Sexual and Reproductive Health

General Concerns

We provide a full range of services, including those listed below. Urgent concerns are seen on a same-day basis in our Walk-In Clinic. Students can make an appointment for non-urgent concerns. The Center for Awareness, Resources and Education (CARE) at Tufts also provides a wide range of educational information about Sex Health on their website.

Visit the Center for Awareness, Resources and Education (CARE)

  • Care for people who’ve experienced sexual assault
  • Birth control/Contraception
  • Emergency contraception
  • Evaluation and treatment of acute or chronic vaginal, anal, testicular or penile concerns/symptoms/trauma
  • Screening, treatment, and prevention of sexually transmitted infections
  • Annual examinations including breast/chest exam and Pap test
  • Counseling regarding both planned and unplanned pregnancy
  • Evaluation and treatment of testicualr pain or lumps
  • Treatment for urinary tract infections, genital warts, and many other issues.

Birth Control and Emergency Contraception

What methods of Birth Control are available to me?

We provide consultation about various contraceptive methods including pills, the NuvaRing (vaginal contraceptive ring), IUDs (Intrauterine Devices) and Nexplanon (the implantable rod).  While we don't insert Intrauterine Devices (IUDs) or Nexplanon (the inplantable rod) in our office, we can give you information on local providers who do.  

What is Emergency Contraception (also known as EC)?

Emergency Contraception (EC) is a safe way to prevent pregnancy after unprotected sex. EC is available whenever Health Service is open by coming to our Walk-In Clinic. Two types of EC are available at Health Service: Plan B and Ella.

If you have questions about EC when Health Service is closed, call our nurses advice line: 617-627-3350.

For more information and resources related to birth control, contraception, and gynecologic health, visit the CARE website.

Visit the CARE website

HIV Testing and Prevention

HIV Testing

We provide confidential HIV testing. We do not share test results with anyone, not partners or parents, except as mandated by state law.

Make an appointment for routine screening or utilize our Walk-In Hours any time if you are worried about a symptom or have been exposed to someone diagnosed with HIV.

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 our Walk-In Center 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. 

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.

Most insurances, including Tufts student health insurance, cover the cost of medications for PrEP.  We will help you connect with patient assistance programs that will cover the co-pays, so that PrEP will be available to you without any out of pocket expense.

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.

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.

For more information and resources related to HIV Testing and Prevention, visit the CARE website.

Visit the CARE website

LGBQ Healthcare

Health Service welcomes and affirms students of all gender identities, expressions, and sexual orientations. Our medical staff has been trained in LGBTQ health issues. Our approach to health and sexual health is inclusive. Please come and see us!

Transgender Health Care

Health Service offers a range of services for transgender, non-binary, and/or gender non-conforming students. Our staff are trained on transgender issues, and our forms and electronic medical records offer you the opportunity to self-identify gender identity and preferred pronouns.

Contact us to:

  • speak with a clinician specially trained in transgender health care
  • initiate or continue the prescribing of hormone treatment
  • receive information on local surgeons who perform gender affirmation surgeries

Call 617-627-3350 to make an appointment.

For questions about insurance and billing, please contact the Health Service Business Office. For mental health care, or to receive support for a letter for a gender affirming medical procedure, please contact Counseling and Mental Health.

Hormone Replacement Therapy (HRT)
I’m interested in starting Hormone Replacement Therapy (HRT)

The offices of Health Service (HS) and Counseling and Mental Health Service (CMHS) support trans and non-binary students who are wishing to feel affirmed in their gender. We aim to follow the standards of care developed by the World Professional Association of Transgender Health (WPATH). With respect to Hormone Replacement Therapy (HRT), CMHS coordinates care with HS. This includes a discussion about potential mental and medical health-related concerns that may interact with the effects of hormone treatment.  We aim to make this process as smooth and quick as possible. The timeline varies case by case. These steps and projected timelines are approximate to help with planning and preparing.

If you are already being seen at CMHS for counseling:

Please speak with your therapist and inform them about your desire to pursue hormone treatment. In some cases, you may be referred to meet with another clinician for a brief evaluation.

If you are already connected with a provider at HS:

Please notify your provider that you are interested in pursuing hormone treatment. Your provider will refer you to CMHS for a brief evaluation.

If you are already taking hormones:

Health Service can help you monitor your hormones and/or manage your prescriptions while you are at Tufts and will coordinate care with your other prescribing provider as needed/if appropriate.


First Step: Meet with a CMHS Clinician

First: Meet with a CMHS clinician

  1. Call CMHS at 617-627-3360 and ask to be scheduled for an intake appointment with a trans care specialist. Note: Though all our providers are trans affirming, several have received specialized training in providing trans-related care.

The following CMHS clinicians are part of the trans care specialist team:

All Tufts/SMFA Students
  • Megan Tucker
  • Michelle Chen 
  • Ritu Sharma
  • Marilyn Downs
  • Francis Chen
  • Julie Ross
SMFA Dual Degrees Students Only
  • Maria Hiraldo
  1. You’ll meet with the clinician for approximately 2-3 appointments to discuss the following:​
  • Mental health history
  • Key aspects of your gender identity and history
  • Your hopes for HRT and anticipated barriers
  1. Prior to your initial appointment at HS, your CMHS clinician will collaborate with your HS provider. The following information will be provided:
  • Demographic and identifying information
  • Nature and length of your work with the CMHS clinician
  • A statement that the following criteria are met: 1) 18 or over, 2) Presence of gender dysphoria, and 3) Upon evaluation, student appears to be appropriate for referral to HS for a discussion about HRT.
  • Other relevant information that will help in providing you with the best care
  1. Optional: Though not a requirement, some students may decide to pursue ongoing counseling.  CMHS offers brief therapy and can also assist a student with a referral to a local provider.
Next Step: Referral to Health Service (HS)
  1. Call HS and indicate that you’d like to schedule an appointment to begin hormones. Note: Though all our providers are trans affirming, some have received specialized training in providing trans-related care.

You’ll be scheduled for an appointment with one of the following trans care specialists:

  • Margaret Higham
  • Stacey Sperling
  • Ariel Watriss
  1. You’ll meet with the medical provider for approximately 2-3 appointments:

Appointment #1: Discussion of your medical history

  • Relevant discussion of your gender identity and history
  • Creating a roadmap of your hopes and goals for treatment
  • Review hormone effects, dosing timelines, possible complications, & consent forms
  • Answer questions you may have

Note: After this appointment, you’ll be asked to complete relevant lab work.

Appointments #2 - 3

  • Review lab work
  • Physical exam (generally clothing on unless there are specific health-related questions)
  • Solidify a comprehensive understanding of your health history, including a discussion about possible contraindications
  • Answer follow-up questions about hormones and sign consent document
  • Review the medication (i.e., initial dosing and management of dosing over time, how medication is obtained and how it is taken)
  • Answer questions you may have
  1. When you and your provider decide together that moving forward with HRT makes sense for you, you’ll receive a prescription to begin. Please see this link for more specific information related to gender affirming hormones/medications (insert hyperlink when page is complete – see the email + attachement that Margaret previously sent).

Additional appointments

  • Some students may be offered additional appointments related to various medical concerns, for example, if you need more support around receiving injections.
  • After beginning hormones, you’ll work in an ongoing fashion with your provider for routine follow-ups, usually scheduled at one, three, six, and 12 months.

*Note: There are sometimes contraindications that might necessitate a 2nd opinion or a more experienced provider’s care from an outside organization. In these situations, CMHS and HS are aware that students may experience a range of emotions related to the request for a second opinion.  We will do our best to support students through this process.

Medications for Gender Affirmation Treatment

Most insurance plans cover gender affirming hormone medication the same way they cover other medications: insurance covers most of the cost, and the member covers a copay.  The exact co-pay is set by the insurance plan and varies from plan to plan.  In addition, many insurance plans have a “deductible” that can significantly impact the cost of your medications.  This is an amount that the member pays out of pocket, before the insurance benefits become active.  The deductible can be any amount, but is often between $1,000 to $6,000.  So it can be difficult to determine what the student’s out of pocket expenses will be without knowing a lot about the insurance plan.  We can help you understand your insurance at our Business Office in Health Service – just call the main number at Health Service, 617-627-3350, and listen for the prompts.

Before starting hormones or medication, your health care provider will talk with you about medication effects, side effects, what to watch out for, and what dose to use, depending on your goals and medical history.  Below is some basic information about the commonly used medications and hormones.

Feminizing Hormones/Medication: 

  • Two medications are given for feminization—Estrogen and Spironolactone 
  • Estrogen is a hormone that comes in pill form, as an injection, or as a patch.  Most adults under 35 take the pill form twice a day.  
  • Spironolactone is an “androgen blocker” that helps suppress testosterone levels.  It comes in a pill form and is usually taken daily twice a day.
  • Estrogen and spironolactone are readily available in any pharmacy.

Masculinizing Hormones:

  • Testosterone is the masculinizing hormone. 
  • Testosterone comes in many forms:  injection, patches, gels, and implants.  Since patches, gels, and implants are expensive and difficult to deal with, most people use injections.  
  • Injections are given either once a week or every two weeks. 
  • We recommend that Testosterone be obtained from pharmacies that have special expertise—Health Service commonly works with New Era Pharmacy in Portland Oregon which ships directly to you.
  • At New Era, a 10 ml bottle of Testosterone lasts for 9 months or more depending on your dose, and costs $65 out of pocket, which is much cheaper than using your insurance. 
  • Prescriptions for needles and syringes will also be needed.
  • Our nurses will work with you to help you learn to administer your injections.
  • We will also provide you with a small sharps container for safe needle disposal.


For Ongoing Support

While seeking gender affirming treatment can be very exciting, the process can also feel stressful so having support will be important. In addition to short-term individual counseling at CMHS and LGBTQ+ Healthcare at HS, students also have access to many other supports including Trans at Tufts and other CMHS groups, as well as many discussion and peer facilitated support groups offered by the LGBT Center on Campus. If you’re seeking ongoing counseling and support, you can schedule an appointment with a CMHS Case Manager to help with referral. Please see additional campus resources here.

Other Healthcare Resources

Though all students who pay the student health fee are eligible for services, some students may prefer not to seek gender affirming treatment at Tufts University Health and Wellness. The following local health centers also provide care, though wait times for an appointment may vary and costs may depend on your health insurance coverage.

Fenway Health (Boston)

  • Ansin Building (Main): 1340 Boylston St, 617-267-0900
  • South End: 142 Berkeley St, 617-247-7555
  • Sydney Borum Jr. Health Center: 75 Kneeland St, 617-457-8140
    • Ages 12-29, same day appointments only

Boston Medical Center – Transgender Medicine and Surgery

  • One Boston Medical Center Place, 617-638-1833

Boston Children’s Hospital - GeMS Clinic

  • 300 Longwood Avenue, 617-355-6000
Additional Information
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

Our transgender health care specialist clinicians can both initiate and continue the prescribing of ongoing hormone treatment for students. For initiation, 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 information on local surgeons who perform gender affirmation surgeries: facial feminization surgery, mastectomy (breast removal), augmentation mammoplasty (enlarging breasts), hysterectomy-oophorectomy (removing uterus and ovaries) and orchiectomy and neovaginoplasty (removing testicles and surgical construction of a vagina). 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 UnitedHealthcare StudentResources. This policy covers a full range of transgender health benefits including gender affirmation surgeries, hormones and counseling.

Exclusions: The following are not covered:

  • Facial Feminization surgery, including but not limited to: facial bone reduction, face "life", facial hair removal, and certain facial plastic reconstructions.
  • Reversal of genital surgery or reversal of surgery to revise secondary sex characteristics
  • Cryopreservation of fertilized embryos
  • Sperm banking
  • Voice modification surgery and voice therapy
  • Rhinoplasty (except if criteria is met)
  • Belpharoplasty (except if criteria is met)
  • Abdominoplasty (except if criteria is met)
  • Surgical or hormone treatment on enrollees under 18 years of age
  • Surgical treatment not prior authorized by UnitedHealthcare
  • Drugs for hair loss or growth
  • Drugs for sexual performance for patients that have undergone genital reconstruction
  • Drugs for cosmetic purposes
  • Hormone therapy except as described in the Covered Services section.
  • Other exclusions may apply. Check the plan-specific documents before making a determination.

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).

Medical Record Documentation
  • 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. Please review the steps provided here for a Preferred Name Change. We can also enter your preferred pronouns into your medical record.

STI Testing

Screening can be important for anyone who is sexually active and Health Service provides routine STI testing. 

  • Make an appointment for routine sexually transmitted infection (STI). Utilize our Walk-In Hours if you are worried about a symptom or have been exposed to someone diagnosed with an STI. Important: In order for the STI test to be accurate, patients are asked to not urinate within 2 hours of the test.
  • There are tests for many, but not all, STIs. A Health Service clinician will discuss your sexual history with you as well as symptoms of various STIs.
  • For more information and resources related to STIs and Testing, visit the CARE website.

Visit the CARE website