For some transgender students at the University of Nebraska-Lincoln, the University Health Center lacks accommodating healthcare. The health center doesn’t have any providers who have the experience, skills or knowledge to offer transgender healthcare, according to UHC Director Dr. James Guest. This means transgender students can’t receive hormonal continuation therapy from the health center after they’ve started the transitioning process. UHC providers also can’t prescribe transgender patients with the prescriptions they need during the transitioning process.
Transgender students can only receive hormone prescriptions from the health center if the prescriptions have been prescribed by an outside doctor and are commercially available. The UHC doesn’t do pharmaceutical compounding, which is the creation of a particular pharmaceutical product to fit the needs of a patient. When transgender students visit the health center, they are referred to Planned Parenthood in Lincoln, a nonprofit organization that researches and gives advice on contraception, family planning and reproductive problems and also offers transgender health services. Transgender student Scott Schneider, a senior biology and psychology major, has been in the transitioning process for more than four years. He said being referred to a provider outside the health center is inconvenient because he has pay out-of-pocket when he could visit the health center for free. Students receive free visits to the health center because they pay student fees.
“They have to figure out transportation across town,” LGBTQA Resource Center Director Pat Tetreault said. “It’s time-consuming and it’s also very costly,” Schneider and Tetreault said transgender healthcare “doesn’t require much training.”
In 2010, Tetreault sent a survey to medical providers in Nebraska and Iowa asking them about the care they offer transgender patients.
“The majority were like, ‘No, I didn’t get any training. I realized I have LGBT clients and educated myself,’” she said. “I don’t think it’s that (the health center employee doesn’t want to offer transgender services), it’s more about the physician’s comfort level and wanting to be trained.”
Guest agreed that the training to handle transgender patients shouldn’t be difficult.
“However, in the learning process, you have to learn what might go wrong,” he said. “You have to know the complications and side-effects. These are common medicines, but they’re not being used in the common way.”
And because of Chancellor Harvey Perlman’s intent to privatize the health center to local provider Bryan Health by May 1, Guest said he can’t yet hire a physician to handle transgender care. Until the University of Nebraska Board of Regents votes on the university’s contract with Bryan Health on March 15, Guest is unable to guarantee employment length or benefits to anyone he hires because he doesn’t know who will operate the health center in May. Regardless of whether the university continues to operate the health center, Guest said the next provider he hires will be asked to have experience in transgender care. It won’t be required, but it will be preferred, he said. Guest also said he is willing to offer space within the health center for a specialist to come in to provide transgender healthcare to students.
“It’s a service I see as important as we move forward as a community,” Guest said. “Whether or not (the transgender student population is) growing, I don’t know, because it’s a population that is hard to track and count.”
In the health center’s fall 2011 patient satisfaction survey, two of 380 students identified as transgender, according to Guest.
“If you only have two responding, it’s hard to generate a lot of services for that small of a population,” he said.
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