Providing hormone therapy and simple advice

Providing hormone therapy and simple advice

As an endocrinologist, the core of my work centers around hormones and glands throughout the entire body. I was a chemistry major in college and hormones plus receptors felt like a great fit with my interests.

About 10 years ago, I became interested in prescribing gender affirming hormonal therapy for individuals who are transgender or non-binary. One of my first transgender patients was the adult child of one of my coworkers. She wanted her child to have a provider who would treat him with respect and provide care to him safely. I was honored she wanted him to see me so that I would help get him started on gender affirming hormonal therapy.

Throughout my career, I’ve been fortunate enough to work with a team of health care providers who value treating all of our patients with respect and exceptional quality, including transgender and non-binary individuals. My goals center around helping people live their best, healthiest life utilizing the highest standards of care.

In endocrinology, we use hormonal therapy to alter hormone levels to match an individual’s gender identity. For example, feminizing hormones induce features such as breast development or body composition changes and masculinizing hormones induce increased facial and body hair or voice deepening.

My approach in prescribing these hormones is to try to understand each individual’s pathway to my office, assess their readiness and understanding of the process, and discuss both the benefits and risks of these medications. Each patient’s experience is different, but many tell me that after starting on gender affirming hormone therapy, they finally feel as if they’re becoming the person they were meant to be. Others tell me they feel more comfortable and happier in their bodies.

In my practice, I tend to see two major challenges impacting LGBTQ+ patients: insurance and access to care, and discrimination in both health care and the community. Some patients’ insurance companies will not cover significant portions of their care. Other patients have had to wait several months for care due to lack of available specialists. And sadly, there are patients who have had negative interactions with health care providers or who face discrimination at work or at the grocery store.

As an ally, Pride Month is about creating an inclusive and supportive environment by listening and speaking out against discriminatory comments or environments. It is also about providing any education or support where I am able to do so.

My advice is simply to listen to people, try to educate yourself by reading, and ask questions respectfully. For example, if you aren’t sure of someone’s pronouns, just ask them. I firmly believe we all need to work together to build an inclusive society for all people.

Dr. Sarah Swarts is an endocrinologist at Aurora BayCare Medical Center, Green Bay, WI.

Looking for an LGBTQ+ friendly health care provider? Find one in Illinois or Wisconsin.

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Dr. Sarah Swarts