Dr. William Powers - HIV Specialist - Powers Family Medicine

11/27/2025

Just an update.

Monday I got back from the funeral and saw patients and cleared all portal messages to zero. I've had some other calamities going on as well (mostly staffing related) which I've been trying to solve asap.

I've just spent today trying to clear emails to zero, as these have been built up for almost 5 days without replies. I'm sorry. That will be done shortly.

After that I'm going to hit portal messages, as there's another 70 that arrived since Monday around 9pm. I will likely not get to all of them tonight before hitting what I call "the coherency wall" where its better to let them go a few hours and get some sleep rather than replying like ChatGPT version 1.0 or like every other doctor who phones it in. That's not my style.

I will have to triage the most critical ones to tonight. I will be working tomorrow (Thursday) to clear these out. I will have turkey at some point I promise.

I also hope to have out the "State of the Union" message sent to all emails and portal messages by the end of the weekend, detailing everything to be expected in the coming year, including the DPC program. We are losing a provider, and I will be soon on the search for a new full time one. Dayna will be resigning in a few weeks, and while this is terribly sad for us, she deserves to have a life as a new mom and with her new family, and while we are sad, we are bursting with joy for her.

Other rather severe problems with the office have now been rectified. Excising these has been painful, but I do wish to welcome our new office manger Pepper. More info on her to come soon, but if you need to reach her, Pepper@powersfamilymedicine.com is how you can do it for now.

I have known Pepper now since we first became friends when I was a medical student in 2009. I can count on one hand the humans I trust even on par with her, and I think she will serve us well in the future, and ameliorate many of the issues we've been unfortunately been plagued with for a long time. I apologize for my lack of awareness of some if not all of these. They will be fixed soon. I promise. Pepper is wildly competent, trustworthy, and efficient. I'm amazed at how much she's accomplished already.

I have repeatedly asked Pepper for a headshot so I could post it here, and while she has accomplished every other task asked of her in record time, she's dragged her feet on this one for awhile (she's a bit shy), so in typical Dr. Powers tactless fashion, here's a fun selfie of us together. Pep is one of my best friends in the world, and comes with a background of managing an entire medical billing company, so I think she's going to be a great fit for PFM.

Things will get better soon, they have to, I'm sure of it!

- Dr Powers

11/24/2025

Phlebotomy will not be available tomorrow 11/24/25 (Monday) at PFM. The nearest quest draw station is in Novi, but labs should be open Tuesday back to normal.

11/21/2025

As it's sort of leaking out prematurely, I will simply say, please anticipate soon a formal announcement about staff changes at PFM, next year's DPC program, and other important updates before 2026.

We apologize for any administrative headaches, missed messages, or other failures that apparently have grown more severe over the past year. I am unfortunately becoming more aware day by day of things to which I was oblivious. While my practice may do many things right, I would like us to do everything right, and so we must adapt. We've just had a large internal staffing change, and will soon be introducing our new office manager. We are hopeful that moving forward, a vast amount of our prior issues will no longer be a concern, thanks to our new management.

Thank you for your patience at this time, the formal announcement will be sent via email and portal message to all registered patients soon. I had wished to make this sooner, but various PFM calamities, coupled with my soon-to-be wife's father's sudden passing has been a challenging week. As always, I'm doing my best for you, and I appreciate your understanding that I am just a person.

- Dr Powers

11/17/2025

Dr. Powers (me) will be out of the office until Friday 11/21/25 , when I will be able to do some telehealth appointments. I have an open schedule for next week, but some re-arrangement may be necessary for me to attend memorial services.

We appreciate your understanding during this difficult time.

I have access to a computer again, and I am currently digging through a very very large message backlog. The idea of having ignored all emails and portal messages for 4 days is a bit horrifying to me. I'm terribly sorry, and I'm doing my best to address everyone's needs ASAP.

- Dr P

11/14/2025

Dr. Powers' fiance has a critically ill family member and they are both leaving immediately for the airport. We apologize for delays in portal message replies over the next few days. Thank you for your understanding.

11/07/2025

Currently I am massively overwhelmed with requests/messages/emails/etc. I just finished patients for the day at 530pm Friday. I am going to spend the next few hours triaging the most critical issues that need to be addressed tonight, and catch up on non-urgent issues / refills/ etc. when I work on Saturday and Sunday when I don't have any scheduled patients to see.
I'm doing my very best, thank you for your understanding!

- Dr Powers

PS: Quest is insanely behind, we're talking weeks to get lab results right now, just FYI.

10/30/2025

This weekend in Detroit is Youmacon, the largest annual Anime and Gaming convention in Michigan!

Please permit us a little extra time to reply to portal messages this weekend as a result, so that we can all have some much needed fun.

See you there!

- Dr Powers

PS: Enjoy this highly revealing photo of me. Though it doesn't show any skin! Happy Halloween! =)

10/20/2025

There is a massive outage of AWS services today. As a result, our EMR is disrupted. We're doing our best, but some patients may have to reschedule as we literally can't even place orders or send messages.

https://www.cnbc.com/2025/10/20/amazon-web-services-outage-takes-down-major-websites.html

https://status.athenahealth.com/

We apologize for anyone who has to reschedule, but in the modern federally EHR mandated world, we have no choice but to use an EHR and when they are down, we are crippled.

Status page and application status page provided by StatusCast.

10/03/2025

NB:

1. We are not quest diagnostics or your imaging provider or labcorp. We cannot make them run the labs you submitted faster. Being mad at us for them not being in, is like being mad at Delta Airlines because the hotel at your destination was dirty. They are ALL running very slowly, and also trimming back many labs they once offered (like a corticosteroid binding globulin) that we often ordered. Patients are welcome to go to literally any lab or imaging provider with the only stipulation that if you don't use the ones we link electronically to, you have to make sure we get the results. I am almost daily responding to multiple portal messages angry at me stating "I'm paying X for my DPC and my labs still aren't in!". This is grinding me down. Some patients are using companies like DrSays or Jasonhealth to buy their own labs privately. We can always provide a list of what ones you need.

2. I am doing the best I can right now with messages. PFS/PSSD/Why am I transgender whole genome sequence reviews are currently paused while I catch up on work. Portal messages are around 48-72 hour turnaround right now, so if you need something critically, please email Marisa@powersfamilymedicine.com or call the office during business hours until I'm back at zero.

3. I have 400 DPC patients and I'm responsible for 5208 registered total patients in the practice via oversight. I receive on average 40-50 many paragraph long messages per day. If you are asking yourself "am I bothering doctor powers by sending this message" then you are not bothering me, because you actually have insight. I WANT my inbox to be filled with pressing medical issues that need an immediate response that cannot wait for an appointment.

Sending me a message like "I inject 5mg of estrogen weekly, and my bottle is 20mg/ml and 5ml, how many days will I get out of my bottle" is going to give me a heart attack. (The answer is (5x20)/5 = 20 injections total x 7 days per injection = 140 days).

Or "I need a refill on my progesterone" on a script I sent 45 days ago that was for 90 days that has 3 refills on it. You do need a refill, but that's why you have 3 on your bottle still. Please contact your pharmacy rather than making me re-send the RX every 90 days.

I want to stress, if you are the patient who says "I don't want to bother him with this" you're actually not the problem, so I'm probably shouting into the void here, as those with self insight are never a bother. Doing my job is literally what you pay me to do. I don't mind that ever.

Thanks for listening to my Ted Talk!

- Dr Powers

09/18/2025

As everyone knows, we started the DPC program so that the practice could continue to serve the nearly 3000 patients whom are not part of the program, but who have Medicaid or medicare or other insurances that reimburse us poorly (or at times, the patient's socioeconomic situation makes it such that they struggle to pay their bills). In addition, the amount of money we've had to spend on legal to remain compliant is rather absurd at this point, and I suspect malpractice cost is soon to follow suit and skyrocket for transgender related care providers.

That being said, the DPC has mostly worked this year to sustain us.

Unfortunately, it does seem that in the immediate future, reimbursement for "gender care" will be eliminated through all government insurances, and I suspect many commercial insurances will follow suit, as the vast majority have already cut down on many gender things they covered 2020-2024.

The threat of this is enough to cause us to have to likely make changes for next year, as if this came to pass, even with our current DPC program, the results would be catastrophic for the office financially. Almost 80% of all of our patients are transgender. If we suddenly cannot get even the pittance we currently receive from Medicaid/others for the services rendered, we will financially collapse. This would be the equivalent of telling Wal-Mart that the government mandates all items that aren't "white" be sold for free. Walmart would either sell only white items from then on, or collapse.

We are considering the possibility of adding a tiered DPC program, offering a cheaper DPC option via another provider in the office, and me a higher tiered one. We have not definitively decided on this yet, but last year, people felt blindsided by the thanksgiving announcement, and so I'm attempting to let people know ahead of time this year that such things may come to pass.

We do not intend to bend the knee like the University of Michigan or well...everywhere else. That being said, I still have cats to feed and employees and their families to keep solvent. I've been pretty public about the fact that I made $17 an hour as a doctor for 3 years. I did everything I could to support the community during these tough times, but even with that, without the DPC we would have had to shut down. Times are getting more tough by the day, and so we appreciate your understanding of potential future changes as we do our best to keep our doors open for you.

- Dr Powers

09/11/2025

When you slay the enemy who fights with a pen by the sword, you martyr them and amplify their voice a million times more.

When you dance on their grave, you draw pilgrims to it.

This community preaches love, tolerance, and acceptance.

For that to be real it has to be extended to the worst of us. The least of us. Those who need it more than anyone else. Including those who hate us most of all. Otherwise when onlookers gaze, no one will be able to tell the difference of who is the hateful person.

Hatred can only beget more hatred when it breeds with hatred.

Keep this in mind over the coming days and think before you speak.

Be the change that you want to see in the world. Do not speak it. Be it.

-Dr. Powers

Ps: The chaos that is the comment section below, the anger, the hatred, the resentment, all of it, is why I made this post. None of it makes the world better and none of it helps any of the people involved live better lives, be better understood, or be given empathy. Please try and listen to what I have to say. This is not the correct answer. The only way out of the mess that we are in is through love and empathy and education. Not through hatred and aggression. Yes, the way you make a N**i not a N**i is to hug them and help them understand who you are and why you are. Not by shooting them. All that does is add more hate to the world and convince more people to become N**is, K*K, whatever.

09/06/2025

Three years ago, I made the bold claim that Folic Acid supplementation was the primary CAUSE of the rise of Autism, RFK and this presidential administration just claimed that it's the CURE.

Original post on reddit:

https://www.reddit.com/r/DrWillPowers/comments/1na3zik/three_years_ago_i_made_the_bold_claim_that_folic/

Of all the possible molecules in the known universe, three years ago I made the claim that folic acid (synthetic Folinic Acid) hyper-supplementation was the primary driving cause behind the rise of Autism diagnoses over the world, and I backed it with evidence:

https://www.reddit.com/r/DrWillPowers/comments/13q28zq/dr_powers_crazy_conjecture_on_the_cause_of_autism/

What do you think the odds are that of all the possible chemicals out there that exist, that RFK and this administration would settle on Folinic Acid as the cure for autism?

https://www.cnn.com/2025/09/05/health/hhs-report-autism-folate-acetaminophen

I don't have access to the level of government health data that the HHS does, and so there are two possibilities here.

Folic acid (a synthetic form of folate, vitamin B9) does not cross the blood brain barrier, and hyper-supplementation with it causes autism in a way that Folinic Acid would not (due to the fact that Folic acid can actively prevent the transport of 5-methyltetrahydrofolate across the blood brain barrier, which is the active form). The government screwed up when recommending folic acid, as they tried to do a good thing preventing spina bifida, but instead caused another health crisis. They are now going to try and spin this such that they have the "cure" to the problem they caused.

By administering folic acid to pregnant women with MTHFR defects (who struggle to methylate it and turn it to its active form) we have raised fetal estradiol levels to a threshold where miscarriage events are decreased (this is true, it did) and all the babies born with non-verbal autism are effectively children who would have been miscarried due to major neural tube defects, but now survive to term but with neurological impairment.

In either situation, the government caused the rise in Autism by recommending folic acid and even mandatorily adding it into our food. They will now try to skirt blame for this as if this can be figured out by some random family doctor from Detroit, I'm certain people much smarter than I am have done the same.

Specifically, it is the theory of myself, Kate Meyer, and our team trying to unravel the underlying causes of gender dysphoria that the linkage between autism and gender dysphoria is derived primarily because of estrogen signaling anomalies. I have many posts under this username on this subreddit about the various genetic ways in which someone can have a signaling defect in the estrogen signaling pathway.

Estrogen is required to masculinize the brain of a male fetus. The default configuration of a human brain before s*xual differentiation is female, and it is exposure to androgens and then later estrogens which actually cause brain masculinization.

Failures in the genes for estrogenic signaling, or decreased estrogen exposure in utero result in the failure of an XY fetus to properly masculinize, resulting in one of the causes of gender dysphoria. However, that same low estrogen state as noted above, results in autism, linking the conditions together.

However, this is not the only "Type" of autism. I theorize there exists a different subtype, which is caused by excess estrogenic signaling. A mom and fetus who would have had genes that produces a normal estrogen level during pregnancy gets exposed to hyper-supplementation and now estrogen levels are much higher than they would be naturally. This results in "high estrogen signaling" autism. Unlike the non-verbal, socially withdrawn phenotype, these people are socially bombastic, outgoing, but also lack the ability to perceive social norms well. (This is what I am). They tend to be male, or FTM or a very masculine woman.

It is my theory that testosterone exposure is required in order to be able to develop an autism phenotype, and this is the primary reason for the increased incidence of autism in XY humans, but also the reason why most XX humans with ASD are q***r or gender non-conforming in some way (at least from what I've seen with 5000 patients in my practice).

This is also the reason why some transgender women struggle to achieve much with their transition. They are transgender due to a genetic failure in the estrogen signaling system, which caused their brain to be under-masculinized, but after being born and electing to transition, they struggle to make much progress while taking estrogen therapy. They can be castrated and inject huge amounts of estrogen and still remain mostly flat-chested. If your estrogen receptor flat out does not work properly, your brain does not masculinize in utero, but then estrogen therapy after birth does not result in the same feminization that other people would receive upon being exposed to estrogenic molecules.

In contrast, a man who looks in the mirror and feels "gender dysphoria" that he does not see "He-Man" looking back at him will go to the gym with the goal of looking as masculine on the outside as he feels on the inside, inject tons of testosterone or anabolic steroids, and grows breasts easily. This person has a strong estrogenic signaling system, which made their brain hyper masculine.

Estrogen feminizes after birth, but before birth, it is the primary masculinizing hormone. It appears to give the homunculus map to the brain of "I should have a p***s and be masculine".

"Stone Butch" le****ns are XX humans who do not desire any pe*******on or ge***al contact, and prefer only to top their partner. Not always, but as a stereotype, they tend to appear highly estrogenic in appearance, curvy and large chested. Estrogen closes growth plates, and they tend to be quite short. In contrast, more feminine q***r women tend to be taller, lankier, and smaller chested. This is a stereotype, but something I have perceived having 5000 LGBTQ people in my practice. Before birth, estrogen masculinizes, after birth, it feminizes.

Estrogen signaling anomalies are associated with hypospadias, a defect of pe**le formation, which I routinely see in transgender women. This is sometimes subtle, with the urethral meatus not being truly at the tip of the p***s, but having a slight vertical slit downwards from the opening.

Basically, this is the primary linkage why Autism is so prevalent in the trans community. Its not a bunch of "confused" autistic people. The disorder of autism is a disorder of estrogen signaling anomalies, which simultaneously affect the development of the gender of the brain.

The true cause of Autism was our government pushing for the adoption of folic acid hyper-supplementation, a synthetic form of vitamin B9 in order to prevent spina bifida. This worked, it did, and if you look at the global incidence maps for autism vs the map for spina bifida, you can see they are the exact inverse of each other. These maps, as well as research studies are linked in my post from 3 years ago:

https://www.reddit.com/r/DrWillPowers/comments/13q28zq/dr_powers_crazy_conjecture_on_the_cause_of_autism/

Additionally, if that wasn't enough, anti-folate receptor antibodies are known to be associated with autism:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8398778/

It is entirely possible that Autism in some children may occur due to the sudden development of folate receptor auto-antibodies, which could be triggered by immune system exposure to quite literally anything.

This phenomenon is already well documented in the development of other neuropsychiatric illnesses such as OCD in a child recovering from a Streptococcal infection, this is known as PANDAS, and so its not a stretch to believe that literally any other illness or immune trigger could cause this to happen as well:

https://en.wikipedia.org/wiki/PANDAS

Its also entirely plausible that some children could experience improvements in their symptoms from dietary changes as many parents have claimed. If folic acid signaling is the core issue, dietary changes could matter, as could changes in the gut microbiota, which is known in humans to be related at the very least to some types of hormone metabolism, particularly DHT, which is the alternative exit pathway for testosterone in human metabolism of s*x hormones. Testosterone can become DHT, or it can become Estradiol, as you can see here:

https://en.wikipedia.org/wiki/Steroid_hormone #/media/File:Steroidogenesis.svg

Here's a study supporting what I claim:

https://pmc.ncbi.nlm.nih.gov/articles/PMC6962501/

I don't know how else to put this, but I suspect our government is about to spin things to make it seem like they have the "cure" for autism, when the very cause was our own government recommending a synthetic form of vitamin B9 to a population filled with carriers of MTHFR (methylene tetrahydrofolate reductase) gene mutations as a national guideline for pregnant women. This worked as intended, and cut the rate of spina bifida astronomically, but simultaneously resulted in all kinds of new problems related to changes in estrogenic signaling in the population, particularly autism and gender dysphoria.

I wish it weren't the case, but in countries who introduced folic acid guidelines later, they only experienced a rise in their Autism cases later.

My own father read an article in the 80s about the possible benefits of Folic acid for pregnant women before it was a guideline, and encouraged my mother to take huge doses of it throughout her pregnancy. I am very much a "high estrogen" signaling phenotype. Hyper masculine, no social fear, but socially awkward.

The curve really demonstrates this pretty clearly. In the 80s, people started voluntarily supplementing pre-natal folate based on early published study results. In 1991 the US government started recommending folic acid supplementation for pregnant women, and it was artificially added to our food in 1998. Take a look at when this curve takes off:

(See Photo 1)

r/DrWillPowers - Here are the heat maps globally for Autism and Spina Bifida, which are effectively demonstrations of "these countries give folic acid during pregnancy and these do not" :

(See Attached Photo 2 and Photo 3)

r/DrWillPowers - Rate of Autism (Blue low, red high)
Rate of Autism (Blue low, red high)

r/DrWillPowers - Rate of Spina Bifida (Blue low, Red High)
Rate of Spina Bifida (Blue low, Red High)

I've been sitting on this a long time, and I haven't really wanted to do a write up on it as I'm already a target. I have more transgender patients than any other doctor ever has before. I have worked immensely hard to try and do so in the most ethical way possible. To try and explore every possibility with patients, and determine if there is an underlying endocrinological problem that can be fixed that could alleviate their gender dysphoria before transition (sometimes there is).

Regardless of how hard I work to be ethical, to base my work on good science, and to always value the autonomy of the patient above all else, I continue to see my name being dragged all over the internet, more than ever before. Every day I log into reddit to see someone spinning some tale of something that never happened at my office, claiming I'm some monster.

I'm starting to feel a little paranoid that this is a Psy-Op and the setup to take me down as a provider. The amount of effort people are putting into writing literal fairy tales of things that never happened about me is more than I can believe is just weird people online being weird anymore. It feels like a concerted effort.

I have very publicly claimed this now for 3 years, and now the government has basically come out and said the exact 100% opposite position. The statistical probability of me picking the nearly exact molecule as the cause of autism as what they consider the cure 3 years before they came out with this seems so astronomically improbable that I cannot wrap my brain around it being anything other than a coverup.

In short, I'm saying this here and now. I've done my best. I've tried my hardest for 13 years to be an ethical and good doctor, and to help as many people as I possibly could. I've worked to not just "follow guidelines" but instead tailor my care to the needs of each individual patient. I've done my best to recognize patterns and try and understand the underlying molecular biology and genetics of gender dysphoria, and all the associated health conditions linked to it, including Autism. There are so many connected conditions to gender dysphoria, I can't list them all, but Ehlers-Danlos/hypermobility, Orthostatic Hypotension / POTS, IBS, "Fibromyalgia", Hashimotos Thyroiditis are just a select super common few. This is not a defect of personality, but a phenotype, usually derived from a genotype, but sometimes caused by environmental or drug exposures coupled with epigenetic factors.

All I ever wanted to do since I was 5 years old was to become a doctor and to help people, and I know that has always been my motivation, and I know that I have done that. I sleep well at night. If you've ever seen me as my actual patient, you know this. I give my all every day for my patients, and I would never do anything to harm anyone, least of all those who entrust me with their health. We live in a post AI world, and where the court of public opinion decides all. Please do not believe the nonsense that I am sure is to come and be spread about me to discredit me and my very valid scientific opinion.

Should I suddenly meet my end in an "accident", lose my license over some "Trumped" up nonsense, or be brought up on criminal charges like my poor gender-services center colleagues at the University of Michigan, know that I did my best to help people, and that's all I ever tried to do from the start.

I hope I'm just being a little paranoid, but after all I've seen happen so far in my life, and the amount of things I've accurately predicted due to my weird autistic pattern recognition ability, I struggle to believe I'm not going to be punished for claiming this publicly.

Be a kind person, and always work to reduce the suffering of other conscious things. We are all the same thing. Everything is one.

- Dr Powers


Edit:

Seems a few interesting publications came out I wasn't aware of that sort of lend some further credence to my theory from 3 years ago that came out after I put that original post up.

Toxic Effects of Excess Vitamins A, B6, and Folic Acid on the Nervous System

https://pmc.ncbi.nlm.nih.gov/articles/PMC12350011/

Uncovering the Hidden Dangers and Molecular Mechanisms of Excess Folate: A Narrative Review

https://pmc.ncbi.nlm.nih.gov/articles/PMC10648405/