Gender-Affirming Care on Every Level

Gender Affirmation Clinic Supports Patients and Families Through a Major Transition

Providing care in a safe and inclusive environment for a historically marginalized community

By George Menz | Photos: Stephen Legendre

For Brandy Panunti, MD, System Chair of Endocrinology at Ochsner Health, supporting LGBTQ+ individuals isn’t just a job. It’s her passion.

As part of Ochsner’s larger LGBTQ+ health initiative, Dr. Panunti and her team at the Ochsner Gender Affirmation Clinic - Tchoupitoulas are helping gender diverse patients feel seen and supported by providing them with the same access to high-quality care as the rest of the Ochsner community.

Historically, the LGBTQ+ community has been underserved, but the multidisciplinary model at Ochsner’s Gender Affirmation Clinic is making a profound difference by providing compassionate and individualized care. The specially trained providers follow the World Professional Association for Transgender Health (WPATH) standards of care and incorporate research to ensure that patients receive the best outcomes.

This holistic approach is designed to mitigate any of the shame, embarrassment or fear that many come with when addressing sensitive health issues. The clinic provides a safe, welcoming and inclusive environment for all. Services include primary care, HIV PrEP, hormone therapy and behavioral health, with care coordination for pelvic health, voice training and surgery preparation.

For LGBTQ+ youth in particular, the clinic is vital. Because of the complexity of care required for young patients, they work with a team of four experts who provide support every step of the way—physically, emotionally and socially.

This collaborative approach, said Cielo Alleyn, MD, Section Head of Pediatric Endocrinology, is critical to the efficacy of care. “Having everybody in one location means we can train our support staff, and every person that the patient is interacting with, to provide affirming care at the hospital,” she said.

In addition to Drs. Alleyn and Panunti, the team also includes Cesar Roque, MD, who provides primary care, and Clifton Mixon, PhD, Interim Section Head of Pediatric Psychology. Dr. Roque and Dr. Mixon offer essential services as part of Ochsner’s ongoing care.

Dr. Mixon and Dr. Alleyn work together closely to ensure patients receive care that integrates their physical and behavioral health care needs. “Pediatric gender-affirming care is family-centered. Parents play a critical role in supporting their kids, and we engage and involve them throughout the whole process, from the initial consultation until adulthood.”

It is important to note that parental consent is required for any gender affirming medical interventions. ​

“My role is helping make sure that the patient’s psychological needs are met along with their physical needs and helping make sure that their family can come together and understand their child’s transition,” said Dr. Mixon.

Dr. Cielo Alleyn, Section Head of Pediatric Endocrinology

Dr. Brandy Panunti, System Chair of Endocrinology

Taking a holistic, human-centered approach to gender-affirming care means that hormone therapy is only one part of the treatment process.

“A huge focus of the visit when I’m seeing gender diverse patients is the social aspect of their lives,” Dr. Panunti said. “How long have they been on this journey, do they have support, do they feel safe at home, which bathroom do they choose to use when they go out, how are they choosing to disclose their identity to people.”

For trans and gender-questioning youth, understanding their social context is essential. “To care for patients, we have to know our patients,” Dr. Panunti said, adding that “Part of knowing our patients is doing the things we have implemented—using preferred names and pronouns and talking about orientation.”

She also offers support to her patients beyond the clinic to help them transition in every area of their lives. “I will write a letter on their behalf to their universities,” she said. “I’m aware of how to change your gender markers on your driver’s license, birth certificate and passport.”

Particularly for pediatric patients, Dr. Panunti said, it is non-negotiable to pair hormone treatment with ongoing therapy. Transitioning is an emotional process, particularly because of social pressures. But Dr. Mixon offers families support through these often challenging conversations. “Our philosophy is to be gender affirming,”Dr. Mixon said. “That means letting the child lead the conversation and working with parents to ensure the child has the support needed to explore their gender identity safely.”

“It is not uncommon for parents and patients to come in having had some conflict over the child coming out and declaring and expressing their gender identity,” he continued. “We help them better understand each other by working through it all. While uncomfortable, that’s how change happens: parents coming to understand their child and learning better strategies for communicating with each other about transition.”

In her fifteen years of experience, the changes that Dr. Panunti has witnessed make her work at the clinic especially meaningful.

“It has been a marginalized population for so long,” she said, “so it makes me happy. This is truly the area that I enjoy most, and it gives me professional fulfillment to be a real advocate for the patients.”

"It is very rewarding when you see a patient affirmed and thriving. ” Dr. Alleyn said. “It is really a wonderful thing to see.”

Dr. Clifton Mixon, Interim Section Head of Pediatric Psychology

Dr. Cesar Roque, Family Medicine Specialist

"It is very rewarding when you see a patient affirmed and thriving. It is really a wonderful thing to see."

- Dr. Cielo Alleyn, Section Head of Pediatric Endocrinology

To those open to but struggling to understand the clinic’s mission, Dr. Mixon offered encouragement.

“It’s okay if you don’t fully understand the concept of gender identity. It’s okay to have questions and to seek out answers. Just don’t let the newness stop you from opening your heart and treating these kids with the same respect and love that all kids deserve.” He added, “These are children who are amazingly brave, kind, and very much know who they are. I hope you get to meet some of them one day.”