New LGBTQ clinic offers lifeline
Ava Feminelli’s favorite part of working at Anchor Health in Stamford is getting a glimpse of the faces of new patients after their appointment at the LGBTQ-friendly clinic.
Feminelli knows the feeling. As a transgender woman, she had a lifechanging experience when she first met Dr. A.C. Demidont, head physician at Anchor. For Feminelli, the encounter was a far cry from previous interactions with physicians.
“It was the first time that I really felt seen by a medical provider,” she said from Anchor’s new Stamford offices at 30 Myano Lane. Feminelli works as a patient care associate at the clinic and remains one of Demidont’s patients.
So, when Feminelli finally gets a look at new patients, she’s expecting to see a facial expression akin to a huge sigh of relief.
“One of the best parts of working in the front is seeing people walk in, shaky and nervous, and they walk out beaming like a pair of high beams,” she said.
Such a reaction is why Anchor Health Initiative opened in the first place, according to Demidont and president Jean Doyen de Montaillou.
It’s the only free-standing clinic in Stamford that focuses on gay, lesbian, transgender and gender non-conforming health services, and one of only two in the state. Circle Care Center in Norwalk offers similar services.
Anchor has another, smaller, location in New Haven.
The Stamford clinic has been open for just over a year, and already has about 1,000 patients, said Demidont. Half of them are transgender.
Filling a need
Demidont wasn’t surprised that so many people flocked to the center, since one of the reasons she chose to open Anchor Health in Stamford was to provide care for what she described as the “underserved” LGBTQ community in the city and state.
“There is a hole in the state medical system regarding LGBTQ health care in general,” she said. “This area was chosen because it’s a place where there aren’t enough providers.”
There are roughly 1.4 million transgender people in the United States, according to estimates by UCLA’s Williams Institute. Local numbers for Stamford and Connecticut are hard to come by, but Demidont estimates there are at least 15,000 transgender people in the state.
And yet, finding transgender medical care in Connecticut remains a burdensome and confusing process.
Janet Tarzia, the mother of Jessie Tarzia, a transgender woman and former Stamford High School student, said looking for medical care for her daughter about seven years ago was a major challenge. For starters, she had no idea where to begin her search, and didn’t have much luck looking online for help.
“The challenge was getting local information,” she said. “Where is the person who I go see to help us get through this?”
Nick Tarzia, Jessie’s father, said it was like “being thrown in the water to learn how to swim.”
When searching for an endocrinologist to provide hormone therapy for their 11-year-old daughter, they found there were only two physicians who would see her in the entire state, and one had just retired.
The endocrinologist, located in New Haven, told the Tarzias they needed to have their daughter go to a New Haven therapist to get a recommendation for hormone therapy, which meant they had to make the roughly 50-minute drive on a weekly basis for six months.
Looking back, Janet Tarzia said having a local resource like Anchor Health Initiative “would have facilitated so much.”
Barriers to care
Demidont, a transgender woman, said the biggest barrier to health care for the transgender community remains bias against them, which oftentimes leads to poor and traumatic care from physicians.
“Part of the reason why this organization was founded was because within medicine itself, the LGBTQ community is often very marginalized and there are huge consequences to that,” she said.
A big part of Demidont’s mission is to help LGBTQ patients find surgeons, therapists and specialists who are accepting. For transgender patients, the list remains rather small, she said.
“We have a very strict list of people that we refer to for any specialty, because we try really hard to make sure that the person that the patient is going to see is competent and trans-inclusive, because — believe me — not all providers are,” she said.
Demidont, an assistant clinical professor of medicine at Quinnipiac University’s Frank K. Netter School of Medicine, has practiced as a physician since 2006. Her resume includes St. Luke’s Roosevelt Hospital and Callen Lorde Community Health Center, both in New York City.
The latter serves as the model for Anchor Health Initiative, she said.
The Stamford clinic offers a range of services, from general checkups, to HIV/AIDS care and sexual health care. While the center caters to the lesbian, gay, bisexual and transgender population, it is open to anyone looking for medical care.
Doyen de Montaillou has big plans for the fledgling clinic, hoping to open similar health centers around the country.
He said the Stamford clinic will eventually include an on-site pharmacy and, hopefully, a mental health program. In the short-term, the center is looking to hire case management professionals to work on HIV prevention, thanks to a three-year grant from the state.
Beyond providing services to the LGBTQ community, the clinic also demystifies transgender health care, which remains a little-studied topic in medical education.
Demidont said a traditional four-year medical college in the United States will spend less than 10 hours on LBGTQ issues.
“That’s pretty low, so a lot of students are not prepared to work with the community when they come out,” she said.
The inadequate training can lead to disastrous results.
Demidont remembers seeing a transgender patient in her 50s with acute shortness of breath and chest pain, who came in a day after being discharged from Norwalk Hospital’s emergency room.
“Whatever happened in the emergency room there, she didn’t feel comfortable telling them that she was on estrogen,” Demidont said.
The physicians, apparently, didn’t ask, either, and the woman was ultimately discharged, she said.
Estrogen, a hormone commonly taken by transgender women, can increase the risk of devel- oping blood clots.
Demidont saw the woman the next day and diagnosed her with a pulmonary embolism.
“That could kill you,” she told the patient, who eventually sought treatment at a Greenwich medical center and told the doctors her whole history.
While the miscommunication between the woman and the doctors seemed avoidable, the example illustrates the challenges of transgender health care, where mischaracterizing a patient or causing discomfort can lead to grave results.
Feminelli has had her own uncomfortable interactions with doctors.
“As a transgender woman, I was really worried about medical care and if I was going to be treated with respect,” she said.
Other doctors she encountered were “cold and clinical,” and would preface every appointment with a variation of “I don’t understand people like you, but I’m going to do my best,” she said.
For Demidont, hearing such stories from her patients underscores how much work needs to be done.
“I’m glad they’re here and I’m glad that we exist and every day I wake up and I’m glad that we are making a difference,” she said. “However, it makes me sad that they had to have that bad experience in medicine.”
“There is a hole in the state medical system regarding LGBTQ health care in general. This area was chosen because it’s a place where there aren’t enough providers.”
Dr. A.C. Demidont, lead physician at Anchor Health