Frequently Asked Questions About Transgender and Non-Conforming Services

What services are available for transgender and gender non-conforming people at the UI LGBTQ clinic?

  • We have two primary care providers at the clinic that can care for all of your health needs, both chronic care management for things such as high blood pressure, diabetes, or asthma as well as acute needs such as cold, flu, and injuries. The doctors also start and continue hormone therapy for transgender and gender non-conforming people who desire medication to transition to their affirmed gender. Dr. Nisly is a general Internal Medicine doctor and Dr. Imborek is a Family Medicine doctor.  They specialize in performing annual exams focusing on keeping you healthy including screening for sexually transmitted infections, screening for cancer, and making sure that you are up-to-date on vaccinations.
  • The team at the UI LGBTQ Clinic strives to be your primary care home and includes doctors, nurses, a pharmacist, and direct referral to social workers, mental health therapists, and specialty doctors if needed.

Do I need to have a letter from a therapist before being seen at the UI LGBTQ clinic?  

  • You do not need to be seen by a therapist or have a letter from a therapist indicating your readiness for hormone therapy before having an appointment with one of the providers at the UI LGBTQ Clinic. If you need help finding a therapist who has experience working with transgender and gender non-conforming people, we can help identify a mental health provider for you.

What are the steps before I can be prescribed hormones to transition to my affirmed gender?    

  • It usually takes two separate visits to the UI LGBTQ Clinic before you will be prescribed hormones.
  • During the first appointment, you will meet with one of the doctors and she will review your personal and family health history and perform an exam. You will also meet with the pharmacist who will review the medications commonly used. She will review the risks of the medications and common side effects as well as a timeline of expected changes. You will have baseline blood work done during this visit. If you recently had blood work done, please bring these results with you for the doctor to review.
  • We generally require people to have at least one evaluation from a mental health professional such as a therapist, counselor, or psychiatrist. The evaluation should focus on your gender history and ability to understand the risks and benefits of treatment used to transition to another gender. After the evaluation, the mental health professional will provide you with the necessary letter that you will share with the doctor. If you need help finding a therapist who has experience working with transgender and gender non-conforming people, we can help identify a mental health provider for you. While it is not required that you have ongoing appointments with the therapist, the doctor or therapist may recommend this.
  • The second appointment will be scheduled at least 2 – 4 weeks after the initial visit. You will again meet with the doctor to review the lab results and the letter from the mental health professional. A treatment plan will be agreed upon during this visit and the medication will be prescribed to your pharmacy.

What if I have already been prescribed hormones by a different provider? 

  • The doctor will review your personal and family health history and perform an exam. She will discuss your gender history and how long and at what dose you have been on hormones. Please bring with you any recent lab work and/or records from your previous provider for the doctor to review. You will meet with our pharmacist to review possible risks and side effects of the medications and the expected timeline of changes. If needed, you may have additional blood work drawn at this visit. The doctor will make a decision regarding the type and dose of medication to be used based on the evaluation and review of your test results.  
  • Generally, if you have already been on hormones, you do not need a letter from a mental health professional. However, the doctor may recommend that you have an evaluation or consider on-going therapy with a mental health professional.

What if I have been taking hormones that I have received from the internet or from a friend without a doctor’s prescription?    

  • We are glad that you are considering coming to the UI LGBTQ Clinic to receive treatment under the supervision of one of our doctors with expertise in transgender medicine. We strongly believe that under our care we can decrease the risks associated with the medications while you transition.
  • We will review your personal and family health history and discuss your gender history. We will ask you how long and at what doses you have been on hormones and any other medications. If you have any previous lab results or records, please bring these for the doctor to review. You will meet with our pharmacist to review possible risks and side effects of the medications and the expected timeline of changes. If needed, you may have additional blood work drawn at this visit. The doctor will make a decision regarding the type and dose of medication to be used based on the evaluation and review of your test results.  
  • Generally, if you have already been on hormones, you do not need a letter from a mental health professional. However, the doctor may recommend that you have an evaluation or consider on-going therapy with a mental health professional.

How often will I have to have follow-up appointments with the doctor while on hormones?

  • After you have been started on hormone therapy, you will be seen in approximately 3 months to review the effects of the medication and have lab work completed. The doses of your medicine(s) may be adjusted at this visit. You will be seen every 3 months until you are on a stable dose of the medication, at which time you will be seen every 6 months for two visits and then every year. If you have other medical conditions, you may need to be seen more often.

What procedures for transgender and gender non-conforming people are available at University of Iowa Hospitals and Clinics? 

The following procedures are offered at the University of Iowa Hospitals and Clinics for transwomen (male to female persons):

  • Orchiectomy (removal of the testicles) through the Department of Urology
  • Breast Augmentation through the Department of Plastic Surgery
  • Laser Hair Removal through the Department of Dermatology

The following procedures are offered at the University of Iowa Hospitals and Clinics for transmen (female to male persons):

  • Hysterectomy and oophorectomy (removal of the uterus and ovaries) through the Department of Gynecology

It is the policy of the University of Iowa Hospitals and Clinics that patients are seen first in the UI LGBTQ Clinic before being referred to one of the surgical specialists for transgender surgical care.

Last reviewed: 
April 2018

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