Choosing a college is a complex process when weighing options such as available degree programs, housing, cost of attendance, and extracurricular activities. For transgender and nonbinary students, the decision can also include whether the institution offers gender-affirming care.
Gender-affirming care includes the resources, treatments, and services that recognize and support transgender and nonbinary students’ gender identity. This can encompass providing access to hormone replacement 
therapy, reconstructive surgeries, mental health services with identity-affirming professionals, legal resources to assist with name and pronoun changes, etc.
A 2022 Association of American Universities survey found that 5.1% of respondents identified as transgender, nonbinary, or questioning. This translates to hundreds of thousands of students who need physical, mental, and emotional health care that respects and affirms their gender identity.
Some colleges and universities actively make this care a priority, and their wide variety of programs and initiatives have the potential to be replicated and customized at many more institutions.
The University of Utah offers the Transgender Health Program (THP), which partners with local organizations to provide or advocate for hormone therapy, gender-affirming surgery, fertility treatment, counseling, and more. THP services also include a peer support system, assistance with gender marker changes on official documents, and free patient education seminars. The Human Rights Campaign ranked the university as an LGBTQ+ Healthcare Equality Leader in 2022.
Across the country in New York, the Ithaca College School of Health Sciences and Human Performance offers the Voice and Communication Modification Program for People in the Transgender Community. The clinic, established in 2011, serves transgender participants through skill development in vocal hygiene, resonance, articulation, pitch and inflection, and more. Led by speech-language pathologists,
the program features experiential learning opportunities for graduate 
students while providing individualized treatment plans “designed specifically for the goals of each participant.”
Harvard University, as part of its student health benefits, provides extensive gender-affirming care through comprehensive primary care as well as counseling and mental health services. Those interested can access hormone therapy consults and referrals for gender-affirming surgical procedures. Harvard’s student health insurance plan covers hormone therapy, top surgery (mastectomy), breast augmentation, sperm and oocyte cryopreservation, among other treatments, with low
co-pays for in-network providers. Individual sessions with an LGBTQIA+ competent therapist, group therapy, and peer support programs are also available.
Many colleges offer lists or maps of single-stall and gender-inclusive restrooms on campus, simplified processes for ensuring records are under the student’s chosen name, even if it’s not a legal name change, and support groups for nonbinary, transgender and gender-questioning individuals. For institutions without the financial ability or infrastructure to offer more expansive services, these are efforts that cost little but send a resounding message of support and help create a welcoming environment.
