Health non­profit launch­ing first trans­gen­der care clinic in Austin

Austin American-Statesman - - METRO & STATE - By Marty Toohey mtoohey@states­man.com

As state law­mak­ers en­gage in a vit­ri­olic de­bate about which bath­rooms trans­gen­der peo­ple can use, a Cen­tral Texas non­profit is open­ing the re­gion’s first trans­gen­der care clinic in Austin.

The non­profit Kind Clinic, in a med­i­cal com­plex near 30th Street and In­ter­state 35, will pro­vide free ser­vices such as hor­mone ther­apy specif­i­cally for peo­ple who are trans­gen­der, gen­der non-con­form­ing or non-bi­nary. The ser­vices ex­pand on the HIV-pre­ven­tion work that the Texas Health Ac­tion non­profit has been do­ing at the site since May 2015.

Joe McA­dams, ex­ec­u­tive di­rec­tor of Texas Health Ac­tion, said the trans­gen­der-spe­cific ser­vices were a log­i­cal ex­ten­sion of the

or­ga­ni­za­tion’s larger mis­sion, a prod­uct of grow­ing recog­ni­tion of the LGBTQ com­mu­nity’s needs, and are in­tended as re­pu­di­a­tion of the tone set at the Capi­tol.

“Now is the time to be the an­tithe­sis of what’s com­ing from the po­lit­i­cal side” of the state, McA­dams said. “That’s why we’re lean­ing into this.”

On Wed­nes­day, Kelly Kline, a clinic pa­tient and trans­gen­der rights ad­vo­cate, talked qui­etly in one of the exam rooms with the clinic di­rec­tor, Cyn­thia Brin­son, about her health. The topic quickly turned to the Capi­tol, where Kline tes­ti­fied Tues­day against Se­nate Bill 6, the so-called bath­room bill that would pro­hibit trans­gen­der-friendly bath­room, locker room and chang­ing room poli­cies in pub­lic schools, univer­si­ties and in govern­ment build­ings.

The mea­sure would also over­turn city and county re­quire­ments for trans­gen­der bath­rooms and pro­hibit cities and coun­ties from with­hold­ing con­tracts based on a com­pany’s bath­room pol­icy.

“I had to use the bath­room (in the Capi­tol), and they gave me the ugli­est looks,” Kline said. She shrugged and added, “I love my com­mu­nity, so I had to be there.”

Later, she said of the clinic: “I can’t stress enough how im­por­tant it is to walk into a place where we don’t feel judged.”

A Se­nate com­mit­tee ul­ti­mately en­dorsed the bill early Wed­nes­day, de­spite over­whelm­ing tes­ti­mony against it.

The Austin clinic, which be­gins of­fer­ing its ser­vices Thurs­day, is in­tended partly to of­fer trans­gen­der peo­ple, par­tic­u­larly low-in­come ones, a place they can feel com­fort­able seek­ing med­i­cal ser­vices, man­agers and com­mu­nity ac­tivists said.

“Com­pe­tent and knowl­edge­able med­i­cal care is ex­tremely im­por­tant, and ex­tremely hard to find in Texas” for trans­gen­der peo­ple, said Meghan Stabler, a trans­gen­der board mem­ber of the Hu­man Rights Cam­paign, which ad­vo­cates for var­i­ous les­bian, gay, bi­sex­ual, trans­gen­der and queer is­sues.

Stabler said the stan­dard med­i­cal path is of­ten un­avail­able to low-in­come peo­ple who don’t iden­tify with their birth sex. Pa­tients of­ten need coun­sel­ing on gen­der iden­ti­fi­ca­tion, re­fer­rals to med­i­cal spe­cial­ists when seek­ing hor­mone ther­apy, pe­ri­odic check­ups to en­sure the hor­mones are work­ing prop­erly, and some­times surgery.

The al­ter­na­tive, Stabler said, can be black-mar­ket dis­trib­u­tors for hor­mones and re­liance on a med­i­cally un­su­per­vised, of­ten crim­i­nal en­ter­prise, which puts them at greater risk.

“If you don’t have a good job, you may not have ac­cess to good health in­surance, and you may not have been able to go to an en­docri­nol­o­gist,” Stabler said. “I think this clinic is im­por­tant for peo­ple who need ad­vice, who need care, and who ul­ti­mately need hor­mones.”

The Austin clinic, which Stabler said was sim­i­lar to one in Hous­ton, opened in 2015 pri­mar­ily to re­duce HIV trans­mis­sion among LGBTQ com­mu­ni­ties by, among other mea­sures, pre­scrib­ing pre-ex­po­sure pro­phy­laxis, or PrEP, a med­i­ca­tion that pre­vents HIV trans­mis­sion.

The clinic helps pa­tients af­ford med­i­ca­tion partly through do­na­tions, partly through a com­pli­cated fed­eral process that, boiled down, amounts to pa­tients with in­surance sub­si­diz­ing some of the cost of pro­vid­ing the med­i­ca­tion to unin­sured pa­tients, McA­dams said.

The HIV med­i­ca­tion costs an in­surer about $1,500 a month, while HIV treat­ment drugs can cost about dou­ble that, he said.

The clinic now has 800 pa­tients, he said. It is, he added, the fastest-grow­ing PrEP clinic in the coun­try.

Brin­son of­ten an­swers charges that the clinic is en­cour­ag­ing un­safe sex by re­ply­ing, “Well, peo­ple are al­ready hav­ing con­dom-less sex, so let’s take care of their needs as we can.”

‘(Trans­gen­der) med­i­cal care ... is ex­tremely hard to find in Texas.’ Meghan Stabler Hu­man Rights Cam­paign

TAMIR KALIFA / AMER­I­CAN-STATES­MAN

Kelly Kline (left), a Kind Clinic pa­tient and trans­gen­der rights ad­vo­cate, speaks Wed­nes­day in an exam room with Cyn­thia Brin­son, med­i­cal di­rec­tor for the clinic, which Thurs­day will be­gin of­fer­ing free trans­gen­der health ser­vices.

Dr. Cyn­thia Brin­son is med­i­cal di­rec­tor at Kind Clinic.

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