Gender care program supports Sawyer Plotz through transition, second pregnancy

Sawyer Plotz talks about three things that have felt at odds throughout his life: his sex assigned at birth was female, but his gender identity (his internal sense of self) and gender expression (his choice in clothing, hairstyles, interests) were not.

It took decades for him to realize, “I wasn’t just a tomboyish girl. I wasn’t a girl.”

Plotz began his physical transition in 2018 with multidisciplinary support from the M Health Fairview Comprehensive Gender Care Program. He met with a psychologist for emotional wellbeing and started taking testosterone with support from his primary care team at M Health Fairview Clinic — Smiley’s in Minneapolis.

Two years ago, he received a mastectomy to masculinize his chest.

We asked Plotz to share more about his journey and the role healthcare played not only in his physical transition, but his overall wellbeing.

Learn more about our interdisciplinary approach to gender-affirming care.

Moment of realization sparks conversation around pregnancy

Plotz struggled for years with how he looked on the outside and who he was on the inside. It was in between the birth of his two children, while working with LGBTQ+ advocacy group OutFront Minnesota, that he fully realized he was transgender.

He recalls being at a training for trans allies with both transgender and cisgender people (individuals whose gender identity matches their sex assigned at birth).

“The trainer asked us to get into two groups, one for transgender people and one for cisgender people,” said Plotz. “I had this moment where I felt really strongly, ‘I’m not one of the people whose gender fits with their sex assigned at birth.’ It opened up this flood of realizations.”

At that point Plotz had given birth to one child with his husband, Jon. They knew they wanted to have another child, but Plotz also knew he wanted to start transitioning. Plotz went through a second pregnancy and delivery supported by a multidisciplinary team at the M Health Fairview Women’s Clinic in Minneapolis.

By this point, he had changed his name and was using gender-neutral pronouns. A psychologist at the clinic helped Plotz talk about his identity as a transgender person and ultimately connected him and his husband to specialized counseling and support through the Institute for Sexual and Gender Health.

While Plotz was connected to these tailored resources, navigating pregnancy as a transgender person still had its difficulties.

“There’s definitely room to grow when working with transgender people who need what we’ve traditionally called ‘women’s healthcare,’” he said. “But I think there’s growing awareness and inclusivity, for example when it comes to intake forms – having a place for people to share sex assigned at birth, but also their gender identity and preferred pronouns. I can see M Health Fairview is making it a priority to provide that comprehensive, inclusive care.”

Tailored top surgery aids physical transition

Plotz began testosterone therapy in 2019 shortly after his younger son’s first birthday. He started the therapy through Smiley’s Clinic with his primary care doctor, Family Medicine Physician Carrie Link, MD.

In 2020, he met with Marie-Claire Buckley, MD, a plastic and reconstructive surgeon, to plan for a mastectomy, known as a top surgery for transgender patients.

Buckley, who has been with our system for over two decades performing top surgeries as part of her work, is part of the M Health Fairview Comprehensive Gender Care Program, a multidisciplinary team that includes not only surgery but primary care, reproductive health, mental health, and other services. 

Buckley takes a holistic approach when meeting with patients and preparing them for surgery.

“We need to make sure they have the proper care before, during, and after surgery,” Buckley said. “We also want to make sure they’re plugged into whatever mental health support and community resources they might need as they transition.”

Every patient is unique, and so is every surgery – again tied to a patient’s gender identity and expression, which can vary greatly.

“My patients have a spectrum of how they identify and there’s a spectrum of what they want their chest to look like,” said Buckley. “Everybody’s anatomy is different coming in, so we also find ways to deal with their unique situation.”