Affirming transgender care.

Transgender people hoping to begin their physical transition are often denied hormone therapy until they endure a lengthy psychological evaluation that proves they suffer from gender identity disorder. The process alienates some trans people, discouraging them from seeking basic medical attention.

That's why New York City's LGBT-focused Callen-Lorde Community Health Center has eliminated the usual evaluation process. Gal Mayer, MD, the center's medical director, says welcoming transgender clients means taking them at their word. "We don't put any burden of proof on the patient," he explains. "Anyone who comes in and says 'I'm seeking hormonal care' will receive a prescription, as long as we don't think the hormones will do them harm."

Indeed, drugs are not prescribed indiscriminately. Patients meet with Callen-Lorde staff to discuss the ramifications of treatment, but those conversations are designed to make patients feel accepted and supported, Mayer says. "It's not just that we prescribe hormones," he says. "We know how to talk to transgender patients about their lives." And the word has spread. Callen-Lorde currently treats about 800 transgender people, some traveling all the way from Virginia and Pennsylvania.