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Last week, University of North Carolina at Chapel Hill students marched the mile from campus to the Board of Governors meeting site to protest the UNC System’s blanket ban, imposed by the board, on gender-neutral housing. The new policy -- which overturned the Chapel Hill Board of Trustees’ endorsement of the housing option --  was approved while students were away for the summer under the reasoning that “there are more practical ways” to make students “safe, comfortable and included,” the board chairman said.

But it sparked outrage among advocates and campus officials concerned for the well-being of transgender students and others who would prefer to live outside traditionally designated pairs for college roommates.

Among elite institutions, UNC’s move was unusual – many institutions are in fact moving in the opposite direction. There are now about 150 colleges that offer gender-neutral housing, according to a running count by Campus Pride. Granted, that’s out of more than 4,000 institutions – and it’s taken more than 20 years to get to this point.

But for many of those campuses, whatever controversy ensued when men and women started living together has dissipated, and officials have moved on to more administrative-type policies. Last month, American University became the latest institution to cover gender reassignment surgery under its student health insurance policies.

“We’re seeing a progression. Trans students and allies have been working now for a number of years at many schools to create gender-inclusive bathrooms and gender-inclusive housing options, because those are pretty basic – to have a place to sleep and a place to pee,” said Genny Beemyn, director of the Stonewall Center at the University of Massachusetts at Amherst, the first campus to offer gender-neutral housing, back in 1992. (A recent settlement by the U.S. Education Department's Office for Civil Rights suggests colleges would be wise to provide these options.) “They’re looking now to address other important issues, and so gender in name documentation, hormones and surgeries are coming up more and more frequently for schools that have really begun to address transgender issues.”

Insurance in particular. Several colleges have added transgender surgeries and hormone therapies to their student insurance policies over the last couple of years, with at least 70 in all covering one or both of the expenses. (The additional services add virtually nothing to the cost of premiums.)

Campus officials say the development of transgender services has been part of a larger inclusion agenda, often driven by students or a single, instrumental staff member.

American already covered hormone therapy though its policy, but added surgeries this August. (The campus also offers gender-neutral housing.)

“We really saw [hormone therapy] as a first step, and it was really in response to requests we got from students,” said Rob Hradsky, dean of students at American. “Because we are a very inclusive community, our students are very supportive of one another and people really embraced adding the new coverage.”

Most colleges have been looking to insurance policies as their next step in addressing transgender student issues.

“In some respects, we’ve moved through a lot of the issues that would be controversial so that this was less of a dramatic change than it might be for campuses,” said Larry Moneta, vice president for student affairs at Duke University, which, beginning this year, offers up to $50,000 in insurance policy coverage for gender reassignment surgery, hormone therapy and counseling. “Now we’re making the adjustments to practices and systems -- like insurance systems -- that just feel rather normal to me.”

Another practice gaining traction -- one from which non-trans students will benefit just as much -- is a preferred name policy. The new one at the University of Wisconsin at Madison allows students to note their preferred name through their online learning platform, which is then transmitted to class rosters and the online student directory. While plenty of students of all gender identities may prefer a nickname to a given name, the issue is important for many transgender students for whom the name with which they were born represents a gender with which they don't identify.

"It's really the institution saying, we should do this, not just the campus center being the fly in people’s ointment,” said Gabe Javier, director of Wisconsin’s lesbian, gay, bisexual and transgender campus center. “This is a campus climate issue, and an institutional climate issue, being able to be represented in a way that fits who you are in the way that you wish. So it made sense for our institution.”

Without these sorts of policies that institutions are tackling, students can encounter serious, potentially dangerous difficulties. A student whose insurance doesn’t cover hormone therapy might try to get it illegally, or lie to the health center about why they need it. A student whose given name does not match their preferred gender is subject to additional stress in classes.

At the University of California at Riverside, one of the first public institutions to offer gender-neutral housing, officials are rolling out new technology for a preferred-name system, and transgender-related medical costs are covered under student health insurance.

Nancy Tubbs, director of the Riverside LGBT center, remembers the moment she realized she needed gender-neutral housing: at a conference Riverside hosted in 2003.

“We had a student from UC-Santa Barbara who came to us in tears because they did not feel safe,” she said. “I had this moment as a director of a center going, whoa, this was not even on my radar.”

Professionally staffed offices like Tubbs’s are a huge plus when it comes to making changes. And the other important factor is illustrated in that moment at the conference.

“My personal opinion is change is driven by student voices,” Tubbs said. “Where students have felt empowered to say, ‘We need a change because I can’t get my education because of what I’m experiencing on this campus.' ”

Riverside is rolling out its preferred-name system now. But officials are already looking ahead at what’s next: information systems for employees, and education for supervisors and other colleagues of transgender employees who have transitioned or are newly transitioning.

So while some, like UNC, move away from these changes -- either from internal or external political forces, Tubbs speculated -- others are exploring new territory.

“I’m actually just quite pleased with how much of a non-issue these things have become for us,” Moneta, of Duke, said. “I guess success is when there’s just not a dramatic topic of controversy.”

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