Objective: This exploratory study sought to assess transgender college students' experiences accessing primary, gynecological, and/or mental health care through university health services (UHS). Participants and methods: Individual interviews were conducted with eleven transgender undergraduate students attending a large public university in the United States in Spring 2017. Results: The structure, organization, and practices of UHS are not adequately meeting transgender college students' health care needs. Students reported being repeatedly misgendered and addressed by the incorrect name by staff at UHS. Some providers asked inappropriate and irrelevant questions about their gender identity during clinical encounters. These and related experiences deterred many participants from returning to UHS for health care services. Conclusion: UHS could improve health care delivery to transgender college students by adopting standardized and inclusive practices consistent with those recommended by The Fenway Institute.