Planned Parenthood, Metro Trans Umbrella Group Partner On Care Designed By And For Transgender Community

When Beth Gombos first broached the topic of hormone replacement therapy with their then-primary care physician, the response was discouraging, to say the least.

Gombos had for several years been seeing that provider, who knew Gombos identified as genderqueer. But when Gombos asked about hormones for the masculinization of their body, the doctor was unwilling to consider the idea — and suggested Gombos find a new provider.

“It’s harder to get testosterone than it is to get an abortion,” Gombos told St. Louis on the Air.

Gombos is hardly alone in that experience, which they note is part of “a long, horrible history of being mistreated and overlooked and traumatized by institutions in the health care community.”

But this week, a newly launched partnership between the Metro Trans Umbrella Group and Planned Parenthood of the St. Louis Region and Southwest Missouri has Gombos feeling hopeful about the future: TRANSforming Community TRANSforming Care.

The $3 million, multiyear effort will expand health care services, conduct trauma-informed research and build a sex-education curriculum tailored toward — and designed by — the transgender community.

McNicholas described it as “a groundbreaking way of thinking about health care delivery.”

“It’s a real partnership to help address health care disparities in our communities,” she said.

On Wednesday’s talk show, both Gombos and McNicholas joined host Sarah Fenske to break the news and discuss the effort. It’s billed as the first of its kind in Missouri, expanding access to care regardless of a patient’s ability to pay.

“The thing that is different about this program is not just that we’re creating a space to help increase access to a specific health care need for a community, but it’s that we’re doing it with the community,” McNicholas said. “I think too often programs are developed for marginalized folks outside of their expertise. This is a real gamechanger, I think, to bring the community into the process.”

That process is already in the works thanks to Planned Parenthood patients including Gombos, who serves as Metro Trans Umbrella Group’s housing and outreach coordinator.

“What this means is that [Planned Parenthood has] already been getting feedback from a few patients, such as myself,” Gombos explained. “And they’ve been working with our organization. … And once we start to roll out the services officially, they’ll be getting more feedback, and they’ll be changing the programs in order to accommodate the feedback they’re receiving.”

The investment is part of the Missouri Foundation for Health’s Opportunity Fund program, which seeks to address the underlying causes of inequality in all aspects of health.

McNicholas emphasized that in addition to providing health care services such as gender-affirming hormone therapy, menstrual suppression and surgical care, there are additional components.

“We have hired a community-based participatory research expert who will spend time in community figuring out where gaps are … and how can we as a health care organization also start to meet some of those needs,” McNicholas said.

Gombos and her colleagues at MTUG expect that “some folks are going to be wary” of accessing services at first due to past experiences in the health care industry.

“We understand that there’s going to be some concern about whether or not it’s going to be done right, and … the great thing about this is that [Planned Parenthood staff] know they’re not going to get it right every single time,” Gombos said. “The important thing is that MTUG is partnered with them to make sure folks have a safe space to give that feedback and tell us truly how their experience was and what Planned Parenthood can do to make it right and make it better.”

Several listeners joined the on-air discussion, writing in to the show to share their firsthand perspectives.

Emerson, a 21-year-old genderqueer man, said health care “has been a real struggle” since he came out.

“In order to get hormones, I have to use a telehealth service called Plume — it’s expensive, but I know it works, and I’m nervous to rely on a primary care doctor who could at any time decide that they don’t want to prescribe me my testosterone,” Emerson wrote. “I’ve heard horror stories of folks being six months or a year on T, only to have to stop because their doctor becomes out of network or changes practices.”

Another member of the St. Louis community, who asked that St. Louis on the Air withhold her name, wrote: “Our provider in STL was issued a cease and desist letter from Cardinal Dolan after an 8-year relationship with our transgender son. Our physician was no longer allowed to treat him because he was transgender. Our provider was not even allowed to give him a physical. They were allowed to do this because of religious exemptions. I am so grateful that Planned Parenthood is an option for his future healthcare.”

And Feroz, a listener who was born intersex and is a trans person, shared their perspective.

“It is absolutely life saving for many of us to have a medical provider that respects our consent and autonomy,” Feroz wrote in part. “It is life saving that they make care accessible to those of us living in poverty. Partnering with MTUG, and sharing platform with real trans people, gives me hope that we can foster a world where all of us thrive.”

Others took to Twitter to share their thoughts.

“St. Louis on the Air” brings you the stories of St. Louis and the people who live, work and create in our region. The show is hosted by Sarah Fenske and produced by Alex Heuer, Emily Woodbury, Evie Hemphill and Lara Hamdan. The audio engineer is Aaron Doerr.