I have cared for LGBTQ people for 30 years. I was the only person who provided hormone therapy for many years. Now I limit my practice to children, adolescents and young adults. As the patients that I see get younger, I supply support and puberty blockers. I have a close relationship with all my patients. I am now a member of WPATH and follow their guidelines although I do begin affirming therapy before age 18 years.