Trans Healthcare Services

The UC Student Health Insurance Plan (UC SHIP) covers health treatment and care services for trans folks seeking hormone therapy and gender confirmation surgeries. Learn more on the SHCS website. You can also look at the services provided by UC Davis' Gender Care Team.

Hormone Replacement Therapy (HRT)

HRT with UC SHIP

For students insured through the University of California Student Health Insurance Plan (UC SHIP), getting on HRT is relatively easy and inexpensive. Most covered prescriptions, including the most commonly prescribed methods of HRT, cost $5*. To inquire about accessing HRT, meet with your Gender Care Team medical provider. A mental health provider cannot provide this service.

SHCS’ Gender Care Team uses an informed consent model of care. 

During an appointment, the gender affirming care clinician will discuss hormone options, administration methods, and a general timeline of effects. Prescriptions may be filled within a day or two of the appointment. By filling a prescription at the Student Health and Wellness Center Pharmacy, the cost (usually $5) will be charged to the student account. This charge will not contain any medication information to ensure privacy. The clinician may also send a prescription to a preferred pharmacy.

*Some specialty prescriptions, like brand medications with no generic alternative, do not fall under the $5 prescription rule. For more information about what medications are covered and how much they cost, look at UC SHIP’s formulary first, then Student Health and Counseling Services’ prescription benefits.

HRT without UC SHIP

While Student Health and Counseling Services can provide care for students without UC SHIP, the student would be responsible for the full cost of service as no other insurances are accepted by SHCS. The process of obtaining hormone replacement therapy with a non-UC SHIP insurance plan varies depending on provider and insurance company. Patients can access HRT by talking to their primary care provider, getting a referral to an endocrinologist, or visiting a community clinic. Begin by calling the insurance customer service line or using their online provider search system. 

To acquire gender-affirming care outside of SHCS, we often refer students to CommuniCare Health Centers in Davis, Planned Parenthood in Woodland, or the Gender Health Center in Sacramento. Planned Parenthood accepts multiple insurances and provides gender affirming care to the surrounding community. The Gender Health Center hosts their Hormone Clinic twice a month. Book an appointment to get started.

Folks insured through Kaiser, please note that the closest Kaiser location that offers gender care is in Sacramento, about half an hour east of UCD. Kaiser Permanente members can call the Transgender Care Line at 323-857-3818 Monday through Friday 7:30 am to 5:00 pm to speak to a nurse case coordinator. For information about benefits coverage, please contact Member Services at 800-464-4000. As of the time that this document was updated on August 20, 2025 Kaiser no longer offered gender-affirming care to patients under the age of 19.

Patients insured through Medi-Cal who would like to receive services in Yolo county, must ensure to change their address with their county office. In Yolo County, Medi-Cal is administered by Partnership HealthPlan of California. Folks can find a provider directory in each insurance company’s website or by calling the insurance provider directly.

Additionally, the UC Davis Transgender Advocacy Network (TAN) has created a list of trans-approved community resources from doctors to therapists. While this is not an exhaustive list, it is a great starting point. For further assistance with finding affirming providers through UC SHIP or beyond, get in touch with the Gender Care Insurance Navigator.

Gender Affirming Surgery

Gender-affirming surgery refers to any surgical procedure which may be used to make someone feel more comfortable with their body in a way that affirms their gender. Gender-affirming surgeries are not limited to the trans community, nor are they a requirement of transition. Some trans people do not seek surgery while others may undergo a number of gender-affirming surgeries over the course of their life. There is no one right way to use surgery in your gender transition!

Gender Affirming Surgery with SHIP

If you’re interested in getting a gender-affirming surgery using UC SHIP insurance, here are some steps to take.

1. Check if your procedure is covered

Most gender-affirming procedures are covered under UC SHIP. You can find information about what gender-affirming surgeries are covered by UC SHIP on the UC SHIP gender affirming benefits flier.

Non-surgical procedures such as electrolysis or laser hair removal are also covered by select providers. However, due to the limited availability of these types of in-network providers these services are eligible for reimbursement under the in-network rate rather than direct insurance coverage. Only services from non-contracted providers are reimbursable. 

2. Get a referral

You must get a referral from your primary care physician before receiving any services outside of Student Health, including gender-affirming surgeries.

3. Acquire a letter of readiness

Your insurance and/or surgeon may require one or two letters from certified mental health professionals to approve your gender-affirming surgery. As of 2023, UC SHIP requires one letter for pre-certification of gender-affirming surgeries. Please check with your surgeon’s office about letter requirements before committing to a surgery date. Check out the Letters of Readiness section below for more details on how to get your letter written.


4. Find a surgeon/provider:

If you want insurance to cover your procedure, it is important to select a surgeon that is in-network with UC SHIP. If your surgeon is an Anthem Blue Cross in-network provider, then your insurance will cover 80% after you have met your annual deductible. There are currently no in-network surgeons who offer gender-affirming surgeries in the Sacramento area which means you will likely have to travel to San Francisco. 

Here are a few ways to find an in-network surgeon:

  1. Meet with an insurance navigator at Student Health who can give you a list of providers, walk you through the approval process, and nswer most insurance-related questions.

  2. Refer to UC SHIP’s Transgender Provider list.

  3. Use your UC SHIP information to login to Anthem’s website and use the provider search option to find possible surgeons.

  4. Consider booking consultations with multiple surgeons to make sure you find the right fit. Once you find a surgeon that you trust and feel comfortable booking with, the surgeon’s office will collect any necessary paperwork and help you select a surgery date.

5. Determine Cost and Payment

Costs for gender-affirming surgeries vary widely by procedure, location, provider, and insurance coverage. It may be difficult to get an accurate estimate of costs before surgery. Talking to your surgeon’s office and the hospital/surgery center about estimated costs will help you prepare. If you anticipate difficulty paying for your procedure, refer to the Medical Financial Help section below. Patients can expect to pay a copay when they visit their provider and pick up prescriptions. For more information, visit the SHCS Pharmacy website and check out our list of gender-affirming care benefits.

Many surgeons/hospitals will require you to pay the estimated cost a few days or weeks before the surgery. Ask about a payment plan if needed. After surgery, your insurance may update the cost based on how the procedure went (complications, anesthesia, nausea medication, etc.) and any discounts you might qualify for. You could receive a partial refund or be asked to pay the difference depending on what adjustments are made. Learn about the No Surprises Act to understand what your rights are in terms of unexpected billing.

UC Davis offers additional funding in the form of the UC Davis Health Equity Fund.
 

6. Secure Transportation

Hospitals and surgery centers require you to have a designated driver before going through with surgery. This person will need to check you in, pick you up, and drive you home from surgery. Many hospitals will refuse your operation if you do not have a designated care person and will not let you leave the hospital after surgery without that person present. Public transportation or rideshare services will not fill this requirement. If you can’t find reliable transportation for your procedure, consider reaching out to the Trans Advocate at aabernardino@ucdavis.edu for support with securing transportation.
 

7. Prepare for Time Off Work and School

If you can, plan your surgery during a school break or holiday. If you can’t, consider asking for remote work/school options or giving a time frame for when you can return. You may need a doctor’s note to prove medical need which your primary care physician or surgeon’s office should be able to provide. Contact the Student Disability Center if you will need school accommodations.

Time frames will vary but you can expect to return to light work after…

  • 6-8 weeks for bottom surgeries

  • 2-4 weeks for top surgeries

  • 2-3 weeks for facial surgeries

Gender Affirming Surgery without SHIP

Covered procedures and approval processes may vary by insurance, but most of the above steps should still apply. To see what is covered, look for your insurance Perhaps change Trans plan’s benefits catalog or call the phone number on your insurance card and ask about gender-affirming services. If you have non-UC SHIP health insurance and would like information on navigating the gender-affirming surgery process, you will need to establish care with a primary care provider who accepts your insurance for a referral. 

If you have more than one insurance plan (i.e., UC SHIP and United Healthcare PPO), you may be eligible for double coverage on your gender-affirming surgery. If you have UC SHIP and another insurance plan, please note that UC SHIP will default to your secondary insurance anywhere outside of Student Health, and your other insurance will default to primary. If you pursue gender-affirming surgery with two insurances, your non-UC SHIP insurance will be billed first with the remaining bill being sent to UC SHIP. For a referral you will need one letter from a primary care physician and one from a mental health provider regardless of which of your insurance plans they accept. If you opt to use UC SHIP as well as your primary insurance plan make sure to send your primary referral letter to SHCS insurance services so that they can enter it into the system to send to Anthem. If you share insurance with your parents or family, they will likely be able to see that you are pursuing gender-affirming surgery. If you would like UC SHIP to be your primary insurance coverage, you will have to remove yourself from any other health insurance plans, including your parents’. To learn more about the details of double coverage involving UC SHIP, please email the health insurance team through your Student Health portal.

Letters of Readiness for Surgery

We acknowledge that this system is an act of gatekeeping and can be invalidating for many trans* people. Until systemic change can be made regarding this requirement, we try to ease the burden by providing easy and affirming channels for students to request these letters.

Insurance companies and surgeons often require one letter from a mental health professional and one from a medical provider (your primary care physician) to prove the medical necessity of a gender-affirming procedure. These letters certify that the patient has been diagnosed with gender dysphoria by a licensed clinician. 

If you are double-insured and see providers who take separate insurance plans, you still only need one letter from a medical provider and one from a mental health provider. If you are seeking a consultation for a letter of readiness, please consult with your primary care physician and/or mental health provider and tell them you are seeking a letter for a gender-confirming surgery or procedure. 

The letter-writing process typically involves two meetings with a clinician, which will involve a structured clinical interview and at least one follow-up appointment. Once letters are written, they are the property of the student and typically considered valid for one year by most physicians (duration time can vary). SHCS has multiple clinicians equipped to write gender-confirmation letters, meaning they can provide more than one letter if need be. 

If you are seeking a letter for gender-affirming surgery and already have a therapist or psychologist who is supportive of your transition, you may ask them to write your letter.

Gender-Affirming Procedures (non-surgical)

Some non-surgical gender-affirming procedures are handled differently by UC SHIP. In cases where the provider cannot bill your insurance directly, you will have to pay in full and submit a claim to be reimbursed. You have up to 90 days after the date of service to submit a claim per Anthem’s timely filing limit.

To submit a UC SHIP claim:

1. Print and complete this claim form.

2. Make a copy of the itemized bill/receipt(s) for hair removal services.

3. Make a copy of your referral (accessible from student health portal).

4. Mail those 3 items to the address provided on the claim form.

For additional information about insurance or UC SHIP, contact the UC SHIP Insurance Office at insurance@shcs.ucdavis.edu or through your Student Health portal.


Hair Removal

There are no in-network providers for electrolysis or laser hair removal in the Sacramento area, but students with UC SHIP can still get these procedures covered. To take this route, you will need a referral from a Student Health clinician. You will have to find a provider, pay for the procedure up front, then file a claim and submit the receipt to UC SHIP. You will be reimbursed for 80% of the cost after you meet your $300 deductible.

Local hair removal providers:

  • Nicole’s Electrolysis,  Folsom - (209) 294-0634


Voice Training

Voice training is available in person and virtually, making it fairly accessible. There are also various in-network providers.

Regional recommended voice training providers:

Fertility Preservation

Similar to hair removal, fertility preservation is not billed directly to insurance and requires going through the claims submission process. You will need a referral from a Student Health clinician. Our recommended local provider is California IVF. STI/HIV screenings are required. Check out these educational resources if you are curious about fertility for transfeminine folks or transmasc folks!

Medical Financial Help

Medical transition can be expensive! There are a few UCD specific grants and relief funds that might help you afford surgery. If you are concerned about being able to pay for your surgery, talk to your provider and insurance services or talk to your surgery center about payment plans/charity options.

The UC Davis Health Equity Fund is available to help reimburse students who have experienced significant out-of-pocket expenses related to accessing physical or mental healthcare or to students who have a significant privacy concern as a dependent (e.g., sexual health services). Students can apply for financial assistance in the form of a grant for expenses between $50 and $2,500. Any funds you receive from the Health Equity Fund will be included on your 1098-T tax form. Please consult with a tax professional for any tax related questions.

If you have questions, please refer to the FAQ below, or contact the Insurance Services at insurance@shcs.ucdavis.edu.