You just schedule a 1 hr intake visit through our website. You will get an automatic email with our intake paperwork to complete 48hrs to the visit. It's important that you complete the intake at least 48hrs prior to your appointment so we have time to build your chart and we can make the most of our time together. 

The intake visit is 1hr and we spend that time talking about your goals for care, options and common concerns about starting hormone therapy. At the end of that visit I'll give you a consent form to review and sign and enter lab orders. Labs are scheduled with an offsite lab of your choosing. We usually use Quest since they have locations all over Washington State, but we can use another lab if cost, scheduling or other locations are more convenient for you. 

We meet a second time at a 30minute visit to review labs and discuss any concerns or questions about the consent form and continue discussing medications for you. We typically prescribe at this second visit. Follow up visits for medication can depend on your needs and what feels best for you. Some patients like to follow up 1 month after starting medication, others prefer to follow up 3 months after starting medication. 

I provide care with an informed consent model. This means you are the expert on your gender experience and goals. I’m simply here to provide information and resources. You do not need a letter from a therapist or mental healthcare provider prior to treatment.

A typical initial visit will likely take 1 hour. Follow-up visits are generally shorter.

If you are starting hormone therapy, in your first year of care, you should plan for visits every 3 months and labs are typically performed 1 week prior to these visits so we can review results together.

In your second year of hormone therapy visits and labs are typically every 6 months.

After 2 years of hormone therapy, if doses and labs are stable, labs are recommended once a year with visits once a year for refills.

For patients on testosterone, the max I can prescribe is 6 months at a time. This is regulated by the DEA, so unfortunately I cannot prescribe more than 6 months at a time. We will likely need to follow up every 6 months for a prescription once dosing is stable. If testosterone becomes declassified by the DEA or exceptions become legal for GAHT, I’ll provide refills for the max amount I’m legally permitted. We verify patient and prescription information of controlled substances through the prescription drug monitoring program (PDMP) electronic database.

As far as preconception services go- I have patients I’ll counsel on preconception options and optimizing fertility. There are many things you can do to prepare your body for pregnancy that can potentially make pregnancy easier or decrease the risk of certain health conditions even 1 year to 3 months in advance.

If infertility or early miscarriage is a concern, I’ll do initial workups and manage care by ordering, labs, medication or imaging and offer referrals as needed.

Once a patient is pregnant, I can order early labs if needed or an initial ultrasound and then I would transfer pregnancy care to a provider that offers pregnancy care since I no longer deliver babies. For patients planning a home birth or birth center birth with a community midwife, I’ll often continue to see patients as needed throughout their pregnancy to prescribe mental health medications, thyroid medications or meet other needs.

If miscarriage begins or you desire a medication abortion, Spectrum provides care and options counseling and can refer if you would prefer these services at another clinic.