Critical Condition: Queer And Trans Healthcare In San Francisco

I’ve written before about the dire state of transgender healthcare. This will be sort of like a sequel. It’s a little more specific, a little more local, and a little more personal. Where before I wrote about bald-faced hate, today I have to write about a more insidious kind of bigotry, a kind which is subtler and possibly even more dangerous. I have to talk about hatred as it is expressed in terms of budgets and priorities, in terms of who gets funding for what, and which organizations are first against the wall when money runs out.

In San Francisco, queer clinics are dropping like flies. New Leaf was forced to close back in August. I got free counseling from New Leaf and have been without a therapist ever since. Fortunately for me, my own mental state has been such that this hasn’t been a problem– so far. I’m sure a lot of people who depended on New Leaf’s services haven’t been as lucky.

Now Lyon Martin will be forced to close its doors unless the community can raise sufficient funds to save it. Once again, the impact of its closing will be close to home for me, but this time, it will somewhat more serious.

You see, my lover just started estrogen, and they have never been happier. For the very first time, they are experiencing a piece of themself that had always been missing. All this is thanks to Lyon Martin.

Here’s part of a statement that my lover wrote asking our friends to donate to the endangered clinic:

These people provide affordable sliding scale healthcare to underserved minority groups. They provide a service to our community that most healthcare providers are unwilling to offer, in a courteous and professional manner.

I am agendered, a type of transsexual that is not recognized as existing in conventional healthcare. Lyon-Martin provided health care to me in a safe environment where I did not have to lie to obtain the services I needed.

I can’t be without these services…. Before pursuing active transition treatments, I was able to make it from day to day. Almost. It was rough, but dysphoria was all I knew, and all I really expected to know. Now that I have been undergoing my second, more accurate puberty, I know what life can deliver, and I know that I really will have a genuinely difficult time if I am forced by some conservative Blue Shield GP to stop my treatment… I am really, really worried.

Hopefully, the above can illustrate a little bit of  the anxiety and pain that Lyon Martin’s patients are going through while they wait to learn of the clinic’s fate.

The quality of care that Lyon Martin offers is really unique. Their slogan “We treat you with respect” sums up what they have that we need, and the problems with services available through HMOs or non-GLBT clinics. To quote the Guardian,

Lyon-Martin medical staffers receive training on transgender patient care, and it even offers training in that realm for medical professionals from cities throughout the United States. “They are internationally renowned as a model for what it means to offer transgender care,” noted labor organizer Gabriel Haaland, who said he was once denied health care due to his transgender identity. “The healthcare system is a fairly traumatic experience for most transgender people,” he added.

Most mainstream health care providers receive no training in transgender medicine whatsoever. Even those who do provide some transgender care, such as hormones, are often very ignorant in many ways. Non-binary, genderqueer and agendered trans folks still have to lie and pretend to have binary identities in order to access transition services in such places. Staff often display bigotry, and fail to use appropriate pronouns and forms of address. Lyon Martin is a place where trans people don’t have to deal with any of that. Instead of paying out the nose to be dismissed and disrespected, one is given real care regardless of ability to pay.

That is a rare and precious thing.

A lot of criticism has been leveled at Lyon Martin’s board and the way they have handled finances. While this may well be valid, I think it is vital that we acknowledge that this is part of a larger pattern. San Francisco non-profits are losing funding. I have watched organizations that serve the queer community struggling desperately to stay afloat over the past few years. I have seen LYRIC forced to cut hours, The Castro Country Club begging for donations, and New Leaf close its doors. Although these organizations provide very different services, all of them are places of refuge which provide support– social, medical, psychological, emotional, spiritual– to people who don’t know where else to go.

In the case of medical services, this pattern means that many of the same patients are migrating from one dying clinic to another as non-profits fail. Take my own (not particularly severe) case as a quick and dirty example. I’ve been thinking that I need to get into therapy again. Since New Leaf has closed, I was planning to go to Lyon Martin. Now it seems that I will have to go elsewhere, possibly to Dimensions. Whatever free or sliding-scale clinic I find, it is guaranteed to be underfunded and struggling, just like all San Francisco non-profits.

The point is that we cannot be secure in the knowledge that respectful, affordable care will remain available to us. We don’t know that it will. In fact, it seems very likely that it will be taken away. Those of us who have insurance will be forced to rely on soulless HMOs where providing trans-specific care will be a low priority, if it is even dreamed of at all. Those who do not have insurance will be left with nothing.

The good news is that so far the community has made an impressive rally  in support of Lyon Martin. This may be one battle that we can actually win.

So I’m asking for your help. This blog averages 217 views a day. I understand that most of us are fucking broke, and it’s an unfortunate irony that the people who need Lyon Martin the most are those of us least likely to have money to spare. But if every single person who views this blog today donates just one dollar, that’s 217 dollars for Lyon Martin. If every single person who views this blog today donates five dollars, that’s 1,085 dollars for Lyon Martin. If everyone single person who views this blog today donates ten dollars, that’s 2170 dollars for Lyon Martin. Get the idea? A little bit can go a long way. If we all just do what we can, I have no doubt that Lyon Martin will raise the money it needs to reorganize instead of closing.

Donate! Anything helps.

If you can’t give money, at least spread the word. Repost, reblog, get the word out there so that people who can give their financial assistance will. I know it sucks shaking down friends and family for money, but this isn’t for some disembodied cause, for some vague sense of charity and noble purpose. This is to take care of our own community, our queer community, here in San Francisco. This is about real people’s health, real people’s lives.

We don’t have to be beaten this time. This time, there is hope. If we all do our bit, we will know the sweet taste of victory, something that trans people experience seldom enough.

Let this be a line in the sand. We will not lose this one.

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About Asher

Asher Bauer is fast becoming a fixture in the San Francisco kink community, and intends to stay that way. He has worked as a Queer Educator at LYRIC (Lavender Youth Recreation And Information Center), and since has taken his talents as an educator to a wider variety of audiences, teaching on subjects ranging from safer sex to BDSM to trans and queer identities. He is also one of the hosts and originators of Transmission, the new trans-centric party at the San Francisco Citadel, and Invasion, the Citadel's all-genders queer party. View all posts by Asher

9 responses to “Critical Condition: Queer And Trans Healthcare In San Francisco

  • Erick

    As a medical student and someone who is trying in vain to find a willing (that’s about as much as I can ask for) physician to prescribe Androgel in SC, I can fully attest to the importance of these clinics.

    As far as medical education goes, Lyon-Martin is the only place in the US where medical students can participate in an elective rotation in trans health. That’s it. If it’s lost, there goes our only opportunity for hands-on experience in this area. For every student that participates in this rotation, that’s hundreds of lives saved, not to mention the lives saved from the clinic itself.

    For any underserved community, these clinics are invaluable, but for us especially because they may be the only places where we can get QUALITY care, not just minimum. Trans health isn’t just regular health care for people who happen to be trans. Hormone therapy (if desired) requires supervision and regular blood work, with potentially disastrous consequences if unsupervised (read: cancer).

    Transfolks have to fight to survive, and dammit, we will.

  • Ethan K.

    I will talk it over with my wife and see how much we can spare. I wish it were March. We’re still paying for two rents on a single right now. (Moved from another apartment. Couldn’t get out of the lease.)

    We have free-ish healthcare in Canada (depending on where you are) but I have not forgotten that in many places, it is not so.

  • Mo!

    Thank you for this fantastic post, Asher!


  • Wes

    So they do provide estrogen? I had avoided donating in the past because I heard they only offered service to cis women and trans men and refused service to trans women (or anyone in need of estrogen, etc). I’m a trans guy but I don’t want to support anyplace that is trans-misogynistic, so this is very good to know. Thanks for posting; I will definitely donate if I can afford to now.

  • punksexism

    Excellent, thanks Morgan! I will donate next time I get paid.


  • Save Lyon-Martin « TAL9000

    [...] facing closure. We cannot let this happen. As Asher put it in his second post on the subject: Let this be a line in the sand. We will not lose this [...]

  • S.

    I just signed up to volunteer here. I get my first paycheck in October. I’m going to be making a donation.

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