Hormone Replacement Therapy (HRT)


The Magic City Wellness Center is invested in the physical and mental health of its patients. MCWC approaches HRT with a holistic method to ensure its patients overall well-being.


​In order to expedite this process, the initial consult will only be scheduled once the patient is in therapy with a mental health professional and has a letter of support from a therapist. MCWC will be happy to provide lists of therapists when asked.

The Magic City Wellness Center requires a letter from a licensed professional counselor / therapist. The letter must include a statement that verifies you meet the DSM-V criteria for Gender Dysphoria and that you are in the opinion of your licensed professional counselor / therapist mentally competent to understand the risks and benefits of hormone therapy.

The first office visit is a consult. No hormones will be prescribed

Except for minors under 19yo, the initial consult will be alone. We will be happy to answer questions from family members, friends, or partners that will be actively involved in this process.

At the first visit / consult MCWC will review your gender journey, expectations, gender confirmation surgeries, sexual and reproductive health, support network including therapy, as well as go over our informed consent for treatment. In addition, the overall medical history including family history, surgical history, social history, allergies and medications (both prescription and over the counter) will also be explored. One hour is allocated for this consult / visit.

The goal of MCWC is to ensure that the experience is positive for everyone involved.  MCWC will work with patient’s schedules for appointments and in particular patients who travel long distances.

Prior to starting hormones, the patient will have a complete physical including breast, pap smear and/or rectal exam depending on current guidelines as well as complete blood work to assess risk factors. The initial blood work will include screening for HIV/STD/STI’s and a pregnancy test for trans males.

Hormones will usually be initiated at the third visit when the patient’s labs are reviewed. However, there may be a delay in the initiation of hormones if there are major health concerns or contraindications to starting treatment that must be stabilized first. Hormones will only be prescribed when there is an adequate support system for the patient.  As a reminder, the following items are required before hormones will be initiated:  a letter from a therapist before your initial consult, a physical with baseline bloodwork, and a signed informed consent before treatment.

Therapy with a licensed professional counselor/therapist is highly recommended throughout this process but is not a requirement for continuity of hormone therapy at The Magic City Wellness Center. 

Visits will initially be scheduled every three to four months. This is non-negotiable.

Once your transition has been stabilized (usually a minimum of three years), the office visits may be extended to twice a year depending on the overall health of the patient. Hormone Replacement Therapy has medical side effects, and MCWC will monitor hormones with blood tests for liver and kidney function, electrolytes (sodium, potassium, chloride), thyroid, hemoglobin, cholesterol and diabetes.

Blood work must be completed prior to the follow up appointments so that they can be reviewed at the visit. There will be no medication adjustments without updated labs.

MCWC will work with out of town patients so that bloodwork can be obtained in their city to minimize travel to Birmingham. If labs are done out of town, it is the patient’s responsibility to make sure MCWC has them prior to their scheduled appointment. If MCWC does not have the labs, then the appointment will be rescheduled.


In the event a follow up appointment is missed, MCWC will provide a refill on hormones until their next rescheduled appointment. If a second appointment is missed, then no more hormones will be given until the patient is seen at MCWC.

Preventative screening will always be part of the scheduled visits as well as a yearly physical exam. This will include discussions regarding STI, HIV Prevention (PREP) and contraceptive management.

Each patient’s hormone regimen is individualized with their best interests in mind.

Hormone therapy will become a part of the comprehensive care for the individual.

It is expected for patients to take an active role in their transition and to understand the long-term commitment (including financial commitment) to this process.

Utilizing our patient portal will be a way to keep in touch with your providers and give you peace of mind that your needs are being addressed between visits, especially for those patients out of town.

Trans Health