Understanding Gender Care Needs

Courtesy Sabrina Bruce

The story below is a preview from our July/August 2021 issue. For more stories like it, Subscribe Today. Thank you! 


Local businesses are expanding their services for the growing transgender community.



A 2019 study from the Williams Institute at the UCLA School of Law estimated that 34,500 Virginians identify as transgender. While demographics specific to the Roanoke Valley aren’t available, it’s obvious that a significant number of those included in the study reside locally.

For years, a number of health care providers, including therapists, dermatologists, endocrinologists and cosmetic surgeons, have been expanding their services to meet the needs of the growing local transgender community.

When Roanoke resident Sabrina Bruce decided to come out publicly as a transgender woman five years ago, she set about finding the professionals who could help her navigate the complicated transition, which included laser hair removal, facial feminization, hormone replacement therapy and breast augmentation.

“It was a daunting experience. It’s an expensive and emotionally costly ordeal,” she remembers.

For transgender women like Bruce, hair removal is a concern. Family nurse practitioner and master esthetician Michele Meinhart has been offering laser hair removal and injections for temporary facial reconstruction since the mid-2000s when she founded Starkey Medical Esthetics.

“I’m motivated to provide equitable service to everyone in the community. I have a commitment to social justice,” she explains. Throughout the years, she has treated around 100 transgender individuals.

Dr. John E. Vance, an associate professor in child psychiatry at the Virginia Tech Carilion School of Medicine, frequently treats young adults who are dealing with gender dysphoria.

Due to the fact that he wasn’t originally trained to deal with gender-related issues, Vance has worked to educate himself given the increase in transgender patients he has encountered over the past 10 years.

“Psychiatric and psychological services are a big component of their healthcare needs,” he explains. “A growing number of therapists are becoming more comfortable and skilled in working with kids who are going through transition.”

He notes that one of the most important things for health care providers who are dealing with transgender patients to keep in mind is that they should validate the patient’s identity through the use of preferred pronouns and names.

Dr. Erica Reynolds, a pediatric endocrinologist, is one of two medical providers who specializes in gender care at Carilion Clinic. Like Vance, Reynolds has developed an expertise in gender-related medicine over the past 10 years as the result of an increase in transgender patients coming to her for puberty blockers and cross-sex hormone therapy.

“The first few years I was here, I only saw a couple of transgender patients. The number of patients has increased now to the point that I have several transgender patients on my schedule every week,” she explains. “It’s becoming more socially acceptable for them to come out and seek care, which is a good thing.”

Reynolds is currently working with a Carilion psychiatrist to determine if there is a need for a full-fledged transgender clinic in order to better serve the community.


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