Campus & community, People, Profiles, Work life

How UC Berkeley became a national leader in trans care

The Transgender Care Team was created in 2012 at University Health Services to better serve the trans and gender-nonconforming campus community

When things get hard, Anna Harte doesn’t sit back and wait for someone else to solve a problem. She jumps in, head first, and tries to find a solution.

Growing up with a loving mom who was “a little bit of a hypochondriac, which she knows,” Harte learned how to take care of her mom — to listen well and calm her anxiety. It was something, Harte realized, that she was good at. It felt natural to her to step into that role, helping someone feel cared for and supported when they really needed it.

And now, as a medical director of University Health Services (UHS) at UC Berkeley, it’s what she loves most about her job.

person smiling at another person off-camera

Anna Harte is the medical director of University Health Services at UC Berkeley. (UC Berkeley photo by Neil Freese)

As medical director, Harte oversees all the medical services provided at UHS, including primary and urgent care, the radiology lab, the pharmacy, physical therapy, specialty clinics, sports medicine and occupational health. “I’m essentially responsible for all the medical care,” she said. “If something goes badly, my license is on the line.”

When she can find the time, Harte also sees patients, often getting involved in more complicated or challenging situations. “I absolutely love seeing patients. It’s my favorite part of my work.”

In her work, Harte tries to identify the communities who are having trouble accessing care: She looks for specific barriers to care, finds ways to remove and restructure them and then, begins to build a system that’s easier to access and more welcoming to these communities.

“I’ve always had a penchant for trying to find ways to make care accessible for everybody,” said Harte. “And not just physically accessible, but trusted and culturally competent. I don’t think any of us — health care systems, providers, humans — are perfect at that, but we at UHS continue to learn and grow and evolve.”

In 2001, after completing her residency at UC San Francisco in Primary Care Internal Medicine, Harte joined UHS, where she worked Saturdays in urgent care. She also had several other jobs across the Bay Area, including a private practice in Orinda.

Back then, UHS was different in some ways — the health record system wasn’t digital yet, for example, so the staff worked with paper files. But Harte said it felt much the same as it does today.

“It felt very collegial and kind and authentic,” she said. “It didn’t — and still doesn’t — feel purely medicalized. It feels like a human place filled with dedicated people from many different disciplines, including mental health, but other disciplines, as well.

“It also felt — and it still does — like a mini national health system, where you can treat patients and not have to worry too much about insurance, where you can take care of the whole person.”

For a decade, Harte worked in urgent care and then, as a part-time physician, until she became associate medical director in 2011.

a three-story building with a lot of windows

University Health Services is located in the Tang Center on Berkeley’s campus. Harte said that UHS strives to create an environment in which everyone in the campus community feels welcome. (UC Berkeley photo by Bonnie Azab Powell)

Although UHS provided a supportive environment for many Berkeley students, and staff and faculty, Harte saw that there were still several communities who weren’t often accessing medical care, including the LGBTQ+ community, and in particular, the transgender community.

For years, there had been one medical provider at UHS who had been providing all the care for trans patients. But when the provider left that position, there was a big gap in trans care.

“It was really painful and difficult for the trans community because there was no one here who knew anything about, or really wanted to learn about, hormone therapy, for example,” said Harte.

So, in 2012, Harte stepped in and found a solution: She started the Transgender Care Team.

First, she hired a physician, Madeline Deutsch, who is trans and an expert in trans care. Deutsch trained Harte and other providers at UHS in everything, from medical care, including hormone therapy and gender-affirming surgery, to using appropriate terminology and the difference between gender identity and sexual orientation. (Later, Deutch went on to start the Gender Affirming Health Program at UC San Francisco, where she is now the director.)

Then, together with partners across UHS, Harte formed an interdisciplinary trans care team that now includes primary care providers, mental health clinicians, a care manager, a psychiatrist, an insurance specialist and medical assistant support staff. This year, students joined the leadership team for the first time — “which is fantastic,” said Harte.

lgbtq pride graphic

In 2012, Harte started the Trans Care Team at Berkeley’s University Health Services. Since then, Berkeley has become a national leader in interdisciplinary trans care. (UC Berkeley graphic)

Now, UHS at Berkeley is regarded as a national leader in interdisciplinary trans care.

“I will say that now we’re not alone,” said Harte. “There are some wonderful programs all over the country, including within the UC system, so we feel less unusual now.”

Among the services offered to the trans and gender-nonconforming community at Berkeley are hormone therapy, counseling with queer-identified psychologists, health assessments for those seeking gender-confirmation surgery, and advocacy and case management around insurance coverage.

During the academic year, students can drop in to speak with a counselor, without signing any forms, at designated places and times on campus, although speaking to a counselor is not required to receive services.

It’s important to recognize, said Harte, that most care that trans and gender-nonconforming patients need is care that everyone needs, with an emphasis on gender inclusivity and a little extra awareness and care around sexual and reproductive health.

“We generally do trainings with all of our staff — every single human being here — around cultural competency and understanding more about what people need,” said Harte. “And also ensuring that our staff understand that if a student happens to identify as transgender, it doesn’t mean that they don’t have other needs, as well. So, we’re continuing to learn and grow in those ways, too.”

In the past several years, attacks on LGBTQ+ rights have skyrocketed in the U.S. In 2022, state lawmakers across the country have already proposed hundreds of bills that would limit the rights of LGBTQ+ Americans, with about half of them targeting transgender people specifically.

a person holds a heart-shaped sign that reads "Trans people belong"

Protestors march against a bill restricting transgender girls from sports teams in Pierre, South Dakota, in March 2021. Over the past several years, attacks on LGBTQ+ rights have skyrocketed in the U.S. (AP photo by Toby Brusseau for Human Rights Campaign)

Harte said these kinds of attacks only strengthen her team’s resolve to do everything they can to support their vulnerable communities.

“When things happen in other parts of the country, we say, ‘OK, how are we going to make even more of an effort to ensure that we are standing out in what we can do locally? How can we support students who might be elsewhere, on leave or traveling? How much can we interface with our colleagues across the country who might be in those states to help take care of them?’”

Earlier this month, a team of mental health and medical providers from UHS gave a training at an American College Health Association meeting. During the trans care session, they brainstormed with administrators and clinicians in different states with more conservative political climates about how they could support their trans communities.

“We take it really seriously that we don’t just take care of our own, but that we also try to help people elsewhere who are in similar situations move forward,” Harte said.

Harte said that UHS is always looking for new ways to provide better, more integrated care for more people. The work is always evolving, presenting new challenges — and even when things get really hard, she never loses motivation to support the Berkeley community.

“We’re so privileged to be here with people who are going through difficult things — and it’s a huge responsibility to hold that trust. You’re never done — I love that,” she said.

Learn more about transgender care at Berkeley.

Find more trans resources on campus.