As a Las Vegas-based endocrinologist, Michael Uzmann helps patients navigate hormonal imbalances all the time. But he says when it comes to transgender health care, he wishes that gender-affirming care will one day be as available as treatments for diabetes, thyroid disease and adrenal disorders.
“It’s not uncommon for patients in Las Vegas to walk in and be told, ‘We’ll take care of your COPD, blood pressure and diabetes, but we’re not going to offer you gender-affirming care.’ I always thought that was kind of odd,” Uzmann says. “In reality, it’s no different than any other type of care. They come in here with a very specific desire or need with a biological underpinning, and when you treat it, they generally feel better.”
Nevada state legislators have achieved mixed results when it comes to passing new transgender-friendly laws designed to help address this disparity. One major success was the 2023 passage of Senate Bill 163, which required health insurance policies to cover gender-affirming care for gender dysphoria. Though Gov. Joe Lombardo signed it, he more recently vetoed another key piece in Senate Bill 171, which would have enacted shield laws to protect gender-affirming care providers from sanctioning or prosecution.
Dr. Michael Uzmann
If passed, the latter bill may have encouraged more gender-affirming care practitioners to either move to or remain in Nevada at a time when transgender patients of all ages face limited or diminishing access. In a state that’s struggling with a lack of qualified healthcare providers across nearly all disciplines, Uzmann says the issue is especially disruptive for its transgender population.
After moving here in 2013, Uzmann spent five years working with a network of practices that didn’t offer gender-affirming care. But a move over to The DOCS clinic in 2017 allowed him to open his doors to what he identified as a “community in need.” Now operating independently out of his own Las Vegas office, A1 Endocrinology, he’s worked with more than 900 transgender patients ranging from 11 to 84 years old.
As one of relatively few Nevada doctors who provides this care today, Uzmann says many peers have either gone out of business or pivoted away from offering it. When another local leader, Huntridge Family Practice, temporarily closed in 2023 before later reopening with fewer services, Uzmann says he took on an “influx” of roughly 300 new transgender patients. And just before he launched A1 Endocrinology in July, he says his previous employer “discontinued all gender affirming care.
As far as he is aware, Uzmann is also the only remaining local endocrinologist willing to assist minors in their transition process with parental consent. In that sense, he is defying ongoing national pushback that includes the U.S. Supreme Court’s June decision to uphold a lower ruling that a Tennessee state law banning gender-affirming care for minors does not violate the U.S. Constitution’s equal protection clause.
While this is unlikely to directly influence Nevada’s policies, it does heighten the sharp cultural divide that precipitated the scarcity of health care and fueled adjacent discriminatory policies. Only two months earlier, the Nevada Interscholastic Activities Association voted to ban transgender high school students from competing in sports as the gender they identify as. Efforts to codify a similar ban failed in the 2025 Nevada Legislature session.
Gender dysphoria, a legitimate medical diagnosis characterized in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM) as “a marked incongruence between one’s experienced expressed gender and [birth] gender,” has been professionally recognized in some form since 1980. This condition can cause severe depression, self-harm, substance and eating disorders and “higher rates of thinking about or attempting suicide,” according to the Mayo Clinic.
Those who fit the categorization will typically consult with an endocrinologist like Uzmann if they decide they want to transition, while some will also seek out gender-reassignment surgeries that can only be performed by specialized cosmetic surgeons. Uzmann says he knows just one in Nevada who’s certified for male-to-female surgery.
“Patients can do male-to-female surgery, but not the other way around. So, we often have to negotiate with providers in Utah or California for patients who want [female-to-male] surgeries,” Uzmann says, adding that many more opt to get them outside of the United States.
One of Uzmann’s patients—a 57-year-old transgender man from a Midwestern state with far less favorable policies—agreed to speak with the Weekly anonymously to protect himself at a time when he says the Trump administration and its Republican allies have placed a “target” on transgender Americans.
He and his spouse moved to Nevada about three years ago, or roughly a month after he initiated his transition.
“I was suppressing who I am there, and we had to find some kind of safe place to start anew,” the patient says of their decision to leave the Midwest. Nevada, which the Movement Advancement Project ranks in the highest category for inclusive LGBTQ policies, seemed like a perfect fit.
Although the move granted him access to mandatory insurance coverage his previous state didn’t guarantee, the patient also met another barrier when he tried to find a general care physician that he felt was sympathetic to his needs as a transgender man.
“It’s definitely been a challenge to find primary care doctors that are not just for the gay community, but for the transgender community in general,” the patient says. “As I get older, if I need to have a colonoscopy or something like that, I have to feel comfortable enough to be able to go to a physician and even have that conversation with them. We love it here, but that’s been giving us pause as to if we should stay.”
While the medicinal side of transgender care has come a long way in recent decades, Uzmann attributes the ongoing disparities to an “underlying current of bias and misunderstanding.”
“A lot of these patients are on Medicaid and may have struggled with homelessness, so a desire to transition often gets lumped in with a psychiatric diagnosis. But when you look at gender dysphoria—or the generalized feeling that you are not supposed to be this sex—it causes both great physical and emotional distress,” Uzmann says. “The stuff we manage here is more so the physiological aspects of that. They go hand in hand, but I think there needs to be more of an awareness that they’re two different things.”
Though Uzmann’s patient continues to search for an in-state primary care doctor, he cites Uzmann’s efforts on his behalf as a key element to unlocking his true self.
“I was probably going to go to the grave without living authentically, but there came a point where I knew enough was enough,” the patient says. “I’ve never been happier than I am since I transitioned. I never really knew what living was until I was finally walking in my own truth.”
Fortunately for the community seeking gender-affirming care, there are new opportunities with the Gavin J. Goorjian Community Health Center at Las Vegas and Charleston boulevards. The center, which opened October 3, provides hormone replacement therapy plus wraparound services like HIV prevention and treatment.
“At The Center, gender-affirming care means providing respectful, evidence-based healthcare that honors each person’s identity, body and lived experience,” says Leana Ramirez, chief clinical officer. “It’s about making sure every member of our community receives the high-quality care they deserve in an environment that truly affirms who they are. The new center represents an important step forward in that mission.”
Click HERE to subscribe for free to the Weekly Fix, the digital edition of Las Vegas Weekly! Stay up to date with the latest on Las Vegas concerts, shows, restaurants, bars and more, sent directly to your inbox!
