Nurse examines a transgender woman at home. For many trans patients, a visit to a doctor often feels like a forced “outing” in service of an accurate diagnosis.

Nine years ago, when I spotted blood in my ejaculate, I made an appointment to see my urologist. I was the only woman in the waiting room. A handful of men surrounded me, and I could see the gears turning in their heads, wondering why a person who looked like a woman was waiting alongside them.

“Is your husband in there?” one of them said. As a transgender woman, passing as the gender I align with is a joyous and validating feeling. If we were not in a doctor’s office, I would have continued the conversation. But here, I tried to avoid it, hoping to prolong the secret that the urology appointment was for me. “No,” I said with a polite smile.

The waiting room brought up all too familiar feelings: anxiety, uncertainty and fear of what the remaining men would say or think if I were outed. It also highlighted one of the core tensions in seeking quality health care as a trans person: We need providers to honor our gender identity beyond biology while being attentive to biological needs often linked to sex.

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As I approached the front desk, a receptionist inquired if I was checking in on behalf of my husband. A second receptionist — the one I had spoken to on the phone to make the appointment — pulled the first to the side and whispered that the appointment was for me and that I........

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