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In the face of Trump’s healthcare reform, RVA’s Health Brigade steps up to cover the region’s most vulnerable, expand transgender services

RenMartinez | March 16, 2017

Last night, Donald Trump stood on a stage in Nashville, Tennessee and once again reiterated his determination to repeal Obamacare, throwing his support behind the American Healthcare Act.

“The bill that I will ultimately sign will get rid of Obamacare and make healthcare better for you and your family,” Trump said.

This comes on the heels of a series of blows for one of the most vulnerable groups in America, the transgender community. There was the Trump administration rescinding federal guidelines instructing schools to allow transgender students to use the facilities that correspond with their gender identity. The caused the Supreme Court to send the case of Gavin Grimm, a transgender teenager who was unable to use the boys’ restroom at his high school, which would have potentially determined if Title IX protections extend to gender identity, not just sex.

For the trans community, who are often the subjects of discrimination in healthcare settings and are twice as likely as other Americans to live in poverty, the repeal of the Affordable Care Act could have devastating consequences.

“There is real fear,” Jennifer Gallienne said. “But, we will continue to see people no matter what.”

Gallienne is the Trans Health Services Coordinator for the Health Brigade. Health Brigade, formerly the Fan Free Clinic, has been providing healthcare services to the poor and underserved in Richmond for fifty years and, for the past ten years, has been providing primary care services to the transgender community.

Health Brigade offers a variety of services, including medical services, health outreach and advocacy, mental health services, HIV testing, and transgender healthcare. Because of their mission to provide healthcare to the those unable to afford or access healthcare, eligible patients cannot earn more than 200% of the federal poverty level.

Dr. Wendy Klein, Medical Director, who oversees the medical clinic and primary care services, has been at the clinic for two years and is proud to be a part of Health Brigade’s history of championing healthcare.

“We provide a broad range of services to our patients,” she said.

She discussed the Health Brigade’s long-standing mission of inclusiveness and and compassion to those least served, especially the trans community.

“We have the long history of being in the forefront of AIDS/HIV care and testing, which led to a keen awareness of the need for excellent LGBT care,” she said. “We are one of the few places that have providers trained in specifically transgender health care.”

Part of Health Brigade’s mission is to provide quality, appropriate, and affirming  healthcare to the non-binary, gender-nonconforming, and transgender community. This includes hormone administration, gynecological care, individual counseling, and legal services. Health Brigade prides itself on its dedication to complete wellness, not just medical services.

“At Health Brigade, we have always tried to improve the way that trans people are receiving healthcare and have more positive outcomes for them so they can live healthier lives,” Gallienne said.

Dr. Klein explained that the trans health clinic was once separate from the main clinic, but has since been integrated as part of Health Brigade’s mission to provide overall care. And, in order to work and volunteer at the trans clinic, one must be educated and trained to serve their trans patients.

“Our whole staff is aware of preferred pronouns and gender identity,” she said. “It’s compassionate, sensitive care based on established evidence.”

Gallienne, who does intake for trans patients and oversees staff education, emphasized the importance of providers understanding their patients as whole people rather than singular parts.

“The most important is making sure that the people that we’re seeing and that the care they’re getting is quality care, affirming care, and informed care,” she said. “Making sure that who they are seeing is knowledgeable about trans identities and what they’re going through so our patients don’t have to become the educators. They know they’ll be treated with respect and dignity and as a whole person.”

Part of providing overall wellness in healthcare is providing a wide array of services. Health Brigade also provides mental health counseling, psychiatric services, and wellness groups.

“We have a mental health clinic with counselors and limited psychiatry services,” Dr. Klein said. “We can’t take care of acute mental illness, but we’re able to provide counseling and care for general psychological problems.”

“It’s important to see someone as a whole human being,” Gallienne agreed. “It’s not required that any of our trans patients see mental health before they receive hormones, but it available to them if they want to access someone to talk to.”

Dr. Klein explained that, built within the medical clinic, behavioral coaching is provided to address things such as smoking cessation, weight management, stress reduction, and other issues.

“The integrated approach to care that combines mental health, behavioral health, nutrition, all of these things, make for a nice fabric of care, like threads in a fabric,” she said.

The trans community faces particular obstacles in receiving healthcare, such as discrimination, harassment, and gate-keeping. As the Trans Health Services Coordinator, Gallienne strives to not only provide quality care to the trans community, but assist them in getting connected to additional community resources.

“There is no average patient,” she said. “But, we do see a lot of our patients struggling with the same trends going on in the community, struggling to find resources and places they can go that are safe or that they can get treatment or care without facing harassment and discrimination. A common theme we see is not knowing where to go or if where they’re going will be safe or not.”

With the possible repeal of the Affordable Care Act and increasing concerns over the American Healthcare Act, which the CBO predicted would cost up to 24 million Americans to lose healthcare coverage, Dr. Klein stated that the Health Brigade’s mission of providing affordable healthcare to the uninsured and the poor will only become more vital to the community.

“If anything, the need for our services will increase if people lose their insurance on the exchange,” she said.

“We wanted to get the word out that we do accept new trans patients and that we’re a resource for people,” Gallienne explained. “As long as they meet our eligibility services, they are welcome to come. We are always accepting newcomers.”

Dr. Klein and Gallienne agreed that community support is vital to the mission of the Health Brigade and to increasing awareness and acceptance of the LGBT community at large.

“We exist on grants and donations, donations of money and donations of time,” she said, referencing how the community could assist in supporting the clinic’s mission. “There is also lobbying for improved care, lobbying to protect the ACA, lobbying for healthcare for all.”

“All support is welcome.”

Health Brigade is located at 1010 N. Thompson Street in Richmond. For more information you can visit www.healthbrigade.org or call (804) 358-6343.