I have been helping people with hormonal transitions F-M and M-F since 2006. Many patients showed me when I was right out of medical school how hard it is to get care for LGBTQ specific needs. In the Seattle area, my patients had a dire need for an advocate in the healthcare system to get care they needed. So being a family medicine doctor, I educated myself and filled in the gap of care that the community needed and that specialists could not or did not want to provide. We found international treatment guides, physician and psychologist experts, to help guide our treatment of gender transitions. I continue to help LGBTQ on this small island of Kauai, and hope help more people who may feel the medical system has not provided the non-judgmental compassionate care every human deserves.