Equal Access

Izzy Lowell ’02 didn’t set out to establish the only medical clinic in the southeast that exclusively treats transgender patients. She didn’t even set out to become a doctor. An English and art history major in college, she went to medical school only after working in the art world for a couple of years and realizing that she wanted to make a different kind of impact on the world.

She took the required classes to go to medical school while working at an art gallery in New York and then enrolled at the University of Connecticut. During her residency a couple of years later, she says she sought out training in how to serve the trans population because it had been absent in medical school, and it was something that mattered to her.

“My own gender identity is not at all clear, something I explored in college through a photo essay,” Lowell says. “I use she and her pronouns. I haven’t undergone any medical transition, but along the gender spectrum, I’m somewhere closer to the middle than the average person.”

But Lowell’s professional choices aren’t really about gender identity—her own or other people’s. They are about providing fair and equal access to medical care. “Being transgender is about as common as having type one diabetes, and we spend months learning how to treat that in medical school,” she says. “This is an entirely ignored population.”

When Lowell took a teaching job at the Emory University School of Medicine in Atlanta, Ga., she opened a clinic exclusively for trans patients. It ran once a month at first, but quickly the need far outstripped that schedule, and Lowell kept it open twice a week for a couple of years. Then, in 2017, she quit her job at Emory to open Q-Med.

Lowell got licensed to practice medicine in several surrounding states, allowing her to use telemedicine to treat patients in Tennessee, Alabama, North Carolina and South Carolina, as well as in Massachusetts—where she is from, and where she completed her residency.

“Adult trans medicine is very simple—you just try to replicate the normal hormone levels of the gender you’re going toward, and there’s not a lot of in-person exam required,” Lowell says. “Blood work from the lab is the main objective measure, so a patient in rural Alabama—who doesn’t have any support network and can’t go to their own doctor—can find me online. I send them a lab order, they go to their local lab, we have a teleconference, and I can prescribe medicines.” When they need to, patients can drive to see Lowell in Atlanta, and she makes regular road trips throughout the region to see patients.

One of her biggest goals is to provide care to trans teenagers. “Many parents I see realize they’re at risk of losing their child if they don’t do something,” Lowell says. “But I often hear that they want to wait until their child is 18 and old enough to make the decision themselves, or that they’re willing to give their child puberty-suppressing hormones until the child is 18.”

But Lowell says each scenario presents a danger. “In the first case, either the child doesn’t make it to 18, or they go through the completely wrong puberty, which we later have to undo. In the second case, you have a pre-pubescent senior in high school who is ostracized already—but more than that, sex hormones play a huge role in intellectual development, learning and cognition,” she says. “What happens to a child who isn’t allowed to develop in those areas?”

Research shows that when trans children are allowed to transition before puberty, there are substantial reductions in both suicide rates and physical attacks from others—because the child is able to grow into an adult with the typical facial features and body size of their target gender. Says Lowell, “Treating trans teenagers is an opportunity to make a real difference. Hormone therapy is just not a big deal.”

That’s the realization Lowell hopes will take hold in doctor’s offices everywhere in the near future. “My dream is that trans care becomes primary care and that I have to go out of business,” she says. “There should be no need for Q-Med.”

—Julia Munemo