According to WPATH , the primary care provider is ideally suited to support and care for this medically underserved population:

• 1. You are usually familiar with your individual clients.
• 2. You have knowledge on hormone use and screening tasks in other populations for example post-menopausal women or hypogonadal men and can apply this knowledge to trans clients using hormones for gender transition.
• 3. You are also accustomed to empowering clients through education and shared decision making.

Consultation or referral to an endocrinologist may only be appropriate in the case of a medically complex client; it is typically not needed in relatively straightforward cases. Additionally, outside major urban areas, an endocrinologist with experience treating trans clients may not be available. This may result in an unduly long and stressful wait for the client. If consultation is sought, it may be helpful to the provider and client to consider starting an androgen blocker +/- low-dose estrogen (e.g. half the regular dosage) for trans women or low-dose testosterone for trans men, until the consultation can be obtained.

According to WPATH , the primary care provider is ideally suited to support and care for this medically underserved population:

A review of the available literature, and the many combined years of experience at Sherbourne Health Centre and similar health centres suggest that cross-sex hormone therapy is a safe treatment for healthy trans adults. The risks of adverse effects from hormone therapy for trans people are not any different from those for cis people on hormone therapy. Hormone therapy is safe for healthy adults, and still is a life saving measure for people of all ages with minor or even significant health issues. Denying access to hormones can do much more harm than the possible risks of treatment.

Many providers are concerned about the possibility of regret, that is, of treating a client with hormone therapy who later decides he/she/they prefer the sex of origin. This is, in fact, a very rare occurrence. The experience of regret after sex reassignment has been examined largely by case study; the prevalence of people who regret their transitions is estimated at 1-2% of all trans people. ^1,2 More importantly, many of these cases weren’t about people regretting their transition but rather about them regretting the realities of living in a trans-phobic world.