Her first clinic in mid-2015 was booked solid, and in February 2017, she was booking new patients as far out as April or May. Although she is not listed on any of the transgender-competent provider databases online, her clinic is almost always full. “Getting an appointment with you,” one of her patients said when I visited, is “like getting concert tickets.”

Although it’s clear Lowell is proud of what she’s built, it’s also clear she doesn’t want the care she provides to be a limited resource. “Making [transgender care] primary care just means that any transgender patients anywhere in the country can go to their own doctor,” she said. That day at the midtown Atlanta hotel was her biggest effort yet to teach family doctors from all over the state how to care for transgender patients.

Lee Woodall was one of those family doctors. His clinic is on the southern edge of Barnesville, just a few miles from where Jaemon McLeod lives. In his clinic, Woodall and two partners see patients of all ages, including several of McLeod’s family members. He also cares for residents at four nearby nursing homes and prisoners at the county jail, and functions as the county medical examiner.

He went to Lowell’s session mostly because it was something he knew nothing about. He has only one patient he knows to be transgender, and he thinks she comes over from the next county to see him. He’s only ever seen her for issues unrelated to gender—colds, coughs, and the like, he says.

The training changed his thinking about caring for transgender people. Before, “I would have always thought ‘Oh, we need to send them off to somebody who knows what they’re doing.’ But the idea that you don’t really have to know a whole lot to do it, that it’s just like anything else, was affirming,” he says, and “gave me the confidence that sure, it’s not a big deal. It’s just a matter of doing it.”

Over lunch in downtown Barnesville, he says he doesn’t think any doctors he knows would prescribe hormone therapy, although he admits he might be underestimating his colleagues. Any reluctance among his colleagues, he says, is probably rooted in religion. The Southern Baptist Convention has a large presence in these parts, he says. It’s hard for its constituents—even for doctors—to ignore its opposition to “all cultural efforts to validate claims to transgender identity.”

Woodall has been reading the writings of Friar Richard Rohr, a progressive Franciscan priest. He borrows one of Rohr’s metaphors, of our worldviews as boxes that are always with us. The beliefs we acquire through life go into the box. Challenging someone’s worldview can feel like telling them their box is full of crap.

“If you realize you’re holding the wrong box, where do you go?” he asks. He laughs and sticks his fork in a piece of fried okra, but it is clear he is not making a joke—and that he doesn’t know the answer.