Filling in the Gaps ™:
Gender Affirming Care —
Beyond the Binary and the Basics
For the clinician who can find the dosing chart online but has nowhere to learn everything the chart doesn't cover.
Case-based | 10+ CME hours | Adult patients | Self-paced
Course Philosophy
Most gender affirming care training teaches you the protocol. Start the hormone, order the labs, repeat every three months.
Then a real patient sits down.
A nonbinary patient who wants voice changes but not facial hair. A trans man on testosterone with worsening cyclic pelvic pain. A hematocrit of 54 at month nine. A 52-year-old trans woman with hypertension and a smoking history asking for estrogen. A patient two years into therapy quietly disclosing ambivalence about continuing.
The protocol doesn't cover any of that. And "refer out" isn't an answer when there's nowhere to refer.
This course teaches the clinical reasoning underneath the protocols: hormone physiology, the terrain that shapes response to therapy, anatomy-based prevention, and the judgment calls the guidelines leave to you. Built on cases, graded against the actual evidence, and honest about where the evidence runs out.
THE PROBLEM
Gender affirming care is the only field where clinicians are expected to either know everything or do nothing.
You didn't get this in training. Maybe you got a lunch lecture on pronouns. So when a trans patient books an appointment, you're choosing between turning them away, referring them to a waitlist measured in months, or prescribing from a chart you found online and hoping nothing goes sideways.
And things go sideways. Erythrocytosis. Potassium increasing on spironolactone. Unsatisfactory cytology on a cervical screen. Pelvic pain that everyone keeps calling atrophy, and now you are the only clinician they trust and their entry point to seeking care.
None of that is exotic medicine. It's primary care.
But nobody taught you the version of primary care where the anatomy and the reference ranges both need translation.
This course fixes that.
This Course Is Not For You If
You want a plug-and-play protocol you can copy without thinking
You're looking for the 'one weird trick' to fix every patient
You're not willing to look beyond the prescription pad
This Course Is For You If...
You've turned trans patients away or referred them out because "I'm not trained in that" — and you're done doing that
You understand the clinical foundations and are prepared to move past the basics of starting therapy into the clinical reasoning the guidelines skip over.
You can initiate hormones but freeze when the hematocrit climbs, the potassium rises, or the labs stop making sense
You've stared at a lab report wondering which reference range even applies to your patient, and now you dread looking at follow up labs.
Your patient's goals don't match the binary endpoints the protocols assume, and you don't know how to dose for "partial".
You can continue maintenance regimens, but aren’t confident in dose titration and adjustment over the course of a patients’ transition. Hint: it’s not as simple as titrate up and stay there.
You want to balance patient centered care, evidence based care and the gaps in the guidelines to offer the high quality care your gender expansive patients deserve.
You want to do preventive care right for the anatomy actually in the room — not the anatomy the EHR assumes
You want the functional medicine lens applied with an evidence standard, not a supplement stack with EHR templates.
Whether you're building a Gender Affirming Care practice or just refusing to be one more door that closes, this course changes what you can offer, and stops you from being just another medical provider your transgender patients had to educate.
I NEED THIS!COURSE CURRICULUM
MODULE 1: Foundations and First Encounters
MODULE 2: The Initial Visit — Assessment and Informed Consent
MODULE 3: Testosterone Therapy
MODULE 4: Estrogen and Antiandrogen Therapy
MODULE 5: Beyond the Binary — Individualized Regimens
MODULE 6: Anatomy-Based Preventive Care
MODULE 7: Pelvic Pain in Gender Affirming Care
MODULE 8: Surgical Care for the Non-Surgeon
MODULE 9: Mental Health and the Whole Patient
MODULE 10: Systems, Documentation, and Practice Considerations
Course Resources
WHAT MAKES THIS COURSE DIFFERENT
Case-Based, Start to Finish
Every module is built around patients, not slides. You'll work a hematocrit of 54, a potassium of 5.3, and a cyclic pelvic pain differential before you're done. Each module closes with a documentation exercise, because knowing it and charting it defensibly are different skills.
Evidence-Honest
We tell you what the progesterone data supports and what it doesn't. Off-label is labeled off-label. Low evidence is labeled low evidence. The functional medicine content is held to the same standard as everything else — no ideology masquerading as science, from any direction.
Beyond the Binary, Literally
Most GAC education assumes binary transition goals. An entire module covers microdosing, partial effects, cycling, and nonhormonal affirmation, because those patients are already in your waiting room.
Whole-Person, Not Just Hormones
The FiGs lens runs through every module: the metabolic, inflammatory, and lifestyle terrain that shapes hormone response, framed as adjunctive to standard care, never a replacement for it.
Clinic-Ready
Preventive care by organ inventory, referral letters that meet SOC8, awareness of the systems issues that trip up this care, and a SOAP template you can use Monday.
Your Remedy Meducator®
Andrea Phillips is a Nurse Practitioner & Certified Nurse Midwife (CNM).
She graduated from Frontier Nursing University and is board certified by the American College of Nurse Midwives. She previously practiced at women’s clinics in Mt. Vernon and Bellingham before starting Spectrum Reproductive Health in 2022 to provide reproductive health, gynecology care and gender affirming care to the Bellingham, Washington community. Prior to becoming a nurse midwife and nurse practitioner, she worked as a doula and then a nurse in acute care, psych, women’s services and labor and delivery.
She specializes in gynecologic care and gender affirming care and values providing high quality evidenced based care with an integrative patient centered approach. She finds providing gynecologic primary care for acute and chronic conditions, annual exams, and gender affirming hormone therapy very fulfilling. She feels especially rewarded treating patients with sexual pain disorders, as this population so often goes unheard and under-treated.
