His surgery occurred in 1917–18 at the University of Oregon Medical School and he lived the rest of his life as a man. Hart married his first wife, Inez Stark, in 1918 and his second wife, Edna Ruddick in 1925. Hart also served for eight years as vice president for his local Unitarian Church council.
Hart pioneered the use of x-ray photography in tuberculosis (TB) detection which helped implement early TB screening programs that saved thousands of lives. In the early 20th century, TB was the biggest killer in America. Hart was among the first physicians to document how TB spread via the circulatory system, causing lesions on the kidneys, brain, and spine, eventually resulting in death.