Transgender & Nonbinary Care
Gender-affirming services
We want every student to feel comfortable and safe advocating for the care they need. We believe good health means caring for both the body and the mind. Our healthcare team is committed to providing you comprehensive services that support your well-being.
Services overview
What medical services are available at the UCSC Student Health Center?
- CAPS for mental health support (upstairs East Wing)
- Refills for hormone therapy
- Initiation of hormone therapy
- Case management
- Referral for fertility preservation
- Referrals for gender-affirming surgeries (e.g., top surgery, bottom surgery, facial feminization)
- Referrals for additional specialized care (e.g., vocal training, hair removal)
- Routine physicals and general primary care (e.g., respiratory illness, diabetes, asthma, high blood pressure, immunizations, minor injury, etc.)
- Gynecological care
- Cancer screenings
- Breast/chest health screening
- Contraceptive care (birth control)
- STI (sexually transmitted infection) testing, diagnosis, and treatment
- Pharmacy (next door in our East Wing)
- SHOP for support for safer sex and alcohol and drug use (next to the pharmacy)
Hormone Therapy FAQ
How do I obtain referrals and/or access care?
Whether you’re ready to start hormone therapy, obtain a gender-related referral, or just want to learn more about gender-affirming care, we welcome you to fill out an interest form on Health e-Messenger. Select “Gender Affirming Care One Stop.”
- After scheduling, a case manager will reach out to review your insurance info and provide an overview of the gender-affirming care process.
- If you’re already receiving hormones and have UC SHIP:
- For Zoom or phone: Book online on Health e-Messenger → general primary care → telehealth primary care
- Schedule a general primary care or medication refill appointment
- For in-person: call 831-459-2500
What is hormone therapy?
We recognize that “masculine” and “feminine” are imperfect terms. We use them to describe hormone therapy and body changes.
- Testosterone (Masculinizing Hormone Therapy)
- Estrogen (Feminizing Hormone Therapy)
Which medications are available and when might I expect to experience changes?
See below for typical hormone therapy medications. Providers usually start at a low dose and increase slowly based on your body’s response and your personal goals.
- Testosterone: changes usually occur within 6 months
- Available as a topical gel or in injectable form
- Estradiol: may take 6 months to a few years
- Available as an oral pill, a topical patch, or in injectable form
- Spironolactone (an oral pill) can also be used for anti-androgen effect
What is Low Dosing?
“Low dosing” (or “microdosing”) means taking lower doses of hormones. This results in more gradual or subtle physical changes.
Reasons for low dosing include:
- Desiring subtle changes
- Managing pre-existing health conditions
What standards of care does UCSC Health Center use?
UCSC follows the UCSF Transgender Excellence of Care guidelines to create individualized hormone therapy plans.
How do I complete the consent form?
At your appointment, an informed consent form will be sent through Health e-Messenger.
How do I start Hormone Therapy if I have UC SHIP?
Log into Health e-Messenger and choose Schedule an Appointment, then select “Gender Affirming Care One Stop Form”
Choose either:
- Synchronous visit: Zoom with a case manager
- Asynchronous: Receive a follow-up via phone or messaging
- Fill out a questionnaire
- A case manager contacts you to review hormone initiation, fertility preservation, and other requests
- Attend a medical appointment; labs will be ordered
- Get labs drawn at Student Health Center
- Schedule a follow-up to review results
When prescribed hormones, the provider can send prescriptions to:
- UCSC Student Health Pharmacy
- A pharmacy of your choice
If you are prescribed injectables, you may book a self-injection training by calling the Nurse Advice Line: (831) 459-2591
How do I get self-injection training and supplies?
If your hormone therapy regimen involves self-injection (e.g., testosterone injection or estradiol injection) and you pick up your prescription from the Student Health Center Pharmacy, you can schedule an appointment with a nurse to review the necessary medical supplies and receive self-injection training. They will give you the first injection and will meet with you regularly until you are completely comfortable giving injections yourself.
Getting refills for medications started at another clinic
Our providers can continue your hormones.
Complete a Medical Records Release Form to transfer previous records prior to an appointment with one of our medical providers.
Questions? Call Medical Records at (831) 459-3063
Surgery Referrals
If you have UC SHIP, a referral from SHC is required. Go to Health e-Messenger and select “Gender Affirming Care One Stop”
We’ll help with:
- Required documentation
- Therapist letters
- Insurance questions
Covered surgeries may include:
- Tracheal shave
- Top surgery (e.g., breast augmentation/removal)
- Bottom surgery (e.g., phalloplasty, vaginoplasty)
- Facial surgery
Vocal training & hair removal
UC SHIP offers coverage for Vocal Training as well as Hair Removal. What is this? Vocal training is when a licensed speech-language specialist works with you to develop a voice that is more in line with your gender identity, including communication patterns, pitch, quality, and resonance. Hair Removal includes laser hair removal or electrolysis.
If you are interested in accessing these services it is important to know that you will pay out of pocket for the services and then submit a form for reimbursement (pdf). You must also obtain a referral from the Health Center prior to accessing voice training or hair removal services.
Medical and legal records
How to update name and pronouns
- Log into MyUCSC and select the Personal Information tile. Select names from the left side menu. Follow the instructions on the page to add or update your lived name. If you do not see a Personal Information tile on your home page, select Self Service from the Navigator menu. Then select My Personal Information → Names.
- You may get an ID card with your preferred name on it by taking a screenshot of your preferred name to ID Card Services.
- Legal name changes that need to be updated with the University go through the Registrar. Health Center pulls records directly from the Registrar.
Medical Records/Health Info Management - We can help complete the necessary paperwork for legal name and gender marker changes for driver’s license, passport, social security number and other documents.
Gender marker change without hormones or surgery
Some people live as their authentic gender without hormones or surgery. It can be just as important to change legal documents to match their authentic gender. It is not necessary to take hormones or have surgery to make these changes. Please schedule a “Gender Affirming One Stop” visit through Health e-Messenger to discuss this.
Mental health support
Having a therapist to support you through your transition can be extremely helpful. Therapy can also improve family relationships during this time. We encourage students to consider therapy, though it is not required. CAPS offers short-term LGBTQ+ focused therapy and there are off-campus therapists who provide open-ended support for gender journeys.
Another valuable resource is The Lionel Cantú Queer Resource Center, which offers one-on-one check-ins, weekly support groups, social connections, and community building.Advocacy and support are available for trans and nonbinary students who have experienced sexual assault, partner violence, harassment, or stalking. Visit the CARE website to learn more or make a confidential appointment.
Insurance and financial assistance
What does UC SHIP cover?
The Student Health Insurance Plan (UC SHIP) includes many benefits for Gender-Affirming Care.
All students are automatically enrolled in UC SHIP unless they waive it by providing proof of other insurance coverage. Financial aid is available to cover the cost of UC SHIP for qualifying students.
Your coverage may vary depending on whether UC SHIP is your primary or secondary insurance plan. If you have two health insurance plans, your primary insurance will remain your primary, and UC SHIP will serve as your secondary insurance—with some exceptions (such as Medi-Cal, Medicaid, TRICARE, and Medicare). It’s important to understand this distinction, especially when receiving off-campus care (e.g., surgeries or other procedures).
For more information or questions about your insurance benefits, please email insurance and billing
No UC SHIP?
- You can still access services by paying out-of-pocket
Graduating Soon?
- Plan ahead! Meet with your provider and case management 1–2 months before graduation
- Prescriptions can be extended for 3 months
To voluntarily enroll in and purchase UC SHIP, complete the Continuation Voluntary Enrollment form:
Financial Assistance
Various sources of financial assistance are available:
For information about additional resources, please contact Lain Lease.
Contact for case management & support
For questions regarding insurance, financial assistance, fertility preservation, surgery referrals, or if you do not have UC SHIP, please contact:
Lain Lease, Case Manager
Phone: (831) 459-1476
Our team
Our Transgender and Nonbinary Care Team is dedicated to providing gender-affirming care. We are here for our Slugs! Your clinical support team includes Physicians, Nurse Practitioners, and Physician Assistants who can refill hormones and provide primary care.
Lain Lease, LMFT
Clinical Case Manager
Pronouns: Lain / They / He / She
Focus Areas:
- Neurodiversity
- Case management services
- Transgender and non-binary care coordination
- Health insurance navigation
- Sexual and gender identity development
- Social justice and student activism
- Anxiety and panic
Heather Delagi, FNP-C
Clinician, Health Center
Pronouns: She / Her
Focus Areas:
- PEP
- Gender-affirming healthcare
- Hormone therapy
- Sexual health
- STI education, screening, and treatment
- STI risk reduction counseling
- PrEP