My parents are originally from Hawaii but moved to Seattle before I was born. Growing up, I identified more as Japanese- and Chinese-American, but my mom and dad encouraged me to also embrace the melting-pot culture of Hawaii. As an adolescent, Boy Scouts became a significant part of my life with weekend adventures and continuing a family tradition of becoming an Eagle Scout. While working on my medicine merit badge, I remember learning about different Hippocratic Oath versions and wanting to experience the “joy of healing.” The thought of becoming an endocrinologist was yet to be conceived.
After graduating from Claremont McKenna College in Claremont, Calif., with a degree in neuroscience, I spent time exploring basic science labs but wanted more direct contact with underserved and underrepresented populations. I volunteered for several years with The Trevor Project as a suicide prevention counselor for lesbian, gay, bisexual, transgender, and questioning youth. I was also fortunate to live with my grandparents in Hawaii for a summer, volunteering at Kokua Kalihi Valley Comprehensive Family Services, a non-profit organization dedicated to serving low-income Asian and Pacific Island immigrant populations. There, I met with patients and learned about endocrine health disparities affecting them including disproportionally high rates of diabetes and obesity. We provided classes on healthy eating and increasing physical activity, integrating cultural norms of the Filipino, Micronesian, Samoan, and Native Hawaiian communities with improvements in health literacy.
From there, I attended the University of Rochester School of Medicine & Dentistry (URSMD), which instilled in me the science of healing, the art of medicine, and the compassion for taking care of people. My mentors were fellow gay physicians, Drs. Vincent Silenzio (psychiatry) and Christopher Barry (transplant surgery), who inspired me to follow my heart and not be afraid to express myself fully within academia and the community. I was also co-coordinator (with Dr. Glenn Buchberger) of URSMD’s gay straight alliance, Spectrum. We invited alumnus Dr. Norman Spack, a pediatric endocrinologist from Boston Children’s Hospital, to speak to our group. I had only met a couple of physicians who provided medical care for transgender patients and was struck by his enthusiasm for offering gender-affirming hormone therapy to transgender youth. I still didn’t know that endocrinology was in my future but wanted to further explore the breadth of internal medicine.
Attracted to its congeniality, camaraderie, and compassion, California Pacific Medical Center (CPMC) in San Francisco was a perfect first choice residency match. In our clinic, Drs. Joyce Hansen, Sara Swenson, Carie-Chin Garcia, Eugene Lee, and Ingeborg Schafhalter-Zoppoth demonstrated excellent primary care with a strong endocrinology foundation. I also had a chance to work with the vibrant CPMC endocrinologists, Drs. Karen Earle, Kjersti Kirkeby, Diana Antoniucci, Melissa Weinberg, and Anthony Yin, who generated excitement from both bread-and-butter and emergency endocrine cases. Together, we presented posters at the 2014 and 2015 Endocrine Society Annual Meetings on cases of hypercalcemia secondary to suspected granulomas from poly(methyl methacrylate) injections and a comparison of three guidelines for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules from our clinic.
During my chief residency at CPMC, I formally recognized my love for endocrinology and traveled the country to find another “best fit” program for fellowship training. At the University of Colorado (CU), I met Dr. Margaret Wierman, now on my mentorship committee, who reemphasizes that endocrinologists are “hormone detectives.” We uncover every clue in patients’ histories and physicals to gain insight into their hormone balance. My co-fellows, Drs. Kelsi Deaver and Richard Millstein, and I have mutual gratitude for the knowledge imparted to us by the faculty in the CU Division of Endocrinology, Diabetes & Metabolism. Dr. Michael McDermott, my first inpatient attending on the first day of fellowship and whose first question to me on rounds was to name the syndrome of Graves’ disease with coexistent toxic nodular goiter (i.e., Marine-Lenhart syndrome), possesses an aspirational clinical acumen that accompanies a dedication to teaching the next generation of fellows.
I have added “hormone detective” to my list of identities and will continue to advocate for my patients as well as the science and art of endocrinology.
As a postdoctoral research fellow, I am under guidance from Drs. Daniel Bessesen and Marc-Andre Cornier. These mentors have expanded my obesity and metabolism research experience which includes a pragmatic obesity treatment trial offering a variety of weight loss tools in the primary care setting, large national database analyses of patients’ weight-related healthcare experiences and providers’ obesity medication prescribing practices, and a study of appetite regulation in older adults with obesity versus normal weight adults. Together with former fellow, Dr. David Saxon, we presented several oral and poster abstracts at Obesity Week 2017 in Washington D.C.
More recently, my clinical and research interests are evolving into the realm of transgender health. Spearheaded by Dr. Micol Rothman, also on my Mentorship Committee, we are developing the UCHealth Integrated Transgender Program at Anschutz Medical Campus that brings together endocrinology, primary care, ob/gyn, plastic surgery, dermatology, and urology to provide comprehensive care in a safe space. With the support from the Division and my mentors, I hope to develop a translational research program emphasizing transgender patient obesity and cardiovascular disease risk. Current increased visibility of transgender social and health issues has reinforced the importance of this marginalized community. Organizations like the Endocrine Society are also raising awareness through recent transgender-focused publications such as the recently published Clinical Practice Guideline for transgender care, Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline.”
My sister, Dr. Kate Iwamoto, a pediatrics resident at the University of Maryland, and I are the first physicians in our family. Our parents nurtured us to care for others regardless of race, religion, sexual orientation, gender identity, and many other labels that often divide. Whether it is getting coverage for a new diabetes medication or gender-affirming treatments, tailoring patient treatment strategies remains my priority. Looking back, I am thankful for the support of my partner, Andy, and my family, friends, colleagues, and mentors. I have added “hormone detective” to my list of identities and will continue to advocate for my patients as well as the science and art of endocrinology.