In this episode, medical students Nick Sookhoo and Andrew Sullivan explore the current state of primary care for transgender individuals in the United States. Transgender rights are under attack from all directions, and queer and transgender individuals often still find it difficult to access basic healthcare with dignity and respect. Andrew and Nick are joined by James Lauren, a queer trans nurse practitioner (https://www.jameslaurennp.com/) working in primary and gender-affirming care in New York City and currently enrolled in the Hunter College Doctor of Nursing program with expected graduation in 2025. In the interview, James explores the question of continued resistance toward gender-affirming practice among providers and what might be some of the driving forces behind that resistance. The episode demonstrates that gender-affirming care should be just like any other aspect of the practice of evidence-based medicine: data-driven and with risks & benefits weighed in a case-by-case basis with patients. Through early education and exposure, medical students can be a part of systemic change such that the next generation of queer and transgender individuals do not have to face such difficulties.