Transgender Health

Some people who identify as transgender choose to go through a process of “transitioning” from the gender they were assigned at birth to the gender that is consistent with their identity.The process of transitioning takes on many aspects of life, from social, emotional, and physical. When it comes to physically transitioning (specifically, in terms of surgery and/or hormones), there are many options for transgender people. The transgender experience lies on a spectrum, and many transgender individuals can pick and choose from a variety of options to reflect a gender expression accurate for them. Some transgender people decide to take hormones but don’t do surgery, while others do surgery but not hormones. Some do both. Some do neither.

Regardless of a transgender individual’s gender identity (FtM, MtF, genderqueer, etc.), the decision whether to physically transition lies with the individual. Just remember that when it comes to physical transition, it’s your decision how far you want to go, what you want to do within the time frame that is comfortable for you, and that it is the doctor’s job to guide you along the way.

For transgender students who choose to transition, the process is often exciting, stressful, and scary all at once. There are many physical, emotional, social, and legal challenges that transitioning persons must face and Stanford students are no different. The physicians and counselors at Vaden Health Center recognize both the challenges and the joys of transitioning and are here to support you on your journey. Some people who transition choose to change their name and the pronouns they prefer, so please let our providers know the name you prefer and the pronoun that is appropriate for you, and ask that they note this information in your file.

Mental health counseling:

Counseling is often recommended for individuals who are thinking about transitioning. You can learn more about counseling recommendations developed by the World Professional Association for Transgender Health (WPATH) by clicking here.

• CAPS employs counselors who are experienced and knowledgeable about the unique needs of transgender persons. You are invited to request one of our counselors with a specialty in supporting transgender students when you call CAPS to set up your initial appointment or at any time after counseling has begun.
• Your counselor can offer not only emotional support and coping strategies as you navigate through your transition, she or he can also provide letters to support beginning hormone therapy and gender confirmation surgery, or advocate for you within the university or legal system.
• Because of the brief nature of the services offered at CAPS, some students are referred to providers in the community who can offer ongoing support. The process of transitioning takes time and it is possible that this may be the best option for you. If this is the case, CAPS will assist you in finding a provider in the community with the experience, knowledge, and skill that will offer you the most support.

Medical services:

Vaden seeks to provide care that is affirming to transgender students. Below is some basic information on the comprehensive care offered by Vaden. Some people who identify as transgender choose to pursue medical procedures that support their transition process and/or their gender identity. Please see the sections below on Health Concerns of transgender students for more specific information about medical procedures.

• Vaden’s Medical service offers comprehensive care to transgender students including (but not limited to) hormonal therapy, pelvic exams, Pap smears, breast exams, acne treatment, and STI/HIV screening. To make an appointment, go to https://vadenpatient.stanford.edu and click on Transgender Health Care.
• If you need help accessing medical services, contact Robyn Tepper, MD: phone 650-723-0932

Sexual Health for Transgender Individuals

For some transgender people, the idea of sex may trigger feelings of gender dysphoria. For others, they are fine with their genitalia, regardless of their gender identity. It depends on the individual and when they are ready to have sex.

Safe sex practices for pre/non-op transgender people correspond to the same concerns that cisgender people have when it comes to safe sex. For penis to vaginal/anal penetration, be sure to use condoms and lubricant, and to change condoms when switching between the anus and the vagina. When practicing oral sex on a vagina, be sure to use a dental dam. If you use toys (non/pre/post-op transmen in particular often use strap-on dildos for penetrating their partners), be sure to clean and disinfect them properly, and to cover them with a condom during penetration.  STI screening and anonymous HIV testing is available to registered students.

If you are a post-op transwoman, be sure to use lubricant when having penetrative sex and if your sexual partner has a penis or is using a dildo, make sure they use a condom.

For post-op transmen who have gotten bottom surgery that allows for their neo-phallus to reach erection, be sure to find condoms that sufficiently fit. Some transmen have complained that traditional condoms do not fit them. One method suggested is to use the thumb section of a latex glove.

As an issue of safety, be sure that your sexual partner knows beforehand about your transgender identity and that your genitalia might not be what they would expect. Transgender people have become victims of hate crimes and even murder in such encounters.

 

Helpful Links

Stanford and Local Resources:

LGBT Community Resources Center- Stanford’s safe and accessible space on campus for students questioning, investigating or struggling with sexual orientation and/or gender identity.

Lou Sullivan Society - Local support for FTMs in the San Francisco Area. Usually frequented by older transmen, but still a good resource to find mentors.

Carla’s MTF Support Groups - Listing of local support groups for MTFs in the Bay Area

TransGender San Francisco - Transgender-centered events held in the San Francisco Bay Area.

The Brown Boi Project - Targeted towards FTMs and transmasculine people of color. Based in Oakland.

Online Resources:

Susan’s Place (susans.org) - The biggest online transgender community for MTF, FTM, and genderqueer persons.

Hudson’s FTM Guide (ftmguide.org) - Advice for transmen on HRT, binding, packing, and passing.

FTM Underworks (ftm.underworks.com) - An online vendor to purchase decompression shirts for breast binding for transmen. 

Big Brothers Used Binder Program(http://www.thetransitionalmale.com/BBUB.html) - A site where transmen can obtain used decompression vests

Transgender Health Information:

WPATH Standards of Care For Transsexual, Transgender, and Gender Nonconforming People - These Standards of Care are non-binding protocols outlining the usual treatment for individuals who wish to undergo hormonal or surgical transition. Clinicians' decisions regarding patients' treatment are often influenced by this standard of care (SOC). WPATH was formerly the Harry Benjamin International Gender Dysphoria Association, Inc. (HBIGDA)

GenderTalk - National Website with various resources

TransHealth - Online magazine of health and fitness for transsexual and transgendered people

TransGenderCare - A large archive of Trans health information

National Coalition for LGBT Health - Offers a variety of health resources for LGBTQ people.

UCSF Center of Excellence for Transgender Health - Medical information primarily for providers

Transgender Law:

Transgender Law Center - Current News and Information Relevant to Transgender Law, including legal name changes

Transgender Law and Policy Institute - Advocacy for Transgender Legal Rights

Additional Resources:

Trans Academics - A place where people of all genders can discuss gender theory, the trans community and its various identities, both as a part of the academic world and day-to-day life.

PFLAG (Parents and Friends of Lesbian and Gays) - PFLAG promotes the health and well-being of gay, lesbian, bisexual and transgender persons, their families and friends through support, education, and advocacy.

 

Related Topics:

• Gender Confirmation Surgery
• Health Concerns for Transwomen
• Health Concerns for Transmen
• HRT for Genderqueer Individuals