What is HRT?
Hormone replacement therapy is using sex hormone drugs to either replace those no longer produced in adequate quantities after menopause in a ciswoman or to affirm gender identity by providing desired body changes in non-cisgender (often transgender but sometimes non-binary or occasionally gender-fluid) people.
Do I need a prescription for HRT?
Yes, sex hormone drugs except the Morning After Pill ("Plan B" or others, medication taken to delay ovulation and try to avoid a pregnancy after a sexual encounter) require a prescription, and testosterone is a controlled substance so has certain limitations to prescribing. It is unsafe and illegal to obtain these drugs through the internet or from another person for whom the drug was prescribed, but revealing that you may have done so to a provider can be informative to your care and is not used for legal action.
Can I get a prescription for HRT at Student Health?
Yes and no—your initial prescription must come from a qualified provider (usually primary care or endocrinology specialist, often through a Planned Parenthood clinic or Howard Brown Health Systems in Chicago). After initiation follow-up care--prescribing, exams and labs—can be provided for most patients after receipt of medical records from the initial provider and completion of a consent to have hormone therapy with your provider at Student Health.
Who can take HRT?
Many people can safely use HRT if it is appropriate to help them. People with ongoing major health issues such as high blood pressure, diabetes, epilepsy/seizures, depression or other emotional conditions, and thyroid or other endocrine/hormone disease must be under treatment for these conditions. People with active or severe liver disease may not process drugs including hormones appropriately so may be unable to take HRT. Taking estrogens can increase the clotting factors present in blood, increasing risk of blood clots in some people, so higher risk people such as those who have had a clot (DVT or PE) or have a known genetic clotting tendency, or smoke tobacco, are obese, or are planning to have surgery may not be candidates for estrogen therapy for a time or at all. Testosterone can raise the risk of atherosclerosis/blood vessel blockage and heart disease such as heart attacks, so the risks and benefits of its use must be discussed. HRT must not be used by anyone contemplating pregnancy or making a partner pregnant, so family planning and contraception must be discussed with the HRT prescriber.
How much does HRT cost? Does insurance pay for it?
Costs vary a lot. The insurance plan provided through SIU/Gallagher/United Health Care currently covers oral estrogen (usual copay) and injectable testosterone (usual copay) but not injectable or topical (through skin) estrogen or topical or testosterone or implants. You may need to talk with your insurance company and your provider to make a plan that fits your needs and budget.
Can I inject myself with hormones? Can I get injections at Student Health?
Yes and yes. We can prescribe equipment for self-injection, either into skin or muscle, and educate you on the procedure. If prescribed by one of our providers, hormone injections can be given in clinic but will be assessed the usual door fee each time, so usually weekly or biweekly for most hormone therapies.
What is PrEP?
Pre-Exposure Prophylaxis, or PrEP, is a pill that is taken everyday to reduce the risk of becoming infected with HIV.
Who Should Take Prep?
PrEP is recommended for anyone that is at higher risk of contracting HIV. You may be at higher risk of contracting HIV if you are 1) injecting drugs 2) using shared equipment with other people injecting drugs or 3) are at increased risk of being exposed to HIV through sex
You can reduce your risk of contracting HIV through sex by covering body parts and toys, usually with latex or polyurethane condoms and gloves, or plastic ("Saran") wrap, and avoiding sexual contact when using drugs or alcohol. When safer sex practices and Prep are used together, you greatly reduce your risk. If safer sex and injection practices are not possible, or when an uninfected person has a partner who is HIV-infected, PrEP may be a good option for reducing (though not eliminating) the risk of becoming infected with HIV.
Side effects of PrEP
Risks/side effects of taking PrEP (brand name Truvada) include nausea and vomiting, dizziness, headache, and rash. Longer-term effects such as changes in body fat distribution or softening of the bones (osteoporosis) can also occur. A person who does become infected with HIV while taking PrEP could possibly develop an infection resistant to Truvada, which can complicate long-term management of HIV infection. This is why re-testing for HIV infection is required every 3 months.
How do I get PrEP?
Only a doctor can prescribe PrEP. Your doctor will complete a health history screening and take some blood to test for HIV and hepatitis B infection, as well as your liver, and kidney function. These screens are required before taking Truvada and must be repeated every 3 months as long as you remain on PrEP.
How much does PrEP cost?
Truvada must taken once a day on a continuous basis. Cost for a student can vary. There may be programs through the local Public Health Department clinic or through the drug manufacturers to help people who cannot afford to pay for PrEP but would benefit from taking it.
Can I get PrEP at the Student Health Center?
Yes. All primary care providers should be able to advise you about PrEP and start the treatment if appropriate. Our pharmacy stocks the necessary medication.
We understand that there is a wide variance in how the LGBTQ+ population identifies and expresses themselves. We are sensitive to these differences and will be continuing use clear, unambiguous language to make you feel most comfortable.
Please feel empowered to remind people of your name or pronouns. If you do not feel comfortable telling the person who makes the mistake, please tell your provider of the incident so they can address your concern with the staff member. If you are not comfortable telling your provider of their own error or a staff member’s, please do report the incident to our LGBTQ+ Patient Advocate, Paul Hagan.
Access to all gender restrooms are available in the facility. Ask a Student Health Services Employee and they will direct you to the right direction!
Members of the LGBTQ+ community may have to cope with stigma, discrimination, or violence.
They may have negative feelings about themselves because of their sexual orientation or gender identity, feel isolated or lonely, or feel that they must hide their sexual orientation or gender identity.
What are the most common LGBTQ+ mental health issues?
- Depression
- Anxiety
- Post-traumatic stress disorder (PTSD)
- Substance abuse
- Thinking about or attempting suicide
- Depression
What is depression?
Depression is when feelings of sadness, loss, guilt, or anger interfere with everyday life for long periods of time. Lesbian women are 2 times more likely and gay men are 3 times more likely to have depression compared to heterosexuals.
Symptoms of depression include:
- Feeling agitated, restless, or irritable
- Changes in appetite, concentration, sleep, or energy
- Feeling hopeless, worthless, guilty, or self-hating
- Losing interest or pleasure in doing things you once enjoyed
- Thinking about death or suicide
What is anxiety?
Anxiety is when constant worrying interferes with everyday life.
Symptoms of anxiety include:
- Feeling restless or edgy
- Tiring easily
- Having trouble concentrating or feeling as if your mind is going blank (continued)
- Feeling irritable
- Having tense or tight muscles
- Having trouble sleeping
What is Post-traumatic stress disorder (PTSD)?
PTSD can occur after experiencing a traumatic event involving the threat of injury or death.
Symptoms of PTSD include:
- Reliving the traumatic event through flashbacks, upsetting memories, or nightmares
- Feeling detached or numb from feeling
- Lack of interest in normal activities
- Difficulty concentrating
- Being startled easily
- Feeling more aware, irritable, or angry
