Zach McCallum, 55, doesn’t embarrass easily. But the self-described bald guy with a beard felt grateful when his gynecologist said he could check in on a regular medical floor. That meant he could skip the waiting room full of women.
“It was incredibly validating, and I felt very seen,” McCallum says. “(I thought) this is a practice that values and cares about their trans[gender] patients and is going to do what they need to do to make them feel comfortable.”
Everyone needs a kind doctor they can trust. But it can be a challenge to find medical care that is supportive of and knowledgeable about transgender people’s health. Here’s how to find gender-affirming doctors for adults.
Use Online Resources
Christy Olezeski, PhD, is a Yale Medicine psychologist who works with people who are transgender and gender expansive. She says it’s important to see a doctor who’s confirming, supportive, and understands the science behind your care; and that those doctors are out there.
“There are a number of folks who are leading with that information,” Olezeski says.
She’s referring to websites or online directories geared toward people who are transgender, genderqueer, nonbinary, or gender nonconforming. These resources provide names and bios of affirming primary doctors, surgeons, speech therapists, gynecologists, and other health professionals.
To learn more:
Do an internet search. Type in “trans-friendly doctor near me” and see what pops up. Look for big and small signs of support. For instance, “If this doctor says he’s a member of the Portland Gay Men’s Choir, he’s probably going to be OK with you,” McCallum says.
Use LGBTQ+ provider directories. These listings aren’t always vetted by medical groups. But it’s a good sign when a doctor wants you to know they’re trans-friendly, says Amanda Kallen, MD, a Yale Medicine gynecologist and reproductive specialist in the area of fertility care for people in the LGBTQ+ community.
You can check for affirming doctors in your area through:
- World Professional Association for Transgender Health (WPATH) provider directory search
- GLMA provider directory
- OutCare provider directory
- Local LBGTQ+ community center websites
Some LGBTQ+ resources give more details than others. But you may find info such as:
- A doctor’s sexual orientation, pronouns, and gender identity
- How long they’ve worked with trans people
- If they’ve received training in trans-affirming care
- The kind of gender-confirming treatments they offer
- If they use the informed-consent model
(Informed consent means you can get gender-affirming treatment without a referral from a mental health specialist.)
Call your insurance provider. They may have a list of affirming doctors on hand. Double check to see if these health professionals list transgender or LGBTQ+ health care in their online bio. Call their office if you want to know more.
Look for virtual care. You might find a provider in your state but not your town. If you can’t travel, ask if the doctor offers telehealth visits.
You can also look into services such as Folx, Plume, and Queermed, Kallen notes. These transgender-focused health care companies offer virtual health care, including gender-affirming hormone therapy by mail.
The internet is a good general start. But lots of folks find good care by asking others for advice. Here are some ways to tap into your local network:
Talk to your LGBTQ+ community. It’s a no-brainer to ask your friends who they see. You can also search social media or join a Facebook group. Type in “queer exchange” and your city. Or meet someone in the real world.
“Go to a meetup for LGBTQ hiking and ask someone, ‘Hey, who do you see?’” McCallum says.
Ask other doctors. It’s helpful to have a doctor who’s in your corner and will help you find other specialists. “My primary care doctor knows I’m trans,” McCallum says. “She’s probably not going to refer me to a cardiologist who she knows is super anti-trans.”
Look for Signs of Support
It should be easy for you to set your preferred name and pronouns. And everyone in the office should use them. “When I go in for an appointment, it says on the paperwork: patient goes by,”
McCallum says. “It’s right there in big bold letters. They can see that my name is Zach.”
But affirming care doesn’t stop at the sign-in sheet. Here are some expert tips on what to look for:
- Intake forms with neutral language
- Access to all-gender bathrooms
- Easy use of a bathroom that fits your gender identity
- LGTBTQ+ signs of support posted for everyone to see
- Doctors and nurses who are private about your care
You should get step-by-step instructions once you’re in the exam room. Hopefully, Olezeski says, your doctor will ask other questions, such as:
- How can I make this more comfortable for you?
- Do you want to do the exam today or next visit?
- Is it OK if I touch this part of your body?
- What are the words you use for certain body parts?
- Do you want a trusted person in here with you?
Tell your doctor about any past medical mistreatment. They may take more care if they’re aware of how you’ve been wronged in the past. If you’re really nervous about an exam or procedure, Kallen says, it’s fine to ask your doctor about medication to feel calm.
Who Can You See for Health Care?
Many doctors treat people who are transgender. “I’ve had patients whose primary care docs prescribe their hormone therapy or manage their potential gender transitions,” Kallen says. “But I’ve also had patients who see our adult or pediatric endocrinologists.”
The key thing is that you find someone who’s up to speed on trans health care. Here are some questions you can ask your doctor:
- How many transgender people do you treat?
- How long have you prescribed gender-affirming hormone therapy?
- What are the side effects of hormone therapy and what can I do about them?
- How can I have a baby if I want gender-affirming treatments?
- Do you work with a team of specialists who provide trans health care?
Your doctor should also know what kind of health precautions you’ll need. For example, testosterone isn’t birth control. If you have ovaries and a uterus, you may still get pregnant on hormone therapy if you have sex with someone who has a penis.
You may also need routine health screenings. “If you have the parts, you need the care,” Kallen says.
Form a Relationship
McCallum gets medical care a lot. He has a rare health condition called myasthenia gravis (MG). It affects how his muscles and nerves work together. There’s no cure for MG. But he takes medication that helps him feel better.
As far as he and his doctors know, his cross-hormone therapy doesn’t affect his MG care. And he doesn’t mention his gender identity to every health professional he sees. But he talks about trans-related health issues with his family doctor, the person who prescribes his testosterone therapy.
Sometimes sensitive subjects come up.
For example, McCallum needed to switch estrogen-cream therapies a while back. That’s a topical treatment (meaning that it goes on your skin) that eases uncomfortable vagina and vulva symptoms — testosterone can thin vaginal tissue. It was an awkward topic to discuss. But his affirming doctor made it much easier.
“I can’t imagine going to some random gynecologist about that,” McCallum says. “I don’t know what I would’ve done.”