After years of ambiguity, disorganization, and a dearth of doctors certified in hormone replacement therapy, Student Health Services is working to get an HRT program for transgender students off the ground.
In the past, SHS staff prescribed hormones to at least one student. Dr. Maria Dunton prescribed testosterone to Quentin Barth HM ’19 once before Dunton left The Claremont Colleges in fall 2017, Barth told TSL.
The prescription allowed Barth, who uses The Claremont Colleges Student Health Insurance Plan, to buy a six-month supply of the medication at a pharmacy for a reduced price of about $25. Depending on insurance, testosterone injections can cost upwards of $750 for a five-month supply, according to testosteronetherapy.org.
Before Dunton, Barth had a doctor in Los Angeles who prescribed him testosterone. However, he said that situation wasn’t ideal because the nurse didn’t correctly read his charts and made insensitive jokes.
Dunton’s departure created these types of difficulties again for Barth and other students seeking HRT at the 5Cs, especially since Barth said Dunton planned to roll out an official program under an informed consent model last semester.
The model allows transgender clients to access hormone treatment and surgical interventions without undergoing mental health evaluation or referral from a mental health specialist, according to the Journal of Humanistic Psychology.
“I remember telling all my friends about her plans because I was really excited by them,” Barth told TSL.
Dunton currently works at Pinnacle Medical Group in San Bernardino, California, according to the group’s website. She could not be reached for comment before press time. It is unclear why she left.
Following Dunton’s exit, Barth said nurse practitioner Nancy Aceves was willing to copy his previous prescription but “didn’t really know what she was doing or all the things to check for with the blood tests.”
“I don't think she really had the background to know what sort of things could go wrong in the same way Dunton did,” he said.
Barth thinks that if SHS can find a doctor who is knowledgeable and culturally competent about transgender issues, an HRT program should exist.
“Accessing necessary medical care definitely shouldn't be as hard as it is,” he said. “If SHS got a good doctor to run a hormone program, that would make me very happy.”
SHS is working toward such a program with Monsour Counseling and Psychological Services and the Queer Resource Center. The three organizations have created a trans healthcare committee to discuss the best practices for transgender students, appropriate referrals, and how SHS can better serve its transgender students.
Before her departure, Dunton was a member of this committee.
Currently, SHS providers refer transgender students off campus to the Center for Transyouth Health and Development at the Children’s Hospital Los Angeles — one of the largest transgender clinics in the United States, The Claremont Colleges Services Vice President for Student Affairs Denise Hayes wrote in an email to TSL.
Upon request from the prescribing doctor, SHS’ lab can obtain specimens and monitor lab results. SHS is also equipped to conduct pre- and post-operational exams, Hayes wrote.
The Claremont Colleges’ Student Health Insurance Plan covers up to $100,000 of gender reassignment benefits per policy year, according to the QRC’s website.
Before an extensive HRT program can be put in place at SHS, however, Hayes wrote that the committee needs to identify specialists in hormone treatment who can train providers to become initial prescribers and/or provide hormonal maintenance care.
The push for an HRT program comes amidst a staffing shortage at SHS, which has caused restricted hours of operation.
Concurrently, SHS is searching for a new director following the departure of Dr. Nayan Shah last fall, and HRT is a priority in the hiring process, Hayes wrote.
“We are asking each of the candidates for the position of director of SHS about their experiences in prescribing hormone replacement therapy and their willingness to pursue training in this area,” Hayes wrote.
In the meantime, Hayes encouraged transgender students to use other resources available to them as 5C students, including the QRC, Monsour, and the Chaplain’s Office.