Despite training and resources, transgender students still face healthcare barriers on campus

Although ASU has some helpful services, students claim they are not adequately advertised and can be difficult to access

For senior film major Sisko Stargazer, the experiences that come with being a gender-fluid college student vary drastically.

The support they feel from some faculty and friends at ASU can be undercut by ignorance that forces them to constantly educate others, Stargazer said.

Transgender students are at a greater risk of dealing with school-related mental health issues and need more support on campuses, according to a September 2019 report in the American Journal of Preventive Medicine.

Although they're academically successful, negative social experiences have put unnecessary pressure on Stargazer, citing instances such as sometimes being misgendered by close friends and faculty.

"In a way I kind of feel like a clown sitting there — I’m like how do you forget something so big and important about me?” Stargazer said.

Oftentimes, transgender ASU students have strikingly different experiences on campus, seemingly influenced by factors such as their major or the faculty they interact with. Many report having some kind of negative experience at school relating to their gender, usually caused by students.

The perks and pitfalls of University resources

ASU's healthcare staff is committed to creating a welcoming environment for students, said Dr. Aaron Krasnow, associate director of ASU Health Services and ASU Counseling Services. He added that informed care should extend to counseling because gender has a psychological influence on one's experiences.

“Some people have experienced intense discrimination as a result of their personal identity, and for a long time trans individuals have been discriminated against for that reason,” Krasnow said. “That discrimination, combined with the normal challenges associated with being a person and living our truthful identities, can make stress for trans people more acute than for others.”

The University offers optional SafeZone training, which educates faculty from many departments about LGBTQ+ issues, but this training does not offer specialized courses for transgender issues. An ASU page dedicated to transgender resources links to on-campus LGBTQ+ organizations, unaffiliated resources and more.

Krasnow said on-campus counseling is available to all students in addition to outside referrals if that better suits a student’s needs.

Senior computer engineering major Augustus Crosby, a transgender man, said he feels supported by counseling when he can fit it in his schedule. However, he has felt like some counselors don't completely understand him.

Stargazer also uses counseling when they can, but had previously felt it wasn't the right fit. After finding better success later on in the process, Stargazer said their new ASU counselor encourages them to self-advocate more often, and they are satisfied with their current care.

During a past personal crisis, Stargazer said campus resources couldn't help them because of their financial situation at the time.

The American Journal of Preventive Medicine's September study analyzed the largest mental health survey of transgender college students in the U.S., and researchers said there should be campus resources specifically for transgender students.

Researchers used data from Healthy Minds Study, a project that has been collecting mental health surveys from college students since 2007. The report also found transgender students have a higher risk of experiencing mental health problems associated with college, and managing health care stigma plays a role in this.

ASU offers options like gender-inclusive housing and preferred display name options, which can benefit transgender students. 

ASU's interactive map feature allows a user to apply a "gender-neutral bathroom" filter when searching on campus maps. There are dozens of results for gender-neutral bathrooms on Tempe campus, a handful on the Downtown Phoenix, West and Polytechnic campuses and no results on the Lake Havasu, ASU Research Park or Skysong maps.

Crosby relies on other transgender students for information about campus doctors and resources. His doctor from Health Services has been supportive, and he was able to continue hormone therapy with him when his endocrinologist retired. Krasnow said ASU offers hormone replacement therapy and covers the service under its insurance.

The transgender resources page for the University of Wisconsin-Madison, a university of similar size to ASU, has a comprehensive FAQ about different services related to transgender care. These sections inform potential patients about what will happen in each appointment. ASU's page does not describe the services they offer.   

The transgender resources page for UWM also outlines faculty run LGBTQ+ organizations and peer support groups for transgender students.

While Crosby, Stargazer and others said ASU has helpful services, they are not adequately advertised and can be difficult to access.

Navigating the college experience

Crosby would like to be more open about his identity, but he doesn't know how to approach the topic in a professional or academic environment.

Crosby said he chooses not to mention gender at school because he is not visibly transgender and it avoids unnecessary conversations. 

“I don’t tell people in my major at all,” Crosby said. “I think it’s just more stressful to think like, ‘Oh, all these people know I’m trans’ than, ‘Nobody cares because nobody knows.’”

Crosby doesn't mind if someone learns he is transgender, but he doesn't think there's ever an appropriate time to tell colleagues.

Marlon Bailey, an expert on LGBTQ+ studies and a faculty member with the School of Social Transformation, said stigma deeply impacts transgender students.

“Particularly on college campuses, a lot of trans people have mental health challenges just like anyone else,” Bailey said. "But sometimes that is compounded by being in an environment — both in the classroom and out of the classroom — that is disruptive, if not subtly transphobic.

Bailey said certain actions such as “deadnaming,” calling a student by the name assigned at birth instead of the one they chose, and “misgendering,” failing to use a student's correct pronouns, are harmful to academic performance.

“This may seem like a minor, innocuous thing, but it is very detrimental for them and can be traumatic,” Bailey said.

Being misgendered takes a gradual toll on Stargazer. They once almost missed class because of an especially hurtful experience when a professor they felt close with misgendered them.

“People will still get it wrong, despite knowing me pretty well," Stargazer said.

Since Stargazer came out two years ago, they have received negative reactions when reminding people of their pronouns and name. They said feeling responsible to inform others is emotionally draining.

“Sometimes it doesn’t bother me, sometimes it does really get to me,” Stargazer said.

Andrea Gass, an ASU law school graduate and current law library fellow, feels completely supported on the Downtown Phoenix campus, both in class and healthcare.

"When I got here, there was absolutely no barrier to using my preferred name," Gass said.

Gass took medical leave at the beginning of a semester without issue, and she was given time off to change her name in court.

"I don't feel like anybody has made anything of it here," Gass said.

When Crosby transferred to ASU, his legal name change would not go into effect until after the semester began, but administrators were able to note the change on his profile.

Tamira Burns is a health care worker with Peacework Medical, a Phoenix-based organization that provides primary and gender-affirming care to undocumented transgender people, homeless triage and training for health care professionals.

Burns said the ASU staff they interact with often dictate the nature of experiences the students she works with have.

"Even though ASU claims to be a very open space, there are still people there who are discriminatory," Burns said. "Many students still have to fight administration if they even want to get their name changed in the system depending on who they talk to.”

Gage Keranen, a junior biological sciences major, said he has mostly positive experiences on campus but has had uncomfortable experiences at ASU Health Services.

"With Health Services, I have been misgendered and misnamed frequently,” Keranen said. “I have had to explain myself to doctors and nurses many times. It can be exhausting and discourages me from going."

In an email statement, Krasnow said students are strongly encouraged to report any problems they have while seeking healthcare at ASU.

"For any student who has any concern about health or counseling, they can contact me directly," Krasnow said. Students can also use the follow-up survey emailed to them after visits for addressing concerns.

The broader challenges within transgender health care

Burns said campus experiences take a toll on students she works with.

“What happens is that they’re facing consistent discrimination, and so you’re looking at trauma that’s caused by just continuously being on watch and frightened," Burns said.

The circuitous road of maneuvering the equity and health care needs for transgender people goes beyond college campuses.

In early January 2020, state Rep. John Fillmore, a Republican lawmaker who sits on the House Education Committee, pushed for bills that targeted the state’s transgender community.

In January 2019, the American Civil Liberties Union and the American Civil Liberties Union of Arizona filed a class-action lawsuit against the State of Arizona and the Arizona Board of Regents over the lack of access to transgender-related health care for transgender people employed by the state.

Kendra Tonan-Lizzarago, president of Trans Spectrum of Arizona's 2020 board of directors, said the best way to support transgender students is to inform people.

“They’re being discriminated against in some way, shape, or form by being transgender,” Tonan-Lizzarago said. “So in that aspect, obviously if we can educate people and make sure that education is taken seriously, then trans people get a fair shake in life basically.”

Keranen is president of ASU's transgender support group, TransFam. He said the group provides a welcoming space for transgender students to connect with one another, but displays of support and solidarity from the University are effective in making him feel welcome.

"I think most transgender students are relatively unaware of the resources available to them on campus," Keranen said.

Crosby said he wants a resource assisting with moving from college to the workplace and advising about how to deal with gender-specific issues like managing stigma or coming out to coworkers.

ASU has many helpful resources for transgender students, but many students, like Stargazer, find accessing these resources largely depends on discovering who to talk to or where to go through word of mouth, or on their own.

"I've only been out for myself for like two years. It's pretty interesting how much things have changed in all that time," Stargazer said. "I already feel a bit like my spirit has been withered a little."


Reach the reporter at gmlieber@asu.edu or follow @G_Mira_ on Twitter. 

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