Dr. William Powers - HIV Specialist - Powers Family Medicine

04/30/2026

Someone very kindly sent me some flowers this morning (which Fen was very interested in so thanks for making sure they were cat safe!)

But I don't know who sent them, and the florist also didn't know.

So I want to say thank you, but I don't know who to thank! But if you stay anonymous, know that they are appreciated! =)

04/29/2026

I might have done a really cool thing. It seems to me and the top world researchers that I may have elucidated the hidden mechanism of a devastating disease known as Post Finasteride Syndrome that's been a medical mystery for decades. I recently got to present my private research to the world's top researchers as the world congress for the disease, and I was overjoyed that they agreed with my findings and model, and research will now be directed at it. I did an interview after the congress with Robb, head of the charity SIDEfxHUB who represent those permanently harmed by rare adverse drug reactions.

Finasteride is a drug handed out like candy by tons of telehealth services to men losing their hair, but it has a dark side where a tiny fraction of people who take it are either neurologically damaged, have their s*xual function obliterated, their androgen signaling silenced, or even their facial skin scarified from it. These people were treated like they were crazy for a long time. One of the top recent papers on the condition was titled, "Post-Finasteride Syndrome: An Induced Delusional Disorder with the Potential of a Mass Psychogenic Illness?"

Imagine being 22, losing your hair, and you sign up for an app that with no examination from a doctor, mails a pill to your home. You take one pill, and you never can achieve an er****on ever again. Your facial skin melts, and you have deep scarring that never recovers. You go to doctors, who tell you, "it's all in your head". This has been the truth of this for over 20 years.

Not anymore. The condition is real, and caused by extremely rare inborn errors of metabolism in androgen synthesis, transport and excretion that when combined with the drug, causes a catastrophe.

Hopefully from my discovery, there will be new treatments, and hope for these people. I've spent years working on this theory, and i'm very pleased to share it with you. =)

41 likes, 16 comments. "Dr. Will Powers Interview [PFS / PAS / PSSD Summit 2026]"

04/25/2026

The congress was incredible.

I got to meet some of the most famous and distinguished s*xual medicine doctors and PFS/PSSD/PAS researchers in the world and rub elbows with them, it was awesome. They were also the kindest and most receptive people to me. I've never had such an experience before in my whole life as a clinician. I am always the iconoclast, the black sheep, some "quack" they dismiss without even hearing what I have to say.

I was very concerned that when I dropped my theory and showed all my evidence, a lot of these people wouldn't be receptive to it as there's hundreds of PFS "theories" and what's one more from some random family doctor in Detroit right?

Well, as it would turn out, all these doctors and researchers had many things to present, new findings, new research.
Without getting too into the weeds, their research findings basically plugged into my theory like a puzzle piece one after the other. it was almost hilarious to see it happen, where each person's discoveries in the field neatly aligned with "yep, if that's true, then X should happen, it does? awesome!"

I got to speak for almost 2 hours, and showed them the biochemistry, the pharmacology, and the unique genetic mutations that make someone's androgen metabolism system fragile, such that adding finasteride is like pulling out that one critical structural support beam in a jenga tower and it crashes.

When I was done, people were pretty stunned, but in many ways, also validated. These researchers have spent almost 20 years figuring out the weirdest quirks of this disease, and the strange things it does to a human body. It was from their published findings, particularly the findings of Dr. Mohit Khera and Dr. Melcangi and "The Drs. Silvias" (coincidentally both of his main research team members are both named Silvia!) that I began to construct my theory on how PFS has to work and why it happens. Any theory has to match with the experimentally derived factual findings. When I really put my brain to this awhile back, I started constructing possible theories, but every single one used their research as the foundation of the theory, as what they published is simply factually true.

For example, while many PFS sufferers experience what appears to be androgenic signal loss, Dr. Khera published and proved the Androgen receptors in PFS patients are upregulated about 1.7x over normal. It has always been strange that these people have upregulated AR expression but weak AR signaling. My theory explains why. Intracellular crowding of weak metabolites acts to effectively block good androgenic molecules from binding, resulting in weakening of androgenic signal, and the body responds by doing all it can, which is to upregulate AR expression (but it can only do that so much, and not enough to overcome a metabolite load many orders of magnitude greater than a 1.7x increase in AR receptor expression.

I have been asked to do some published research and possibly some trials with multiple different research teams as my theory conveniently explains why they have found what they have found experimentally, and they'd like to push it further. It is our intent to put this theory to test immediately. A publication will be made as a result of everything discussed at the conference as well, and submitted for publication ASAP.

I'm still sort of blown away by all this. I'm so used to being dismissed and derided that these people not only welcoming me in kindly, but genuinely listening to me and wanting to work with me and fit their findings into a viable model of PFS is just like....beyond my wildest dreams. I was SO sure they would dismiss me like so many have before, but they didn't...I just....i don't have words for how that felt. I've cried multiple times since i've gotten home, almost feeling like its some sort of trick. That couldn't have happened right?

I'm terrible at "diplomacy". I don't know how to write this in a way that doesn't make me come off as an overconfident dick. But for the first time in my entire medical career, I spoke to other doctors about my ideas and how the molecular biochemistry of those ideas works, and I felt heard. Not just heard ,supported, encouraged, and appreciated.

Honestly, they were thrilled. It resulted in a great deal of joy in the room, as it felt like all these separate teams now had a bridge connecting all their individual works, and all their hard work, late nights, and sacrifices they made for years and years really made a big difference. A lot of them referenced the idea of "the blind men and the elephant" where multiple blind men are touching an elephant, and describing what they feel, "A rope, a fan, a tree trunk, a thick snake, a spear!"

I think I might have been able to see those decades of that hard work, all their accomplishments, and I took all the puzzle pieces, rotated them around for awhile, and finally got them all flat on the table. I can't believe I was the guy who got to say "its an elephant".
We united as a group afterwards, and after dinner and drinks, met again this morning to develop a plan of attack. We're all focused on it as an Elephant now, and we are committed to seeing it brought to heel.

I hope to be able to say more soon, but know this, everyone left the congress feeling excited and eager, it went amazingly well.
Soon, I'll be posting a document about the various lab tests someone can do as a screening to see if they are susceptible to getting PFS. Now that we have a fairly good grasp on the "why". resources can be directed at the "what' in terms of how to defeat this thing.

I continue this work privately as well on PSSD and PAS.
I am quite convinced that I can solve them as well if I can gather enough data, see enough patients, and chip away at it just like I did PFS all these years. Please be patient with me, I swear I'm doing my best. Do not lose hope. I wont rest until we can restore you all to as healthy of a state as is humanly possible.

Thank you for everyone for your support, and to my patients for their understanding in me replying rather slowly this past week.
More updates to follow, but this is what I've got for now!

04/15/2026

There's always some sort of 3D printed free shwag thing to pick up when you're at the office. Usually PFM branded fidget spinner keychains or fidget spinner rings, but lately, I've had sort of an obsession with this particular model.

This is a 3D printed dragon egg, and they are exceedingly fun to play with and fidget with.

As a prime autist, I wish to share the joy of these with my patients that are also of the neuro spicy variety.

In the waiting room, there is a large Easter basket filled with different colored ones, please do help yourself to them for free when you visit us (as well as our usual keychains and rings)!

04/10/2026

This is sort of a strange mix of a happy post but also a warning post.

I have been working on solving the root cause of a disorder known as "Post Finasteride Syndrome" for 6 years. I have collected countless labs, stories, and genomic sequences on people suffering from this disease in an effort to understand how it works. Previously considered a "psychogenic illness" this very real disease basically annihilates the s*xual function, androgenic signaling, and at times cognitive capacity of a person who takes the drug finasteride for hair loss. Because this is a very rare reaction, it was sort of brushed off by the medical institution for 30 years, but in recent years, a push has been made by various foundations such as the Post Finasteride Syndrome Foundation to advocate for these patients and fund research studies, but unfortunately, no cause or treatment has been found until now.

I'm quite certain I have identified the root cause of the disorder, the specific genetic markers that make someone susceptible and the exact pathophysiology of what causes the cascade and horrific drug reaction. I have been invited to and will be presenting my findings at the World Congress for PFS in two weeks to basically the titans of this field. I'm going to get to shake hands with the doctor who invented vi**ra. I am terrified, anxious, but also excited about this congress.

Next week, I will be taking the week off in order to prepare my presentation and collate all my data to present my case there. I will still respond to patient emails and requests, but there won't be any appointment slots available. I am sorry about this, but this is truly important, and all the people whose lives were devastated by this disease, only to then be told it was, "all in their head" need me to do this. The rise of telehealth services such as Hims/Ronin/Bluechew, etc that have been mailing the drug to the homes of young men trying to regrow their hair and "block their DHT" have resulted in an ever expanding number of people whose lives have been devastated by this drug. Every single day I see a new su***de post on the subreddit for this disorder, another young man (or even sometimes women) taking their life as they cannot live with the permanent effects of what happened to them from taking this reportedly "safe" drug.

To be clear, 99% of the people who take this drug are fine, but a small subset of the population has the correct combination of genetic anomalies which prevent the normal sulfation/hydroxylation/glucuronidation and other androgenic metabolism/processing enzymes from doing their jobs, and when finasteride is added to their system, they effectively close the last remaining exit pathway for androgen metabolism, resulting in a catastrophic metabolic pileup that causes the disease. There is no one specific mutation that does this, but rather a collection of them that all interact to create a perfect storm, which was immensely difficult to solve, but now has been.

I couldn't have gotten to the point where I could literally have done this all on my own without the knowledge I've acquired over the years treating the transgender population, and mastering the extremely complex intricate endocrinology and in this case "intracrinology" that is required to provide them top level care. That knowledge was critical to understanding this disease.

This is going to be a fork point in my career, as I now will be caring for this additional sub-population, and it is my hope that these two communities, as they are both humans with inborn errors of metabolism/signaling in s*x hormone pathways can unite and support each other and recognize the variability in the human experience and our genetics that give rise to the diversity of our species.

As a result of this discovery, and its imminent publication, my wait list has exploded. While I have discovered the "Cause" I have not yet proven that my plan for a possible cure works. We will see, but if it does, I expect it to explode even more than it already has. As a result, those who do not renew their DPC membership with me, your spot is instantly going to be taken by someone else waiting for that spot. This is not a request for people to drop off. Those who have been with me for years, and supported me and my business before this point are whom I deeply enjoy caring for, and want to continue to do so. But in short, if someone does elect to drop DPC, then decides to come back, in fairness, you will have to go onto the wait list.

In short, if you want to keep your membership, please do keep it current, as otherwise, you will likely have to wait for quite a while as the rate of people joining the wait list now is...astounding.

Of course, everyone has their own financial situation, and I understand this completely, but I wanted to be frank and honest about this.

Thank you for supporting me in my career, and for being such great patients and helping me learn exactly how you all tick. It is because of my transgender patients, and the many years of hearing their stories, seeing their labs, and trying to understand their underlying differences of molecular biology and genetics that I was able to help this other completely different but someway similar population of Post-Finasteride Syndrome Sufferers.

I hope that through the connections I will make at this congress I will be able get some support in publishing my other research, and proving once and for all that all people with gender dysphoria are in fact actually inters*x, and that the cause of the development of that dysphoria can be proven on paper and through genetic and other testing. That transgender or q***r people are not in any way mentally deficient or "choosing" to be as they are, but that their state is as inborn and coded into their being as someone's flame red hair or my green eyes.

Thank you for your understanding for next week, and your patience as I try to juggle both responsibilities and communities moving forward.

Most Sincerely,

Dr Powers

03/26/2026

FYI to DPC patients, I am falling a little behind on messages and things will temporarily likely take 48-72 hours for a reply.

On average, 25% of all of my patient population sends me an email message every day. I know that might seem absurd, but that number is actually real. I am doing the best I can to reply to everyone and handle everyone's needs (as email has become a predominant means of handling stuff in 2026 due to political nonsense) but I am also working full days, and there are only so many hours in the day.

When you email, please do your best to be as concise, direct, and clear about what you need, and all the necessary information (pharmacy, drug, dose, etc, about things in your first message to help prevent back and forth messaging that can cause delays).

This also helps me not miss things you might need, as a 10 paragraph message is a lot harder to respond to and address than "I need this please". Appointments are still welcomed and preferred though for complex issues, as it gives me 30 minutes to focus directly on your needs and ask immediate clarification questions.

I work from oldest to newest in terms of messages, so please do not "bump" your email by replying to yourself as it just puts you literally at the end of the pile again as you've become the newest message.

Thanks for your understanding.

- Dr Powers

Edit: this evening I have been interviewing applicants to possibly replace Dayna, so sorry I haven't had the usual hours post work 6pm-10pm to do messages.

03/14/2026

Farmington hills is out of power and will likely be out of power for many days due to the severity of the wind storm. There's also some damage to Dr. Powers' property. We appreciate your patience this weekend as it is very difficult to respond to patient messages with no electricity and/or do refills/etc from a cellphone!

02/24/2026

Crisis Averted!

We have managed to secure Malpractice insurance with 48 hours to spare. While it will cost me vastly more rupees than it used to in order to open this chest, we can continue to serve our teen patients. This insurance policy does not forcibly exclude them. No patients under 18 will lose access to our care. That was a compromise I was very unwilling to make and there are still some good companies out there who can prioritize people over profits.

Thanks to everyone who helped with this, including our new office manager Pepper who spearheaded this whole endeavor. She worked tirelessly for months while simultaneously cleaning up other very large messes left behind by others. PFM is so grateful and lucky to have her.

Effectively, business will continue as usual and nobody is losing access to their HRT.

I can't predict what other miseries 2026 has in store for us, but at least for now, one very large fire has been extinguished.

Thanks for your support through these trying times.

-Dr. Powers

02/18/2026

We are doing all we can to prevent having to suspend operations such that we can secure a malpractice insurance provider who will allow us to continue to treat our transgender teenagers. They may be a tiny fraction of the practice (literally less than a percentage point) but they are just as important as every other patient.

Every iron is in every proverbial fire right now, and I will be making an updated statement in a few days about what options remain to us. In the event we are unable to secure malpractice insurance in time, there may be a brief shutdown period of operations when we lack malpractice coverage and we enter further negotiations to obtain it, but where we are forced to make concessions about who we can and cannot treat moving forward in this political environment in order to be able to provide care to some of our patients even if not all of them. I will not choose this option unless it is the only one available to me.

Please do not panic, we are doing everything possible under the sun to do solve this before the end of Feb. A mass message will be sent to all registered patients in a few days if there is not a very happy update to give here instead.

I'm doing my best for ALL of you. That means even the "undesirables" too.

I'm sorry that things are this way, if I was king, it'd be different, but I'm not, and for now, I'll do what I can.

-Dr Powers

02/11/2026

Unfortunately I have COVID. Got hit like a freight train and the rest of this week of DPC patients will have to be rescheduled.

I appreciate your understanding. It's been 3 years since I've had it and so I'm getting hit by a truck unfortunately with this bout.

I appreciate your patience if I'm a little slower than usual getting back to my messages/refills. If someone needs something critically, please email questions@Powersfamilymedicine.com

02/06/2026

New PFM finger spinner keychains just dropped. Score one for yourself for free at the office starting Tuesday when you check out!

People seemed to like these even more than the spinning rings so I made a fresh new batch and style!