Transgender Care: How Family Inspiration Led to Professional Reimagination

Pamela St. Amand, MD, FACOG (she/her)

I have been a practicing obstetrician–gynecologist in Beaumont, Texas, since 1984—when my baby was one year old. That same child later came out as a lesbian at age 21 and as a transgender man at age 23. The latter did not shock me too much, as my child had always preferred a short haircut, no dresses, masculine toys, and sports. Instead, my concern was that he would have the best medical care possible.

In the early 1980s, I had worked with Walter J. Meyer III, MD, at the University of Texas Medical Branch at Galveston; he had been something of the “father” of transgender care in Texas and nationally. I reached out to him about my child’s care, and he immediately answered my questions regarding the diagnosis and treatment that would be recommended, including the initiation of testosterone therapy. My son received care at the Rosenberg Clinic on Galveston Island, as did most transgender patients in Texas during those years and until the clinic closed in 2016.

In watching my son receive respectful, lifesaving care, I realized the need for more physicians to provide medical care, including hormone therapy, for transgender individuals. I also realized that obstetrician–gynecologists, like me, already have much of the necessary knowledge of the nuances of hormone therapy to provide that care to patients.

Still, recognizing that it was important to learn from the experts how to provide medical care for transgender individuals, I joined the World Professional Association for Transgender Health (WPATH) and began attending its meetings. I also started integrating transgender care into my practice; I began seeing trans men for routine gynecologic care, and as time went on, I added the provision of hormone refills to my practice. After several years of study through my WPATH membership, I felt that I had attained the knowledge needed to begin initiation of testosterone therapy in appropriate patients; after more study, I was fluent counseling trans women on estrogen and testosterone blockers; now, I have developed the knowledge and confidence to evaluate trans women and initiate hormone therapy in appropriate patients.

Through WPATH, I have grown my skills and evolved my practice. I can meet the needs of more patients with compassionate, evidence-based care. I encourage my obstetrician–gynecologist colleagues to consider expanding their own fluency in hormone medicine to embark on transgender care by joining me this fall at the meeting of the U.S. Professional Association for Transgender Health.

Respectful transgender care touched my family. It is my honor to be able to provide it to others.

For more information, please refer to ACOG's Frequently Asked Questions on Health Care for Transgender and Nonbinary Adults.

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Disclaimer: Published submissions reflect the experiences of individual ACOG members and may not represent official organizational opinions of ACOG.