I'm struggling with this question myself right now. My primary care physician is ten minutes from home, but my therapist and endo are in a clinic that specializes in trans care and are 1:20 away. I just had my first blood tests from the endo, and a lot of them duplicated the tests done by my local doctor. I'd love to get them coordinated, but I'm in the middle of a very conservative area, and am not confident of a positive outcome if I tell my local clinic I'm trans. My endo would be happy to take over my primary care, but I really don't want to drive that far (and pay all the tolls) for some sniffles.
Complicating matters is the local clinic has one or two MDs, with nurse practitioners working under them. That's not a problem generally - my absolute favorite caregivers in the past have been NPs. The problem here is I never know which one I'll be seeing. I want to develop a one-on-one relationship with my doctor. I'm usually surprised by who walks in during my appointments.
I was worried enough about it all that I started looking around for younger women doctors, thinking, as noted above, that they may be more accepting. I went to two offices and asked if I could get just five minutes for a private meet and greet with the doctor to see if they would be ok with it. In the first, the receptionist said sure, we'll set up an appointment on the computer, have a seat. She then wandered around the office, yakking with coworkers, getting coffee, etc. After 20 minutes I walked out. The place was kind of shabby, so I wasn't excited about it anyway.
The next office seemed neat and clean, and the receptionist was friendly, but would not set up any kind of appointment unless I initiated a records transfer from my current doctor. I wasn't going to do that until I knew this new doctor was willing to take me on. So I walked out of there, too.
Note that none of these people knew why I wanted to talk with the doctor, and I was presenting as my male self, so at that point trans issues didn't enter into it. I guess the docs around here just aren't hungry enough.
My labs follow up with my primary doc is next Monday. I'm leaning toward telling whoever I end up seeing, and letting the chips fall where they may. The further I go into transition, the more courage I've been able to muster, and it's my health that's at stake. Of course, I can talk big now, but I may turn to jelly when the time comes.
Any advice is appreciated...
Stephanie