual identity. Dr. Ekta Kumar, a licensed Clinical Psychologist at USC Student Health, co-leads Gender Spectrum.
For those that are well into their transitioning journey, the therapists can offer letters of support for gender affirming surgeries, something that many doctors require before surgery. For those that are questioning their identity, therapists can help them understand the process of what they are feeling, according to Kumar.
“We help them explore what gender expression and gender dysphoria looks like and feels like,” Kumar said.
According to the survey done by The Trevor Project, 48% of LGBTQ+ wanted to receive mental health counseling, but they were unable to do so.
“My hope is for them to know that therapy can be a space where they can be seen, not stereotyped or misunderstood, and that it’s a space that is supportive to them. I want to help them reach the goals that they would like to reach,” Kumar said.
For students like Diaz and Proctor-Asher, USC Student Health has been a vital part of their journey.
“It’s such an amazing thing to have this resource, and it’s such an important thing for a lot of trans people,” Val Diaz said.