By Erin Wilkins
Eli* is a patient at Family Tree Clinic. He’s a transgender man in his late 40s and hasn’t seen a health care provider in well over ten years. His fear of being mistreated or discriminated against because of his gender identity prevented him from getting the check up he desperately needed. Going to the doctor is a potentially traumatic experience for Eli and other trans, genderqueer, and gender non-conforming folks.
Luckily, Eli heard about Family Tree Clinic from a friend and finally felt able to make an appointment. He recently visited the clinic and got the long overdue STI screening, blood pressure check, and pap test he needed.
When he left, he shared with the staff that he felt an overwhelming sense of relief after having the first medical experience of his life where he felt fully respected, seen, and safe. These are the experiences Family Tree Clinic strives to provide.
In 2009, Family Tree Clinic launched their LGBTQ Health Access Initiative because they saw a huge need for culturally competent, accessible health care in the Twin Cities. Although the research on LGBTQ health is somewhat limited, it has been well documented that LGBTQ individuals often face difficulty accessing healthcare, are less likely to be insured, have higher rates of HIV and STIs, higher rates of smoking and substance abuse, and disproportionately experience violence and trauma in their lives and personal relationships.
Health care providers of all types tend to be poorly equipped to adequately serve these patients and to address their unique health needs. In an attempt to help address these stark inequities, Family Tree Clinic has worked hard over the past 5 years to expand their LGBTQ-specific services, improve organizational practices to better serve queer and trans patients, and to educate their full staff, from the front desk to the billing department and medical providers. Family Tree’s goal is to meet the needs of Eli and folks like him.
If you haven’t heard of Family Tree Clinic before, they have been a leader in sexual and reproductive health and education for over 40 years. The clinic is located in the Midway neighborhood of St. Paul and serves people from across the metro area and beyond. They also have outstanding sex educators who teach medically accurate, facts-based sex ed classes to youth and adults throughout the metro, as well as a unique and much-needed education program specific to the Deaf, DeafBlind and Hard of Hearing.
In 2014, Family Tree expanded clinical services to include minor illness care (things like upper respiratory infections, smoking cessation, and immunizations) and, during the next few months, they will be expanding services to the transgender community by offering sliding fee trans hormone care. Via the guidance of their patients and the LGBTQ community, Family Tree Clinic clearly heard that the trans community is in need of more access to hormone care.
In 2014, close to 20 percent of Family Tree’s total patients are LGBTQ-identified. When they started the initiative, only about nine percent of their patients identified themselves as LGBTQ. Alissa Light, Executive Director said, “We feel honored and proud that LGBTQ people in our community trust us and choose us to be their health care provider. Through our work caring for many LGBTQ patients and clients like Eli, one of the things that we have learned over and over is that our transgender, genderqueer and gender non-conforming communities experience huge disparities in terms of their overall health and well-being, and in their ability to access health care.”
That is especially true for the folks who are living at the intersections and experience multiple barriers to health care, often living in poverty, without health insurance, and might be navigating medical systems that are racist, transphobic, classist and misogynist. Light said, “It is hard to be healthy and to get even the most basic health care needs met when an entire system is built against you. We know that it’s essential to take the whole person into account, to see the ways they walk through life and understand how their identities and experiences affect their health. This is why community clinics like Family Tree Clinic are so important.”
Family Tree’s organizational journey towards being an ally to trans and gender non-conforming folks hasn’t always been easy or simple. It’s a path that continues to unfold with some growing pains along the way. As an organization that has historically been led by white, cisgender women, this process of integrating trans health services has been an opportunity for self-reflection and transformation. Because Family Tree Clinic is an organization that has always been deeply rooted in social justice and health equity, they have been lucky to find overwhelming support from their staff, board, patients, and wider community in becoming the clinic the community needs them to be.
New and exciting things are on the horizon for Family Tree. Under the guidance and direct participation of the transgender community and building on their partnerships with community organizations like the MN Trans Health Coalition, Family Tree Clinic is building a trans hormone program that mirrors their holistic, affirming, patient-centered approach to health care. “We have heard loud and clear that our community needs a program that doesn’t have so many gate keepers. As a result, we’re working to build a hormone program that’s based on an informed consent model. It will be launched in June 2015 and will be sliding fee, just like all of the services we provide.”
Meeting the direct needs of their patients is always their number one priority. However, Family Tree’s ultimate hope is systemic change among community clinics across the region, allowing increased access to excellent hormone care and healthcare for the people who need it most—people like Eli. And It seems they’re on the path to do just that.
*Name changed to protect privacy.
Erin Wilkins writes for Family Tree Clinic, provider of specialized care for LGBTQ individuals through all stages of life. Family Tree Clinic has been serving the Twin Cities community for over 40 years by providing high-quality and affordable health care on a sliding fee scale. Learn more at www.familytreeclinic.org.