Sexual Health

LBGTQ Health Care

Sexual Health

Transgender Health Care

Women's Health

LGBTQ Health Care

Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students and non-LGBTQ students have many of the same health concerns (e.g., flu, strep, mono). However, you may have unique health concerns as well. You should not have to worry about whether your health provider will understand your specific needs and treat you professionally.

Our medical staff has been trained in LGBTQ health issues. We are comfortable and confident responding to your concerns. Our approach to health and sexual health is inclusive. Please come and see us!

The Health and Wellness Service welcomes and affirms all students of all gender identities, expressions and sexual orientations.

Sexual Health

Make an appointment or utilize our walk-in hours any time if you are worried about a symptom or have been exposed to someone diagnosed with a sexually transmitted infection (STI). Screening can be important for anyone who is sexually active and Health Service provides routine STI testing. STI testing is also a regular part of gynecologic appointments, if indicated.

Which test you get depends on your exposures and sexual practices. A Health Service clinician will discuss your sexual history with you as well as symptoms of various STIs. We can test for almost any STI. Some are blood tests, some are urine tests, and some are done through swabbing.

STI Tests Available Through Health Service

  • HIV
  • Chlamydia
  • Gonorrhea (GC)
  • Hepatitis: type A, type B, or type C

HIV Testing

We provide confidential HIV testing -- this means we will share your test results with you and enter them into your confidential medical record. We do not share test results with anyone, not partners or parents, except as mandated by state law.

State law requires medical provider to report positive HIV test results and cases of AIDS by name to the Massachusetts HIV/AIDS Surveillance Program at the Department of Public Health (DPH). The DPH has strong security measures in place to protect HIV/AIDS reporting data. In addition, state regulations prohibit names from being shared with anyone, including state or federal government entities.

Since HIV testing is now considered a routine screening test and is universally recommended, there are very few anonymous testing sites.

HIV Prevention Medications (PEP and PrEP)

HIV Post-Exposure Prophylaxis (PEP) is a medical treatment that, if taken soon after a high-risk exposure, can significantly reduce your chance of becoming infected with HIV. It must be taken within 72 hours but is most effective if taken within 24 hours of possible exposure to HIV.
More information about PEP

Pre-Exposure Prophylaxis (PrEP) is medication you take every day on a long-term basis if you are at high risk of being infected with HIV. The medication is safe and effective if taken regularly and has minimal side effects.
More information about PrEP

Health Service clinicians are knowledgeable about PEP and PrEP and comfortable with their use. If you feel concerned but uncertain about your risk for HIV infection, contact us. We can talk with you about your concerns and help you decide on a course of action. Your conversation with us will be completely confidential.

About Post-Exposure Prophylaxis (PEP)

PEP is medication that should be taken as soon as possible after a high-risk exposure to reduce the chance of acquiring HIV. It needs to be started within 72 hours of a possible exposure, and ideally within 24 hours. Typically you will need to take a combination of three medications for 28 days.

Most insurance, including Tufts student health insurance, covers the cost of PEP. You will be responsible for the co-pays.

If you are concerned about a risky sexual exposure, come to the Walk-In Center at Health Service as soon as we open the next day. If the next day is a Sunday (when health service isn’t open), you can call 617-627-3350 and follow the prompts to reach our nurse line.  The nurse can connect you with the clinician on call, if needed. 

PEP information from the Centers for Disease Control

http://talkprep.org/

About Pre-Exposure Prophylaxis (PrEP)

HIV PrEP is a medical treatment to protect you from HIV infection. PrEP is for people who are not HIV positive but are at high risk of infection. PrEP combines two medications in a single pill that is taken once a day for a period of months or years to prevent HIV.

It is highly effective if taken very consistently.  Side effects, such as gas, nausea, and headache are usually mild if they occur, and resolve within several weeks.

Most insurance, including Tufts student health insurance, covers the cost of medications for PrEP.  You will be responsible for the co-pays.

If you are interested, make an appointment at Health Service to speak with one of our clinicians. Tell the appointment secretary that you want to discuss PrEP.

PrEP information from the Centers of Disease Control

HPV Vaccination

Health Service carries Gardasil, one of two vaccines currently licensed for use against human papillomavirus (HPV). Gardasil is most effective when you take it before becoming sexually active. The Centers for Disease Control recommend all boys and girls get vaccinated at the age of 11 or 12. If you did not get vaccinated when you were young, the CDC recommends a catch-up vaccine up to the age of 21 for men and up to the age of 26 for women.

It provides protection against 4 strains of HPV: two strains that most commonly cause cancer of the cervix, and two strains that most frequently cause genital warts. It is a three shot series, given over a 6 to 12 month period. The vaccine does not treat HPV; it can only help prevent it. There are dozens of strains of HPV, so those who are immunized need to be aware that they can still catch HPV—vaccination just decreases the likelihood.

Fees and Insurance

Fees vary for different tests. Student health insurance and many private health insurance policies cover STI testing. We will work with you to see if your lab charges can be billed directly to your insurance company.

 

Transgender Health Care

Tufts Health Service affirms and supports students of all gender identities and gender expressions. We offer a range of services for transgender, non-binary, and/or gender non-conforming students. The student health insurance plan offered by the university provides comprehensive coverage for the needs of students who are transitioning; covering gender affirmation surgeries as well as hormones and counseling. Our staff are trained on transgender issues, and our forms offer you the opportunity to self-identify gender identity. Our electronic medical record gives the option of sharing a preferred name as well as an opportunity to share pronouns. We strive to provide a safe, intentional space where trans, non-binary and/or gender non-conforming students can have all of their health and wellness needs met.

We provide reproductive and sexual health care tailored to fit an individual student’s specific needs. Students interested in hormonal therapy or surgeries are invited to establish care with one of our transgender health trained medical providers. We will work with the student to develop an individualized treatment plan.  Many services can be provided at Health Service, and students can be referred to more experienced providers if needed.

Transgender Health Care Specialists

All of our clinicians are committed to meeting the needs of trans, non-binary and/or gender non-conforming students, but three clinicians are especially experienced and trained:  Ariel Watriss NP, Stacey Sperling MD, and Margaret Higham MD. 

Gender Affirmation Hormone Treatment

Continuing Hormone Treatment:  Our transgender health care specialist clinicians can continue the prescribing of ongoing hormone treatment for students.  We request documentation from the previous clinician, with most recent lab results if available. 

Initiating Hormone Treatment:  Our transgender health care specialist clinicians are trained in initiating hormone treatment.  We require a letter of recommendation from a mental health provider prior to starting hormone treatment, as outlined in the WPATH (World Professional Association for Transgender Health Association) Standards of Care.  Clinicians at the Counseling and Mental Health Service are available to meet with you around this issue.

Gender Affirmation Surgery

We have the names of several local surgeons who perform some gender affirmation surgeries:  mastectomy (breast removal), augmentation mammoplasty (enlarging breasts), and hysterectomy-oophorectomy (removing uterus and ovaries).  We will work with you to find other specialists if needed.  A letter of recommendation from both a medical provider and a mental health provider is required prior to surgery as outlined in the WPATH Standards of Care and by most insurance companies.  If you are receiving care at Health Service, your clinician can provide the medical documentation, and the staff at the Counseling and Mental Health Service are available to help with the mental health recommendation.

Insurance Coverage

The Tufts University sponsored student health insurance plan is provided through United Student Resources. This policy covers a full range of transgender health benefits including gender affirmation surgeries, hormones and counseling. We recommend you come in to speak with Mary Daley from our Health Service Business Office, or give us a call at 617-627-3349 if you have any questions about coverage.  Although surgeries and hormones are covered, there are co-pays and out-of-pocket costs associated with all medical care (i.e., the coverage limit does not mean you will not incur any costs). The Health Service wants to help you navigate what can at times be a difficult or challenging relationship with your insurance provider.  If you want more info on the benefits of the student health insurance plan, including out-of-pocket costs, co-pays, and typical coverage: please come and talk to us.

Documentation of Gender Identity in Your Medical Record
  • The Tufts Health Service Pre-entrance Health Questionnaire will ask for both sex at birth, and your gender identity.
  • Your medical record however, will reflect the sex that is entered into the Student Information System.
  • If the name you use is different from your legal name, tell your clinician – we can manually enter this name into your medical record. Both names will show up in your medical record.
  • We can enter your pronouns into your medical record
  • Ask us to show you when you come in for a visit

Women's Health

Tufts University Health Service provides a full range of Women's Health services, including:

  • Annual gynecologic examination including breast exam
  • Cervical cancer screening (Pap test)
  • Screening and treatment for sexually transmitted infections
  • Emergency contraception
  • HIV testing
  • Birth control - Consultation about contraceptive choices, prescribing of most birth control methods including birth control pills, NuvaRing (vaginal contraceptive ring), contraceptive patch and Depo Provera. Counseling regarding Intrauterine Devices (IUDs) and Nexplanon (implantable rod), is available, along with referral to off-campus providers for insertion of both.
  • Counseling regarding both planned and unplanned pregnancy
  • Care for people who’ve experienced sexual assault
  • Evaluation and treatment of vaginal infections
  • HPV immunization
  • Treatment for urinary tract infections, genital warts, and many other issues.

Concerns that are not urgent are typically managed by making an appointment (usually within 1-3 weeks)

  • Annual GYN visits
  • Routine STI screening (no symptoms)
  • Contraceptive counseling and prescriptions

Urgent concerns that need to be accommodated on same day basis in our Walk-in Clinic:

  • Vaginal infections
  • Urinary tract infections
  • Emergency contraception
  • Sexual Assault
  • Pregnancy concerns
I want to start birth control pills. What should I do?

If you are not taking birth control pills, and are interested in starting them, call the main number at Health Service and set up an appointment. At your appointment, the clinician will get a medical history from you, answer your questions and give you a prescription if desired. The visit is completely confidential! You do not need to have a pap smear before being started on birth control pills, but depending on your medical history, your clinician may recommend a pap smear or STI (Sexually Transmitted Infection) testing at your next visit.

Why do I have to come to Health Service to be prescribed birth control pills? Can't it be done on line or on the phone?

Birth control pills are prescription medications in the US. That means you need to meet in person with a clinician who can determine if pills are safe for you and what the best choice would be. Birth control pills are generally quite safe, but there are some women for whom they are dangerous and should not be prescribed. We need to have a face to face consultation before starting any prescription.

What if I'm not sure what kind of contraception I want?

Call Health Service and set up an appointment to talk with a clinician about various forms of birth control. Although birth control pills are the most commonly used form of contraception among our students, there are other good options: the Nuva Ring (which is gaining rapidly in popularity), the IUD, a diaphragm, and condoms.

I already have birth control pills prescribed by my doctor at home. How can I get them at school?

If your doctor practices in the US, he or she can call a prescription into any pharmacy in the country. Out of state doctors can prescribe in MA. Although we do not have a pharmacy at Health Service, we do work with a local pharmacy, Inman Pharmacy in Cambridge, that delivers prescriptions to Health Service and you can pick them up here. Here are some suggestions:

  1. Your doctor can call or fax your prescription to Inman Pharmacy, and specify that the prescription should be delivered to Tufts. If you have never had a prescription filled at Inman Pharmacy, you will need to provide them with a copy of your insurance card and credit card (so they can charge you). For more details about the pharmacy program, see our Prescription Medication section or come to Health Service.
  2. Your doctor can give you a paper copy of your prescription, and you can bring it to Health Service. We will fax it to Inman Pharmacy for you.
  3. If you don't want to use Inman Pharmacy, you can take your prescriptions to any pharmacy of your choice. You can review a list of nearby pharmacies on our Prescription Medication section.
  4. See if your health insurance has a mail order pharmacy program. This is very convenient for students—a three month supply of the medication gets shipped directly to you. Go on-line with your insurance, or call the customer service number to investigate.
  5. If you have an active prescription on file at a pharmacy near home, you can ask to have the prescription transferred to Inman Pharmacy. Call Inman Pharmacy and they can tell you what needs to be done.
  6. If Health Service is going to be your primary care provider (your doctor is from another country, or you are switching insurance) and you need a refill, you will need to schedule an appointment at Health Service. We can start prescribing your birth control pills after getting a medical history and performing an evaluation.
Help! I'm about to run out of pills! What should I do?

If you are currently taking birth control and there are no more refills on your prescription, that usually means you need another appointment with your doctor! Here's what you should do:

  • Call the doctor's office who prescribed the pills!

a. If we prescribed them, call us at Health Service. We can call in a prescription for a one month refill, to give you time to schedule the appointment you need—this may be a quick follow up appointment, or it may be your yearly GYN examination.
b. If your doctor at home prescribed them, call that doctor. They can call in a refill to Inman Pharmacy until you can make your follow up appointment with them.

  • If your doctor won't give you a refill, you can schedule an appointment at Health Service to have us prescribe your pills. If you run out of pills in the meantime and you need contraception, be sure to use a back up method such as condoms!
  • If you have an active prescription at your home pharmacy, you can have your prescription transferred to Inman Pharmacy. Call Inman to request a prescription transfer: 617-876-4868.
How do I get Emergency Contraception (also known as EC or Plan B)?

Emergency contraception can be used up to FIVE days after unprotected sex and significantly reduces the possibility of pregnancy. It is 75% to 95% protective, and is most effective if taken within 24 hours of unprotected sex. You can access EC either from Health Service when we are open, or from pharmacies without a prescription.

  • Come to Health Service any time we are open: You can see one of our nurses and buy it from us as an over the counter medication for $15.
  • When Health Service is closed, you can buy EC without a prescription at any pharmacy.  
How much do you charge for EC?

If you buy EC from us as an over the counter medication, there is a nominal charge that can change from year to year as the wholesale price changes. For the 2016-2017 year, the cost is $15.

What happens at an annual GYN examination?

An annual gynecologic examination should be performed yearly in all women starting in adolescence. The examination is a time to discuss each woman's general health, to discuss health risks, and to perform both a general and a breast examination. Testing is performed for sexually transmitted infections (STI) and other health screenings are done following national guidelines. Based on a woman's health history, her age, and other risk factors, a pap smear may or may not be performed at this visit. If a pap smear is not needed, the STI testing can be done on a urine sample.

How often should I have a Pap smear? When should I first have one?

The "Pap smear" is a test that scrapes some cells off the surface of the cervix (the opening of the uterus), and looks for signs of pre-cancerous changes. It is one of the best and most useful cancer screening tests. It is one of the tests done during an annual gynecologic examination, but it is not the only test. Until recently, a Pap smear was recommended yearly for all women from age 18 on. Recent research has indicated that pap smears do not need to be done so frequently, and new guidelines were developed in 2009. A first pap smear does not need to be done until a woman is 21 years of age, or older if she is not yet sexually active. Between ages 21-29 most women should have a pap smear every two years, and women 30 and over can sometimes go three years between pap smears. However, all women should continue to have a gynecologic examination every year to review other health issues, have a breast examination, get regular STI testing depending on age and risk history, and other routine health screening procedures according to national guidelines.

Does Health Service administer the HPV vaccine?

Yes, Health Service carries Gardasil, one of two vaccines currently licensed for use against Human Papilloma Virus (HPV). Please visit our Vaccines and Immunizations section for more information about the vaccine and fees.

For more information about contraception and women's health: