Gender Affirming Care

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.

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.

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 jmoore5@macalester.edu for them to help coordinate access to this service.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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. 

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.

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 health@macalester.edu, or 5. Contact a counselor via email or phone directly.

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.