Accessing health services for transgender people continues to be a struggle. From hormone treatments to basic medical care, a recent Williams Institute Study showed just how problematic it can be for a trans person to receive proper treatment; but Richmond’s Planned Parenthood (PP) clinic is hoping to change that.
The nationally supported initiative started in late-summer 2016 and was headed up locally by a familiar face to anyone who’s run in trans-circles in the last decade or so.
“I was the transgender health services manager at Fan Free Clinic, which is now Health Brigade. Prior to that I was an activist for trans rights, particularly around health and peer support, for the past 10 years or so,” said Afton Bradley (top image), PP’s Transgender Health Care Services Program Manager, clad in a teal uniform.
A nurse in training and a trans man himself, Bradley started at the Hamilton St. PP office when the program launched. He conducted a needs assessment and started a broad training program for staff dealing specifically with how to work with transgender patients. This is unique for any number of reasons – as the Williams institute Study and Bradley pointed out:
“When you hear about negative experiences that trans people face, often times they have been before the person even gets to the provider,” Bradley said. “The provider might have been trained and well experienced and knows all the right things to do and say, but unfortunately if you’re not training your front desk or training the nurses, that’s not going to ensure that sense of safety and make someone feel really welcome to come to your practice.”
This devotion to attention and respect is one of the reasons PP stepped up to take in transgender patients.
“From filling out forms, to the language used in the waiting room, to insurance coverage, to staff understanding of transgender identities, healthcare environments can be really unwelcoming to gender nonconforming patients,” said David Timberline, Director of Communications at the Virginia League for Planned Parenthood. He said PP’s mission is to be fundamentally inclusive and provide the best care possible no matter the subject.
And it’s made a difference for on the receiving end of treatment, either here in RVA or at the state’s other trans-inclusive branch in Virginia Beach. Richmond resident Rowan Grayson is one of the 150 or so patients whose quality of life has improved thanks to not only transitioning, but also PP’s expanded care program.
After realizing he were trans in his teens, it took some time for Grayson to be able to live as his authentic self. But finally, in his mid-20s, he came out as a gay transgender male and started seeking treatment. He had insurance, so Health Brigade was off the table, but the waitlist for a local endocrinologist is also a barrier. He headed up to DC to the famed Whitman Walker Clinic, but after a few months he heard of PP’s new option and had his records transferred.
“It’s more affordable than going through an endocrinologist, and it’s nice to have everything all in once spot and know they can help with more than just writing a prescription,” he said, noting the one-on-one time he’s received from Bradley and PP’s staff was more than he ever got at Whitman Walker. “They’re bigger, so you don’t get a lot of attention. Plus, being in DC, the networks they have aren’t local for me.”
And that attention went beyond medical needs. Grayson (pictured above) said Bradley has helped discuss name and gender marker change forms as well as with finding a trans-friendly lawyer to handle family issues. And when Grayson entered a relationship, they even helped him get on birth control.
“Having strangers correctly gender me for the first time has been really amazing,” he said – noting both the treatment and the life he’s living this deep into treatment. “The entire staff there is fantastic and super helpful.”
And Bradley is equally as excited about the work he’s doing. He’s thankful to PP for not only allowing him to continue his work supporting trans people, but also doing it in such a approachable and thought out way.
“Planned Parenthood has taken it upon themselves to ensure that their mission, while centered on women’s health, is about reducing barriers to health care for all genders.,” he said.
Part of reducing those barriers is the way in which they treat trans patients – they follow and informed consent model meaning the patient knows their body better than anyone else, and therefor they should be able to make healthcare decisions over their own body.
Both follow the WPATH Standards of Care for trans folks.
“We have to make sure you can make informed medical decisions, just like any other procedure, like surgery,” he said. “The biggest piece of gauging readiness for HRT comes from comprehensive health assessment.”
This includes blood and lab tests to make sure the hormones wouldn’t be dangerous. Then they get vitals and the results and can work from there to form treatment.
“We’re going to do what we can to get them in a medically safe condition to start,” he said. But from there, an endocrinologist isn’t necessarily required. “We have nurse practitioners who see most of our patients. And we have an MD who over sees the clinic… so when it comes to the medical records, labs, prescriptions, the MD has oversight.”
Those interested in seeking trans health services from Planned Parenthood can head to their website and schedule an appointment here. Bradley can be reached directly for questions at 804-482-6154. Financial assistance is also available for those who qualify thanks to a grant from Diversity Richmond.