Gender Affirming Care

Comprehensive Transgender Care:

Trained physicians and advance practice providers offering knowledgeable, compassionate health services to transgender, gender-diverse, nonbinary, and gender-nonconforming adults.

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Gender Affirming Health Care

We provide affirming care for transgender and non-binary individuals, as well as people across the full spectrum of gender identity and expression. Through our integrated care model, which includes primary care, behavioral health, and psychiatry services, we are committed to improving access to high-quality healthcare and partnering with our communities to reduce barriers to care.

Our physicians and advanced practice providers are certified in Gender Affirming Care specialize in delivering compassionate care for the whole person.

Hormone Replacement Therapy

Gender-affirming hormone therapy can help anyone who feels uncomfortable with the physical aspects of their gender. It can be taken as pills, patches, gels, or by injection. Hormone therapy can be given alone or as preparation for gender-affirming surgery. We prescribe gender-affirming hormone therapy and individualize regimens to help you reach your personal goals.

As your partner in total health and wellness, we offer comprehensive and personalized care from our compassionate physicians and advanced practice providers, who are committed to help you meet your health goals and optimize your wellness.

Avance Care HIV Prevention Services with PrEP

Our trained physicians and advanced practice providers are here to help discuss PrEP for those at risk for HIV infection who are interested as a means to prevent HIV. PrEP (Pre-Exposure Prophylaxis) is a medication routinely taken before potential exposure to HIV, aimed at reducing someone’s changes of acquiring HIV.

HIV PrEP is a Grade A health recommendation by the USPSTF. For patients with insurance, Medicare, or Medicaid, HIV PrEP services are fully covered.

Learn More About PrEP & HIV Services

Physicians and Advanced Practice Providers Specializing in Gender-Affirming care.

Midtown | Kings Drive

Rhett Brown, MD

Family Physician Gender-Affirming Care Primary Care Doctor

Dr. Brown is passionate about helping people from all stages of life. He believes in providing support, guidance and acceptance so that patients feel comfortable being their authentic selves. He is an advocate on health issues impacting diverse patient populations, including those within the LGBTQ+ community.

Learn More Visit the Charlotte Location

Midtown | Kings Drive

Carson Rounds, MD

Family Physician Gender-Affirming Care Primary Care Doctor

Dr. Rounds enjoys working with people from all stages of life and is passionate about providing comprehensive, patient-centered care with a particular interest in providing care to diverse populations, including the LGBTQ+ community.

Learn More Visit the Charlotte Location

Image of Avance Care Primary Care Preston Nurse Practitioner Leonora Tisdale

Preston | NW Cary Parkway

Leonora C. Tisdale, DNP, FNP-C

Family Nurse Practitioner Gender-Affirming Care Primary Care Provider

Leonora Tisdale, DNP, FNP-C is passionate about Women’s Health and the health and safety of LGBTQ patients. Leonora focuses on building strong relationships, centering patients’ goals, and providing supportive, holistic care.

Learn More Visit the Cary Location

Midtown | Kings Drive

Michael Sulewski, PA-C

Gender-Affirming Care Physician Assistant Primary Care Provider

Michael Sulewski, PA-C, is a board-certified Physician Assistant providing primary care for patients of all backgrounds. He is committed to advocating for diversity in healthcare and empowering patients through education. He has experience managing chronic and acute conditions, with a special interest in LGBTQ+ care.

Learn More Visit the Charlotte Location

Franklin Street

Jordan Walker, PA-C

Gender-Affirming Care Physician Assistant Primary Care Provider

Jordan Walker, PA-C, is a board-certified Physician Assistant serving patients at Avance Care Chapel Hill. She focuses on building meaningful relationships with patients and making healthcare approachable and understandable. Jordan uses evidence-based medicine to empower patients to make informed decisions and provides compassionate care for individuals from all backgrounds.

Learn More Visit the Chapel Hill Location

Franklin Street

Austin Gamache, MHS, PA-C

Gender-Affirming Care Physician Assistant Primary Care Provider

Austin Gamache, MHS, PA-C, is a board-certified Physician Assistant at Avance Care Chapel Hill. He provides accessible, compassionate, and equitable care, focusing on preventive health and chronic condition management. Austin has a special interest in LGBTQ+ healthcare, including gender-affirming care, sexual health, and mental health, as well as heart health, diabetes, and infectious diseases.

Learn More Visit the Chapel Hill Location

Image of Avance Care Mallard Creek Primary Care Nurse Practitioner James Cook

Midtown | Kings Drive

James Cook, MSN, FNP-C

Family Nurse Practitioner Gender-Affirming Care Primary Care Provider

James Cook, MSN, FNP-C, is a board-certified Family Nurse Practitioner serving patients at Avance Care in Midtown Charlotte. He focuses on providing kind, evidence-based care and supporting patients in achieving their health goals. James has a special interest in preventive health and LGBTQ+ care, including the prevention of sexually transmitted infections.

Learn More Visit the Charlotte Location

Avance Behavioral Health at Centers of Excellence

Rachael Metzger, LCMHC

Behavioral Therapist Gender-Affirming Care Licensed Clinical Mental Health Counselor

Rachael Metzger, LCMHC (She/Her/Hers), is a Licensed Clinical Mental Health Counselor at Avance Care’s Behavioral Health Center of Excellence in Raleigh. She provides inclusive care for LGBTQIA+ and gender-diverse clients and supports those managing anxiety, OCD, depression, and life transitions using evidence-based approaches like ACT and CBT.

Learn More Visit the Raleigh Location

Midtown | Kings Drive

Kea Trespalacios, PA-C

Gender-Affirming Care Physician Assistant Primary Care Provider

Kea Trespalacios, PA-C, is a board-certified Physician Assistant at Avance Care Midtown in Charlotte, providing care for patients of all ages. She focuses on family medicine, infectious diseases, neurological conditions, and community health, emphasizing understanding and validation in her approach.

Learn More Visit the Charlotte Location

Midtown | Kings Drive

Dana Bjuro, DNP, FNP-BC

Doctor of Nursing Practice Family Nurse Practitioner Gender-Affirming Care Primary Care Provider

Dana Bjuro, DNP, FNP-BC, is a board-certified Family Nurse Practitioner at Avance Care Midtown in Charlotte. She provides individualized, evidence-based care for patients of all ages, focusing on holistic family medicine. Dana works closely with patients to support their health goals and overall wellness.

Learn More Visit the Charlotte Location