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Speaker 1: Also media, Hi everyone, and welcomed. It could happen here

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Speaker 1: a podcast about things falling apart and the people putting

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Speaker 1: them back together. And today Garrison and I are joined

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Speaker 1: by Haley and Dan. Both Haley and Dan are gender

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Speaker 1: affirming care providers in the Northeast, and they both work

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Speaker 1: at federally qualified health centers. Welcome to the show, guys,

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Speaker 1: thank you so much in care. Okay, So for people

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Speaker 1: who are not familiar, right, maybe they've been fortunate enough

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Speaker 1: to have like really good healthcare their whole life, or

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Speaker 1: fortunate enough to not live in the United States and

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Speaker 1: have this bizarre like web of healthcare provision. Can you

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Speaker 1: explain what a federally qualified healthcare center is?

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Speaker 2: Sure you mind if I take this with Hailey?

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Speaker 3: So I would start by saying that our industry, our

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Speaker 3: advocacy arms would riot if they assumed that federally qualified

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Speaker 3: health centers weren't good care.

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Speaker 4: Right?

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Speaker 2: So ye smiths with that to start.

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Speaker 1: Oh, yeah, I get yeah, I guess good is a

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Speaker 1: relative to Yeah. I've relied on a federally qualified healthcare

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Speaker 1: center for a while.

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Speaker 2: It was great. They were very nice.

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Speaker 1: Actually, my prescriptions cost a lot less now than they

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Speaker 1: do with my very expensive eyeigh insurance.

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Speaker 2: Yeah.

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Speaker 3: So around the nineteen sixties there was the sort of

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Speaker 3: free clinic movement that got started, and what grew out

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Speaker 3: of that became the federally qualified health center system in

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Speaker 3: the United States. So there are roughly sixteen hundred unique

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Speaker 3: federally qualified health centers all over the country and we

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Speaker 3: as in sort of you know, confederated set of health

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Speaker 3: centers all across the country, are responsible for treating those

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Speaker 3: most in need in the United States, so the Medicaid population,

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Speaker 3: those without insurance. We cannot turn anybody away if you

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Speaker 3: do not have insurance, people in rural areas where healthcare

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Speaker 3: is very difficult to access and to get, undocumented folks,

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Speaker 3: and really everybody in between. At the health center that

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Speaker 3: I work at, we mostly treat folks on Medicaid, which

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Speaker 3: is pretty typical, although you'll find in states with no

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Speaker 3: Medicaid expansion it's a lot more uninsured and less Medicaid.

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Speaker 3: But we are the nation's safety net healthcare provider, and

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Speaker 3: without us, there are roughly one in ten Americans would

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Speaker 3: not get their healthcare.

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Speaker 1: Jeez, well, I guess people who are not in the

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Speaker 1: United States, do you want to go and give us

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Speaker 1: a go one minute speedrun of what Medicaid is medicare Sure.

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Speaker 3: So America does not have a nationalized insurance program, as

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Speaker 3: we are very frustrated with.

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Speaker 2: Most of the time.

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Speaker 3: It's mostly commercial insurance that you mostly get through your job.

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Speaker 3: But if you are not fortunate it's not the right word,

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Speaker 3: but if you're not fortunate enough to get that. Medicaid

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Speaker 3: is the system that gives health insurance to people who

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Speaker 3: are living at or below the federal poverty line. With

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Speaker 3: the Affordable Care Act or the ACABAMBACARE, that level raised

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Speaker 3: a little bit, so you could still get Medicaid if

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Speaker 3: you were at above the federal poverty line.

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Speaker 2: But this is mostly for the working poor. That's who

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Speaker 2: gets Medicaid.

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Speaker 4: Cool.

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Speaker 1: Yeah, it's a great system. Let's talk about how this

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Speaker 1: is funded them And you said the US doesn't have

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Speaker 1: like a single pair healthcare system. So how are these

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Speaker 1: healthcare centers funded right now? Or maybe how were they

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Speaker 1: funded like six weeks ago.

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Speaker 3: Yeah, So most of the work that we do is

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Speaker 3: fee for service. We're not a lot different than a

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Speaker 3: lot of other places in that regard. Right, if you

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Speaker 3: have Medicaid patients, we are a fee for Service program.

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Speaker 3: We give provision of care to them on a per

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Speaker 3: visit basis, same as anywhere else in the country and

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Speaker 3: how that works, and we get reimbursed for it. What

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Speaker 3: makes FQS different than everywhere else is two things. One,

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Speaker 3: we get a special rate that is designated because of

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Speaker 3: our willingness to take on these more expensive, more complicated

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Speaker 3: patients and to ensure they are healthy enough to keep

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Speaker 3: out of expensive.

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Speaker 2: Systems of care like emergency rooms and things of that nature.

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Speaker 4: Yeah.

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Speaker 3: And two is that we have a grant called the

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Speaker 3: FED three thirty And this is a sort of like large,

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Speaker 3: sort of use it as you need to grant that

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Speaker 3: depending on the agency, is anywhere from five to twenty

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Speaker 3: five percent of your total annual funds and is to

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Speaker 3: cover all of the folks who can afford care and

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Speaker 3: are uninshort.

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Speaker 4: Part of my funding also, I do a lot of

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Speaker 4: work with HIV and HIV prevention, so a lot of

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Speaker 4: my work is done via Ryan White funding, and there's

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Speaker 4: some other kind of separate funding streams that's applicable specifically

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Speaker 4: to gender firming care. However, it's all kind of messy

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Speaker 4: and tied up in a lot of those other funding

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Speaker 4: streams that Dan mentioned, and there's some specific limitations because

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Speaker 4: of those funding streams again historically because who knows right now,

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Speaker 4: but through something called the High Amendment, it means that

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Speaker 4: our funding would be at jeoparty if we provided abortion care.

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Speaker 4: So there are some kind of limitations. A lot of

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Speaker 4: what we do as an FQT is providing really comprehensive,

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Speaker 4: expansive care. We're kind of some of the few clinics

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Speaker 4: that do everything that we do under one roof, but

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Speaker 4: there have been some limitations specifically abortion to that.

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Speaker 1: Yeah, it's more of a healthcare experience. So I'm used

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Speaker 1: to with someone from Europe like going to one of

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Speaker 1: these centers and like the American one where you get

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Speaker 1: referral and then yeah, get it approved and blah blah blah,

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Speaker 1: and like a lot.

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Speaker 4: Of the ways that I talk to friends who live

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Speaker 4: in other countries, Like, I feel like my role is

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Speaker 4: kind of more similar to like a GP as a

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Speaker 4: nurse partitioner. There isn't necessarily an equivalent, but I feel

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Speaker 4: like a GP is kind of a very similar universal

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Speaker 4: way to understand a lot of what I do.

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Speaker 1: Yeah, that makes sense. So can you explain Ryan White funding?

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Speaker 1: Like where does that come from? Why is it called

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Speaker 1: Ryan White?

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Speaker 4: So basically, Ryan White Funding was initiated in I believe

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Speaker 4: the early nineties during the AIDS crisis and was a

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Speaker 4: large government initiative. It's named after Ryan White, who was

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Speaker 4: a patient who contracted HIV through a blood transfusion. Yeah,

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Speaker 4: so Ryan White funding right now is a major source

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Speaker 4: for funding things like PREP, which is medication for prevention

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Speaker 4: for HAV as well as direct HIV treatment.

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Speaker 1: Yeah, so a number of these things, right, gender affirming care,

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Speaker 1: perhaps care for people with HIV or preventing people from

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Speaker 1: getting HIV through pre exposure prophylaxis. Like you said, like

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Speaker 1: these are things that have been like like at the

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Speaker 1: center of the culture war for the current government, right,

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Speaker 1: like that they're like the things that they point to

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Speaker 1: is you know whatever they're sort of like Impacton's impacts

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Speaker 1: in Sunstruction of Fascist and he talks about moral decline, right,

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Speaker 1: and this is their moral decline that this is what

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Speaker 1: they use when they're constructing their kind of we will

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Speaker 1: save you narrative. What does that mean for funding? And

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Speaker 1: like what does that mean more importantly for your patients

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Speaker 1: of people who come to you for these different types

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Speaker 1: of care I mean, I.

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Speaker 4: Think it's terrifying. I think I'm more on the fusion

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Speaker 4: facing side. So a lot of the conversations I've been

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Speaker 4: having are just about the uncertainty. I'm a prescriber for

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Speaker 4: a lot of tras, youth adolescents and young adults, and

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Speaker 4: so moreover, the uncertainty of just being able to get

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Speaker 4: their medication. The stress of being publicly named and targeted

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Speaker 4: in this culture war has just created a climate of fear.

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Speaker 4: As my job, I want to be able to reassure

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Speaker 4: patients that I am going to fight for them and

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Speaker 4: do all that I can. But it's really scary. As

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Speaker 4: Dan mentioned, a lot of our patients don't have financial

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Speaker 4: safety net, they don't have a medical safety net. We're

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Speaker 4: really the one option for them, and if our clinic

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Speaker 4: does not continue to offer this type of care, these

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Speaker 4: are our kids who are going to go without hormones.

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Speaker 4: I prescribe puberty blockers. My work as a gender forming

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Speaker 4: care provider isn't just blockers and hormones, but those are

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Speaker 4: medications that we know are life saving. We know that

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Speaker 4: that unfortunately, kids will suicide if they don't have access

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Speaker 4: to those mendications, and so I think you know, talking

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Speaker 4: about funding, talking about kind of these bigger shifts politically,

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Speaker 4: you know, are sayings that unfortunately a lot of the

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Speaker 4: conversations I'm having are really coming just down to safety

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Speaker 4: and safety planning and figuring out support networks and talking

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Speaker 4: about creative ways to get hormones if if we can't

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Speaker 4: prescribe them.

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Speaker 3: Yeah, I think it's worth talking about the fact that,

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Speaker 3: like there are there are so many angles of attack

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Speaker 3: on this right, there is the one that is just

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Speaker 3: very clearly aimed at trans kids, right, the EO that

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Speaker 3: specifies like protecting children it's nonsense, but that is aimed

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Speaker 3: at ending this care everywhere.

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Speaker 4: Yeah.

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Speaker 3: Now are they going to be able to do it everywhere?

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Speaker 2: I don't know. Maybe, but not quickly.

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Speaker 3: But they can end it for FQHCs all across the

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Speaker 3: country by simply making it like the High Amendment. If

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Speaker 3: we were to perform abortion services at the place that

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Speaker 3: I work, then we would lose our three thirty funding

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Speaker 3: and we would lose our a FQ designation, which would

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Speaker 3: cut our rate in half, and that would devastate the

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Speaker 3: business and put us out and mean that we could

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Speaker 3: not care for the thousands and thousands and thousands of

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Speaker 3: other people that we care for besides those kids. Right,

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Speaker 3: then there are also the just the doge fuckery that

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Speaker 3: is going to harm all of this and may create

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Speaker 3: a lot of the same outcomes, right, which is they

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Speaker 3: turned off grants kind of just across the board. Yes,

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Speaker 3: some of them were targeted on things like gender affirming,

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Speaker 3: most of them were just like it's a grant, we're

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Speaker 3: turning it off. And then there was the tro but

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Speaker 3: much of that funding has remained frozen. We have been

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Speaker 3: told that the system is up and running and that

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Speaker 3: they undid what they did, and the courts stepped in,

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Speaker 3: and oh don't we have the courts still here in

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Speaker 3: the United States. Isn't that a good thing? But they

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Speaker 3: just kept the funding off. Whether because they're incompetent or

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Speaker 3: because they're actively defying the law doesn't really matter. And

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Speaker 3: as a result, federally qualified health centers all across the

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Speaker 3: country have laid people off, They have closed clinics and

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Speaker 3: have entirely gone underwater in some cases. And then those

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Speaker 3: people are not there to treat the community that needs

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Speaker 3: them so badly. And all of these systems are grounded

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Speaker 3: in their communities. So when you lose you know the

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Speaker 3: clinic that's in LA that had to close its doors

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Speaker 3: for the office that's on one side of town. The

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Speaker 3: people there knew that place. It was part of their community,

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Speaker 3: part of their existence. It was grounded in that community

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Speaker 3: and its community's needs. And that's just gone. And this

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Speaker 3: puts us in the very difficult position, and you know,

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Speaker 3: leadership in the very difficult position of figuring out, well,

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Speaker 3: do I worry about these trans youth and the fact

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Speaker 3: that they might kill themselves, or do I worry about

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Speaker 3: the impact that standing up on principle and saying I

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Speaker 3: won't toss them to the wolves might have on the

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Speaker 3: rest of the system. And it becomes a very difficult

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Speaker 3: sort of situation for us as providers to navigate. But

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Speaker 3: you know, in fairness to leadership, which I disagree with

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Speaker 3: for them too.

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Speaker 2: Yeah, that's tough.

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Speaker 1: Can you briefly explain that, maybe lay out a timeline

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Speaker 1: because we talked about executive order, Say we talked about

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Speaker 1: a tro like there was a large dumber of executive

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Speaker 1: orders right in the last three weeks, so like maybe

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Speaker 1: people miss them. Can you explain the pertinent executive orders?

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Speaker 1: And then what's a tentative?

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Speaker 2: Is training order. Yeah.

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Speaker 3: So on Trump's first day in office, on the day

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Speaker 3: of his inauguration, so January twentieth, he signs one hundred

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Speaker 3: some odd executive orders. The ones that are particularly of

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Speaker 3: interest to us in healthcare were protecting children against chemical

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Speaker 3: and surgical mutilation is the name of it, which is

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Speaker 3: a disgusting and vile name. Yeah, and then protecting women

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Speaker 3: something something something defending women, Yeah, defending women, which is

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Speaker 3: similarly aimed at transgender individuals and I think will be

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Speaker 3: used after we are under attack for trans youth, to

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Speaker 3: come after trans adults in federally qualified health centers as well.

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Speaker 3: Those eos led to Later that week, on Friday, we

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Speaker 3: got emails to every PI which is principal investor gator

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Speaker 3: on every federal grant that we had. That said because

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Speaker 3: of those two, and there was one about DEI which

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Speaker 3: also in executive order, you are not allowed to use

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Speaker 3: any of these grant dollars in service of anything in

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Speaker 3: defiance of these three executive orders. So that was the

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Speaker 3: first shot we got, and it came only four days later.

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Speaker 3: It's threatening, but it wasn't specific right, It didn't specifically

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Speaker 3: say we're going to do X, Y or Z but

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Speaker 3: it was here's a threat. The following Tuesday, dog is

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Speaker 3: let loose and announces that they are freezing federal grant

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Speaker 3: funding tied to anything that is in opposition to those things.

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Speaker 2: If you actually looked at.

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Speaker 3: The excel file that they released with the actual grants,

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Speaker 3: it froze everything. Like it was not just the stuff

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Speaker 3: that they felt was in opposition to this, it was

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Speaker 3: like everything. We have a ton of grants that were

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Speaker 3: on that list at the agency that I work at,

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Speaker 3: and boy, oh boy, oh boy, was there a lot

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Speaker 3: of panic going around. Wednesday rolls around and they get

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Speaker 3: a judge come in and sort of put a halt

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Speaker 3: on it. And then later that day a press secretary says, oh,

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Speaker 3: we're just going to send the memo. We're still going

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Speaker 3: to freeze everything, and then the judge comes back and

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Speaker 3: puts a temporary straining order. So in theory, what that

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Speaker 3: should have meant is that all of that grant funding

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Speaker 3: once again flows. And it did not importantly too for us,

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Speaker 3: given how much medicaid dollars we take in Medicaid portals,

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Speaker 3: and all fifty states went down, so we could not

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Speaker 3: get any of those dollars in service of what we

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Speaker 3: were doing for twelve hours, but still it was this

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Speaker 3: very concerning situation because medicaid was not on their list

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Speaker 3: of things that they were after, and yet we couldn't

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Speaker 3: even access it on the state level.

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Speaker 2: A few more weeks.

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Speaker 3: Go by and there's news popping about, Hey, you said

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Speaker 3: you unfroze stuff, but it's still frozen. Another judge issued

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Speaker 3: an order saying that, like, no, for real, I meet

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Speaker 3: at this time unfreeze everything. I know some of the

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Speaker 3: grants that we had that we couldn't access seem to

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Speaker 3: have come back online, but I don't know, you know,

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Speaker 3: I think it would be an impossible thing to do

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Speaker 3: an accounting of like every single one that might have

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Speaker 3: been turned off that might might or might not be

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Speaker 3: back on right now. But I am doubtful that at

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Speaker 3: this point every single grant across the federal agency is

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Speaker 3: potentially available for folks.

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Speaker 2: Just seems unlikely to me.

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Speaker 1: Yeah, we should pivot to advertisements here, So I'm going

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Speaker 1: to do that and then we'll.

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Speaker 2: Be right back. Okay, we are back.

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Speaker 1: So you talked about like these grants being turned off

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Speaker 1: or not coming.

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Speaker 2: What does that mean?

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Speaker 1: Does that mean people don't get care? Does that mean

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Speaker 1: providers don't get paid, does that mean they can't access

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Speaker 1: their prescriptions? Like, what does it look like if I'm

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Speaker 1: trying to access care through one of your clinics.

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Speaker 4: So yeah, I'll speak to that a little bit on

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Speaker 4: the prescriber side, because I think, you know, having direct

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Speaker 4: contact with someone who works into the administration is really

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Speaker 4: the only way that I I have really been able

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Speaker 4: to get any updates. So as a healthcare provider, it's

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Speaker 4: been out or chaos. Basically every day we've gotten different

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Speaker 4: messaging around whether or not appointments can be scheduled, new patients,

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Speaker 4: can you know, schedule intakes, whether or not we're able

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Speaker 4: to prescribe these life saving medications, and no one knows exactly.

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Speaker 4: Gender firming care is basically healthcare. There's nothing that separates it.

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Speaker 4: There's no hard line, there's no clear distinction. It is

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Speaker 4: medically indicated, evidence based care. So saying you can't do

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Speaker 4: gender firming care, it literally doesn't make any sense in

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Speaker 4: terms of you know, what we do as prescribers. And

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Speaker 4: on my end, I've been faced with intimidation, I've been

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Speaker 4: faced with kind of whisper networks of misinformation coming from

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Speaker 4: administration trying to get us to stop prescribing because they

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Speaker 4: do see this type of care as a liability. I'm

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Speaker 4: still prescribing. There is no state law in the state

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Speaker 4: that I am in that prevents my ability to act

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Speaker 4: as to the full extent of my scope. There are

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Speaker 4: also no medical indications for me to stop prescribing, and

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Speaker 4: I'm ethically bound as a nurse practitioner to do what

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Speaker 4: I believe is best for my patients, which is to

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Speaker 4: continue to provide them with a care that they need.

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Speaker 4: But it's terrifying.

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Speaker 3: I think importantly, Haley and I have the eventage of

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Speaker 3: working for a more economically stable institution. There's a lot

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Speaker 3: of health clinics out there that have a week's worth

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Speaker 3: of working capital, right, so if all of a sudden

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Speaker 3: they lose access to every grant dollar, it lose access

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Speaker 3: to their three thirty. They were scheduled to draw down

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Speaker 3: on a grant that was going to cover a whole

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Speaker 3: bunch of upcoming expenses, but they haven't done it yet,

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Speaker 3: and then they can't, Like in very real ways, that

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Speaker 3: may mean that the doors are closed and the place

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Speaker 3: goes under and that no one can get care there.

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Speaker 3: And there is this real challenge of you know, how

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Speaker 3: do we decide what is the best thing to do.

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Speaker 3: But for me and what sort of started working with

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Speaker 3: in our agency at least to organize around this is

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Speaker 3: that like, this is an anti fascist practice. That is

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Speaker 3: the right medical thing to do, It is the right

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Speaker 3: ethical thing to do, But it is also our chance

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Speaker 3: to take an anti fascist stance against this government because

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Speaker 3: if we don't stand now for the very first group

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Speaker 3: they're coming for, then the next group, which is without

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Speaker 3: question trans adults and undocumented people, then those groups will

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Speaker 3: fall just as quickly. And then at some point we're

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Speaker 3: doing the poem the first they came for, the socialist thing,

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Speaker 3: and I just refused to be a part of that.

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Speaker 1: Yeah, let's talk about what that means then, Like, like

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Speaker 1: you said, it's difficult to get any response from administration

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Speaker 1: right in terms of what you can do, in terms

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Speaker 1: what you can't do. How are staff and providers organizing

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Speaker 1: to make sure that they're able to keep providing for

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Speaker 1: their patients?

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Speaker 4: So just to provide also like a little bit of

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Speaker 4: a peek into kind of the broader landscape of this.

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Speaker 4: Our clinic is not alone in their confusion on how

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Speaker 4: they've been handling this not only FQHCs, but also hospital

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Speaker 4: affiliated clinics, academic medical clinics have basically clinic by clinic

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Speaker 4: decided on their own plan on how to manage this,

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Speaker 4: which is also incredibly confusing for providers and for patients.

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Speaker 4: But something that was really heartening was that NYU laying gone.

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Speaker 4: This was in the news recently. They canceled appointments for

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Speaker 4: two kids, literally just two kids, which is more than enough,

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Speaker 4: and it sparked this enormous outcry and protests. And so

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Speaker 4: I think there's also, on my end, a lot of

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Speaker 4: solidarity building with other providers who are doing this work,

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Speaker 4: and a lot of inspiration. There are clinics out there,

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Speaker 4: some who are FQHCs like us, who have stood firm

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Speaker 4: and they've said our doors are going to stay open,

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Speaker 4: We're going to keep providing this care, and so I

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Speaker 4: think they're there are models out there, and I think

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Speaker 4: that there are networks of healthcare providers who are committed

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Speaker 4: to continue to advocate and just continue to do this

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Speaker 4: right because a lot of what we're facing right now

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Speaker 4: is intimidation. It's not actual legal threats.

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Speaker 2: As of yet.

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Speaker 3: Yeah, I think the organizing side has been challenging but

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Speaker 3: also hugely rewarding. Right, it became really obvious really early

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Speaker 3: on that both from the federal government's perspective as well

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Speaker 3: as from our organization's perspective, that the uncertainty was where

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Speaker 3: they wanted us all to live and die. That was

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Speaker 3: the place that served them and their goals the most.

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Speaker 3: And so how does uncertainty sort of foster Well, people

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Speaker 3: don't talk to one another, right, Like this is true,

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Speaker 3: kind of an organizational census across the board. Right, if

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Speaker 3: you're in the union, you don't talk about your salary

383
00:19:50,320 --> 00:19:52,719
Speaker 3: doesn't benefit you, it benefits the boss. And so if

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Speaker 3: we're not talking to one another about where our lines are,

385
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Speaker 3: who we're going to treat, whether we're going to keep

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Speaker 3: doing it, or listen to them what we're being told,

387
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Speaker 3: we're not being told that we're consulting lawyers all these

388
00:20:02,040 --> 00:20:04,119
Speaker 3: other kind of things, then we're all just alone in

389
00:20:04,160 --> 00:20:07,320
Speaker 3: the dark kind of you know, trying not to scream

390
00:20:07,359 --> 00:20:09,720
Speaker 3: and cry about the horrors that are happening around us.

391
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Speaker 3: So we pulled together folks with conversation here, conversation there.

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Speaker 3: Folks who before anything was going on internally, you know,

393
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Speaker 3: made really bold statements about what they would and would

394
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Speaker 3: not do around this kind of stuff, And now all

395
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Speaker 3: of a sudden, there's an internal network that's looking at well, Okay,

396
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Speaker 3: So individually we can keep doing this care because it's

397
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Speaker 3: the right thing to do. But as a group, if

398
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Speaker 3: they start coming after us, we have a lot more power.

399
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Speaker 3: There's a lot more that we can do. And I suspect,

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Speaker 3: and you know, Hayley's getting at this point that like,

401
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Speaker 3: there are probably a network of us across the entire

402
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Speaker 3: country in these kind of settings that are not talking

403
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Speaker 3: amongst ourselves at our workplace, but are really not talking

404
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Speaker 3: about it amongst.

405
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Speaker 2: Ourselves on a national level.

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Speaker 3: And I think we have some power that could be

407
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Speaker 3: used there to really make a difference in all of this.

408
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Speaker 3: And I am optimistic that if we talk about this,

409
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Speaker 3: we get to out there, we make sure everyone's communicating

410
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Speaker 3: openly about it, that there's a real possibility that we

411
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Speaker 3: can work together to prevent this from being the first

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Speaker 3: of many dominoes to fall.

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Speaker 4: And one thing that's interesting, I think is that with transhealthcare,

414
00:21:12,680 --> 00:21:17,600
Speaker 4: transhelscare is inherently radical, Like transhalscare is not something that

415
00:21:17,760 --> 00:21:22,080
Speaker 4: came from the kind of medical hierarchy. This is by

416
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Speaker 4: and large a field that was communal trans people were

417
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Speaker 4: doing their own trans healthcare before it became kind of

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Speaker 4: institutionalized into a lot of these spaces. So I think

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Speaker 4: we also have a lot of providers who are willing

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Speaker 4: to function up right. Like the community and the providers

421
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Speaker 4: are intertwined, and I do think there is a real

422
00:21:45,359 --> 00:21:49,440
Speaker 4: kind of radical bent to this type of work, which

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Speaker 4: is why I think a lot of us have been

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Speaker 4: so easily able to collectivize and strategize and kind of

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Speaker 4: come together. It's a pretty small.

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Speaker 2: World as well.

427
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Speaker 3: We sat down on a call and talked about, you know,

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Speaker 3: what are we going to do? And I made mention

429
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Speaker 3: that like, oh, through my other organizing work, I've got

430
00:22:07,680 --> 00:22:10,159
Speaker 3: a DIY connection for us to dial. So that's a

431
00:22:10,280 --> 00:22:12,960
Speaker 3: huge thing that will help us if we can't prescribe

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00:22:13,000 --> 00:22:15,800
Speaker 3: this anymore, if Medicaid stops covering it, yah, YadA, YadA.

433
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Speaker 2: I was like, but I don't have a you know,

434
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Speaker 2: a DIY solution for TEA.

435
00:22:18,760 --> 00:22:21,440
Speaker 3: If anyone knows of anybody, that'd be great, And immediately

436
00:22:21,480 --> 00:22:23,159
Speaker 3: someone's like, oh, yeah, absolutely, I do.

437
00:22:23,240 --> 00:22:23,720
Speaker 2: It's tested.

438
00:22:23,760 --> 00:22:26,120
Speaker 3: It's a ninety nine point nine percent pure we're ready

439
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Speaker 3: to go.

440
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Speaker 2: So now, like I wouldn't have done that.

441
00:22:28,200 --> 00:22:29,560
Speaker 3: There was no way for us to know that that

442
00:22:29,640 --> 00:22:31,560
Speaker 3: was the kind of radical work that people were doing

443
00:22:31,600 --> 00:22:33,840
Speaker 3: if not for coming together on this kind of stuff.

444
00:22:34,160 --> 00:22:38,119
Speaker 1: Yeah, maybe we should explain like the inherent risks, like

445
00:22:38,240 --> 00:22:42,520
Speaker 1: legally and then then distinction between those two hormones legally, right,

446
00:22:42,600 --> 00:22:44,160
Speaker 1: like if people are unaware.

447
00:22:44,560 --> 00:22:47,879
Speaker 4: Yeah, so you know, as a medical provider again, I

448
00:22:47,960 --> 00:22:51,040
Speaker 4: have to be a little bit careful here. But basically

449
00:22:51,080 --> 00:22:54,880
Speaker 4: because the stone has been used by mostly the cistmail

450
00:22:55,000 --> 00:23:00,280
Speaker 4: community as an anabolic steroid and used you know somewhat

451
00:23:00,320 --> 00:23:04,200
Speaker 4: would call it like animalic steroid misuse or steried use disorder.

452
00:23:04,960 --> 00:23:09,200
Speaker 4: It is a controlled substance. Estradial is not. They're both

453
00:23:09,240 --> 00:23:13,800
Speaker 4: bioidentical hormones. Every human on this planet, their body makes

454
00:23:14,600 --> 00:23:18,000
Speaker 4: estrogen and testosterone E and T estradyle and testosterone. However,

455
00:23:18,480 --> 00:23:23,159
Speaker 4: in the United States, testosterone is considered a controlled substance,

456
00:23:23,520 --> 00:23:26,440
Speaker 4: which makes it a little more tricky for folks to

457
00:23:27,400 --> 00:23:30,960
Speaker 4: access without a prescription and also can put them at

458
00:23:31,040 --> 00:23:32,639
Speaker 4: legal risk if they do so.

459
00:23:33,400 --> 00:23:35,880
Speaker 1: Right, Like, there's a built in legal consequence for people

460
00:23:35,920 --> 00:23:38,440
Speaker 1: who are trying to manufacture there or who are trying

461
00:23:38,480 --> 00:23:41,520
Speaker 1: to obtain it like outside of the sort of prescription system,

462
00:23:41,720 --> 00:23:45,320
Speaker 1: not that there aren't other probably legal threats coming down

463
00:23:45,400 --> 00:23:46,399
Speaker 1: the pipeline, I guess.

464
00:23:46,640 --> 00:23:51,200
Speaker 5: Also, testosterone is yes, it is a controlled substance. It

465
00:23:51,280 --> 00:23:54,160
Speaker 5: does flow in the bodybuilding community.

466
00:23:54,200 --> 00:23:55,720
Speaker 1: Yeah, it's not well controlled.

467
00:23:56,400 --> 00:24:00,119
Speaker 5: Yeah, that is also like worth stating because yeah, so

468
00:24:00,119 --> 00:24:01,760
Speaker 5: if you go to your average gym.

469
00:24:02,880 --> 00:24:05,320
Speaker 1: Oh yeah, you can walk across the borders to Tijuana

470
00:24:05,440 --> 00:24:10,440
Speaker 1: and see like gas stations have the prices like unleaded premium. Yeah,

471
00:24:10,480 --> 00:24:13,680
Speaker 1: you can get testosterone prices like displayed in the same fashion.

472
00:24:13,960 --> 00:24:16,840
Speaker 4: I mean, I'm sure you're you're huge fans of Joe Rogan.

473
00:24:17,200 --> 00:24:22,280
Speaker 4: So many many of my other patients who are not

474
00:24:22,440 --> 00:24:27,960
Speaker 4: trans have been influenced to purchase disasterone because of our

475
00:24:28,080 --> 00:24:28,679
Speaker 4: good friends.

476
00:24:30,080 --> 00:24:31,320
Speaker 1: Yeah, yeah, fascinating.

477
00:24:32,320 --> 00:24:34,640
Speaker 3: Which is also gender affirming care for whatever that's worth,

478
00:24:34,760 --> 00:24:37,320
Speaker 3: like gender firm in care too.

479
00:24:37,760 --> 00:24:40,640
Speaker 1: Yes they do. It's a little easier for them. Right now,

480
00:24:51,200 --> 00:24:56,080
Speaker 1: So let's talk about like what this organizing looks like

481
00:24:56,440 --> 00:24:59,800
Speaker 1: on the ground, right, Like if someone's working, maybe they're

482
00:24:59,800 --> 00:25:02,320
Speaker 1: not in an f QHC, right, maybe they're working in

483
00:25:02,320 --> 00:25:06,000
Speaker 1: academic health center. Maybe they're working you know, in one

484
00:25:06,040 --> 00:25:07,840
Speaker 1: of the many other places where you can access gender

485
00:25:07,880 --> 00:25:10,439
Speaker 1: affirming care in this country, and they are feeling like

486
00:25:10,560 --> 00:25:15,520
Speaker 1: alone or they're scared, and they're not receiving any affirmation

487
00:25:15,680 --> 00:25:18,359
Speaker 1: or help from their management, and they don't know who

488
00:25:18,359 --> 00:25:22,080
Speaker 1: they can talk to among their colleagues. Like how are

489
00:25:22,119 --> 00:25:28,080
Speaker 1: people connecting? Like what are people talking about? And like

490
00:25:28,240 --> 00:25:31,360
Speaker 1: how can people who are because you know, the healthcare

491
00:25:31,400 --> 00:25:34,280
Speaker 1: system is vast in this country because it duplicates itself

492
00:25:34,320 --> 00:25:37,600
Speaker 1: because's the nature of American privatized healthcare. Like, how can

493
00:25:37,640 --> 00:25:40,679
Speaker 1: people who want to continue providing care for patients do that?

494
00:25:40,960 --> 00:25:43,000
Speaker 1: How do they organize their colleagues? How do they contac

495
00:25:43,040 --> 00:25:45,320
Speaker 1: people who are already organizing, Like, let's talk through that

496
00:25:45,480 --> 00:25:46,320
Speaker 1: nuts and bolts of it.

497
00:25:46,480 --> 00:25:49,280
Speaker 4: I mean, I think there's a lot of national orgs

498
00:25:49,359 --> 00:25:52,000
Speaker 4: out there that are really doing the work. So if

499
00:25:52,000 --> 00:25:55,840
Speaker 4: you're a medical provider, I would highly recommend to join Glamour,

500
00:25:55,920 --> 00:26:00,800
Speaker 4: which is a gain lesbian medical association, because they have

501
00:26:01,280 --> 00:26:04,960
Speaker 4: some lawsuits and as a member of GLAMMA.

502
00:26:04,640 --> 00:26:06,960
Speaker 2: That could possibly give you some additional protection.

503
00:26:07,880 --> 00:26:12,560
Speaker 4: Following other orgs like Lambda Legal Stage, which is an

504
00:26:12,640 --> 00:26:17,840
Speaker 4: organization for an elder gay lesbian and queer folks. Trans

505
00:26:18,040 --> 00:26:23,000
Speaker 4: people have existed and have built organizations. A lot of

506
00:26:23,000 --> 00:26:27,600
Speaker 4: those organizations are fighting this on a national level, and

507
00:26:28,240 --> 00:26:32,080
Speaker 4: some of those are more geared toward healthcare professionals like Glamma.

508
00:26:32,880 --> 00:26:35,680
Speaker 3: I would say, there's two conversations that we all need

509
00:26:35,720 --> 00:26:38,199
Speaker 3: to be having. Like those external organizations are huge and

510
00:26:38,480 --> 00:26:42,879
Speaker 3: necessary for direction within your own space, you have to

511
00:26:42,880 --> 00:26:44,960
Speaker 3: talk to your colleagues in a way that's honest and

512
00:26:45,440 --> 00:26:48,040
Speaker 3: talk to them about risk taking. Talk to them about

513
00:26:48,080 --> 00:26:50,800
Speaker 3: where you will and will not budge on some of

514
00:26:50,840 --> 00:26:53,400
Speaker 3: these kind of things. Talk to them about the value

515
00:26:53,480 --> 00:26:55,560
Speaker 3: of the work that you all do, because there's more

516
00:26:55,560 --> 00:26:58,400
Speaker 3: of you doing it. Talk to your trans colleagues. They exist,

517
00:26:58,480 --> 00:27:00,919
Speaker 3: they're out there like they have very strong opinions on this,

518
00:27:01,040 --> 00:27:03,880
Speaker 3: I am sure. And then talk to a lawyer. Talk

519
00:27:03,920 --> 00:27:09,119
Speaker 3: to an employment lawyer, because your corporate attorneys have very

520
00:27:09,160 --> 00:27:12,600
Speaker 3: different goals than you do. Their goal is simply to

521
00:27:12,720 --> 00:27:17,119
Speaker 3: protect the company and its bottom line, and both they

522
00:27:17,440 --> 00:27:21,040
Speaker 3: and the federal government and the sort of DOJ are

523
00:27:21,080 --> 00:27:25,760
Speaker 3: spewing absolute bullshit. So don't let them flood the zone

524
00:27:25,880 --> 00:27:29,600
Speaker 3: with nonsense. Get a lawyer who can tell you what's nonsense,

525
00:27:29,760 --> 00:27:33,160
Speaker 3: and stand firmly in that because it is. And then

526
00:27:33,200 --> 00:27:36,520
Speaker 3: when you start thinking about as an organization, as a group,

527
00:27:36,560 --> 00:27:40,720
Speaker 3: as a set of employees communicating with you know, leadership

528
00:27:40,720 --> 00:27:42,879
Speaker 3: about these kind of things, know that the law is

529
00:27:42,920 --> 00:27:45,560
Speaker 3: actually not on their side, it's on yours, and let

530
00:27:45,560 --> 00:27:48,040
Speaker 3: them know that they are exposing themselves to vulnerability for

531
00:27:48,160 --> 00:27:52,280
Speaker 3: malpractice and for civil rights violations and any number of

532
00:27:52,280 --> 00:27:54,080
Speaker 3: other things that they probably don't want to be on

533
00:27:54,119 --> 00:27:57,560
Speaker 3: the hook for. This is the leverage that we've got

534
00:27:57,680 --> 00:27:59,760
Speaker 3: right now. It seems to have slid things down a

535
00:27:59,760 --> 00:28:02,600
Speaker 3: little a little bit internally for us that they've had to

536
00:28:02,640 --> 00:28:06,720
Speaker 3: confront like a very well pointed out legal opinion that

537
00:28:06,800 --> 00:28:10,320
Speaker 3: said that like they were exposing their providers to civil

538
00:28:10,359 --> 00:28:12,920
Speaker 3: lawsuits if they didn't do this, and that the FDCA,

539
00:28:13,400 --> 00:28:16,200
Speaker 3: the Federal Tort Claims Act, didn't protect people under these guides.

540
00:28:16,640 --> 00:28:19,640
Speaker 3: That has been really beneficial to us. The other thing

541
00:28:19,680 --> 00:28:21,920
Speaker 3: I would say is like there's a real union sort

542
00:28:21,960 --> 00:28:24,320
Speaker 3: of feel to a lot of this, And as we

543
00:28:24,480 --> 00:28:26,720
Speaker 3: started coming together, a bunch of us realize, well, we

544
00:28:26,840 --> 00:28:30,359
Speaker 3: all kind of had union conversations somewhere along the way,

545
00:28:30,760 --> 00:28:34,080
Speaker 3: but corporate unions and like SEIU represents a lot of

546
00:28:34,160 --> 00:28:37,520
Speaker 3: like individual sort of arms of companies like the ones

547
00:28:37,560 --> 00:28:41,520
Speaker 3: that we work at. They aren't interested in the politics

548
00:28:41,560 --> 00:28:43,920
Speaker 3: of the work you do. They are interested in your benefits,

549
00:28:43,920 --> 00:28:46,160
Speaker 3: they are interested in you as a worker, but they're

550
00:28:46,200 --> 00:28:50,320
Speaker 3: not interested in like your relationship to the work. And

551
00:28:50,400 --> 00:28:53,640
Speaker 3: so we are approaching this not necessarily as a union,

552
00:28:53,960 --> 00:28:56,080
Speaker 3: but from the perspective that if we need to strike

553
00:28:56,560 --> 00:29:00,400
Speaker 3: on behalf of patients and their access to care, that's

554
00:29:00,400 --> 00:29:02,400
Speaker 3: a tool in our toolblocks, and we don't have to

555
00:29:02,760 --> 00:29:04,560
Speaker 3: do anything more than declare it to strike to be

556
00:29:04,560 --> 00:29:06,960
Speaker 3: protected under the NLRB and some of these various different things.

557
00:29:07,360 --> 00:29:09,560
Speaker 3: And we can do it for political reasons instead of

558
00:29:09,560 --> 00:29:11,440
Speaker 3: for pay reasons, which means we could do it as

559
00:29:11,440 --> 00:29:14,000
Speaker 3: a diverse group instead of as all the nurses, all

560
00:29:14,040 --> 00:29:17,880
Speaker 3: the advanced practice providers, all of the psychologists and therapists

561
00:29:17,880 --> 00:29:21,520
Speaker 3: and lcsws, where they break us apart by discipline instead

562
00:29:21,560 --> 00:29:22,640
Speaker 3: of by.

563
00:29:22,280 --> 00:29:25,440
Speaker 2: You know what sort of managerial status you are.

564
00:29:26,080 --> 00:29:28,320
Speaker 1: Yeah, yeah, I think that's a very good point. I

565
00:29:28,400 --> 00:29:31,600
Speaker 1: read a book recently about how the long shoremen in

566
00:29:31,600 --> 00:29:37,160
Speaker 1: San Francisco stopped weapons going to the gil by striking

567
00:29:37,160 --> 00:29:40,000
Speaker 1: and refusing to load weapons onto ships and like that's

568
00:29:40,040 --> 00:29:43,040
Speaker 1: a union energy we could use right now. Yeah, yeah,

569
00:29:43,040 --> 00:29:45,720
Speaker 1: I think people be well advised to, Like I will

570
00:29:45,720 --> 00:29:47,800
Speaker 1: say that they'd be well advised to check with federal

571
00:29:47,840 --> 00:29:50,800
Speaker 1: and local law because like some state legal landscapes can

572
00:29:50,840 --> 00:29:54,640
Speaker 1: be very different. Right. I want to end with like,

573
00:29:55,200 --> 00:29:58,160
Speaker 1: people are probably afraid of accessing care, right, Like people

574
00:29:58,160 --> 00:30:02,440
Speaker 1: are probably afraid of going to see their providers, like understandably,

575
00:30:02,560 --> 00:30:06,880
Speaker 1: like you said before, like especially kids or people under

576
00:30:06,880 --> 00:30:10,400
Speaker 1: eighteen are like right in the center. The President of

577
00:30:10,400 --> 00:30:12,880
Speaker 1: the United States called out a friend of mine personally

578
00:30:12,920 --> 00:30:18,160
Speaker 1: by name recently. She's a trans athlete, and like they're

579
00:30:18,200 --> 00:30:20,600
Speaker 1: really coming up to people. I understand that people are afraid,

580
00:30:20,640 --> 00:30:22,840
Speaker 1: Like what should they know if they're concerned about their

581
00:30:23,160 --> 00:30:27,080
Speaker 1: hormone supply or they're own puberty blockers? Right now, like

582
00:30:27,960 --> 00:30:30,280
Speaker 1: people are listening, what would you Maybe they don't know

583
00:30:30,320 --> 00:30:33,400
Speaker 1: where their provider stands, you know, Yeah.

584
00:30:33,040 --> 00:30:36,240
Speaker 4: I mean I tell my patients, says, But I'm in

585
00:30:36,360 --> 00:30:40,080
Speaker 4: awe of them. They're incredible. And a lot of them

586
00:30:40,160 --> 00:30:44,840
Speaker 4: are nerdy theater kids who love cats and they want

587
00:30:44,880 --> 00:30:48,600
Speaker 4: to just exist. And some of them are also incredible

588
00:30:48,720 --> 00:30:54,880
Speaker 4: outspoken activists. They are just amazing, And I will fight

589
00:30:55,800 --> 00:30:59,760
Speaker 4: with everything that I've got for them, and I really

590
00:30:59,800 --> 00:31:00,560
Speaker 4: hope they know that.

591
00:31:01,320 --> 00:31:03,760
Speaker 3: I think one of the mantras I've been given to

592
00:31:03,800 --> 00:31:06,200
Speaker 3: fellow colleagues as well as to our leadershift to like

593
00:31:06,360 --> 00:31:09,960
Speaker 3: get their heads on straight, is that like pascism is messy, right,

594
00:31:10,000 --> 00:31:13,600
Speaker 3: Like it's a scary messy. There are a lot of

595
00:31:13,640 --> 00:31:15,720
Speaker 3: throwing stuff with the law on sea and what sticks,

596
00:31:16,240 --> 00:31:19,440
Speaker 3: but the things that in theory are still in place,

597
00:31:20,200 --> 00:31:23,200
Speaker 3: like when and if they fall, we have different problems

598
00:31:23,200 --> 00:31:25,760
Speaker 3: than the ones we're facing now. Right, So we still

599
00:31:25,800 --> 00:31:30,440
Speaker 3: have in this country protections for your healthcare information. So

600
00:31:30,480 --> 00:31:32,520
Speaker 3: if what you worry about in going to the doctor

601
00:31:32,600 --> 00:31:34,320
Speaker 3: is that someone will find out that your trends and

602
00:31:34,360 --> 00:31:35,760
Speaker 3: put you on a list, like, I can't tell you

603
00:31:35,800 --> 00:31:38,120
Speaker 3: that's never going to happen, but I can tell you

604
00:31:38,160 --> 00:31:40,840
Speaker 3: that if it happens through your healthcare clinic, Like, we

605
00:31:40,920 --> 00:31:44,400
Speaker 3: have significantly changed the threat model that we're all living

606
00:31:44,400 --> 00:31:47,880
Speaker 3: in because HIPPA doesn't matter anymore and doesn't exist. Your

607
00:31:47,880 --> 00:31:51,280
Speaker 3: providers are spending enormous amounts of time thinking carefully about

608
00:31:51,320 --> 00:31:53,560
Speaker 3: how they document, where they document, how much of a

609
00:31:53,600 --> 00:31:55,360
Speaker 3: deal they want to make it, whether or not they

610
00:31:55,360 --> 00:31:58,320
Speaker 3: can change the thing they're prescribing for you and what

611
00:31:58,360 --> 00:32:01,800
Speaker 3: diagnosis is for We are finding ways to sort of

612
00:32:02,000 --> 00:32:05,040
Speaker 3: throw as much cover and shade and you know, camouflage

613
00:32:05,040 --> 00:32:08,200
Speaker 3: over this as we can. But you shouldn't not come

614
00:32:08,280 --> 00:32:10,880
Speaker 3: get care. Your life matters. You being in the body

615
00:32:11,040 --> 00:32:13,960
Speaker 3: that you were meant to have matters. Come talk to us,

616
00:32:14,200 --> 00:32:16,320
Speaker 3: come ask for help. We're here to do it, and

617
00:32:16,360 --> 00:32:18,800
Speaker 3: we're not going to stop until they make us. And

618
00:32:19,000 --> 00:32:21,680
Speaker 3: right now they can't make us, and so we're going to.

619
00:32:21,720 --> 00:32:22,240
Speaker 2: Keep doing it.

620
00:32:22,880 --> 00:32:25,920
Speaker 4: And I think the mantra of trans people have always existed.

621
00:32:26,240 --> 00:32:29,920
Speaker 4: Trans people exist, and personally, I'm going to do my

622
00:32:30,000 --> 00:32:32,600
Speaker 4: best to make sure that for every single one of

623
00:32:32,600 --> 00:32:36,240
Speaker 4: my patients that they continue to get what they need.

624
00:32:36,600 --> 00:32:37,520
Speaker 4: However that looks like.

625
00:32:38,120 --> 00:32:39,800
Speaker 5: Then it is good to hear. I know a lot

626
00:32:39,840 --> 00:32:44,440
Speaker 5: of trans people have essentially trauma with aspects of the

627
00:32:44,480 --> 00:32:49,480
Speaker 5: medical community, establishment, whatever, and like you know, not not

628
00:32:49,680 --> 00:32:53,080
Speaker 5: all practitioners, maybe as much in our camp as maybe

629
00:32:53,120 --> 00:32:56,000
Speaker 5: you are. And I would encourage people as they are

630
00:32:56,000 --> 00:32:59,080
Speaker 5: if they're still looking for care through like these these

631
00:32:59,280 --> 00:33:01,800
Speaker 5: sorts of channels, you should you should try to find

632
00:33:01,800 --> 00:33:04,680
Speaker 5: out where other trans people in your city are already going. Yes,

633
00:33:05,040 --> 00:33:08,400
Speaker 5: there's certainly like clinics will have stuff on the website

634
00:33:08,400 --> 00:33:11,160
Speaker 5: that indicate that they either specialize in this or they

635
00:33:11,240 --> 00:33:13,880
Speaker 5: offer this as opposed to you know, maybe just a

636
00:33:14,040 --> 00:33:17,520
Speaker 5: general general practitioner who may not be you know, the

637
00:33:17,600 --> 00:33:19,959
Speaker 5: greatest in this vein, and like this, this still happens.

638
00:33:20,000 --> 00:33:22,760
Speaker 5: I've I've talked to a lot of friends recently who've

639
00:33:22,760 --> 00:33:28,480
Speaker 5: spoken about having increasingly uncomfortable experiences with nurses or doctors

640
00:33:28,720 --> 00:33:31,240
Speaker 5: where they're trying out like different clinics or different or

641
00:33:31,280 --> 00:33:35,800
Speaker 5: different providers, university providers. So it is definitely worth doing

642
00:33:35,840 --> 00:33:38,640
Speaker 5: some research beforehand so you know the place you're going

643
00:33:39,120 --> 00:33:41,960
Speaker 5: is going to be like with you. Which is just

644
00:33:42,000 --> 00:33:45,120
Speaker 5: an unfortunate reality of being trands. But that is that

645
00:33:45,160 --> 00:33:46,840
Speaker 5: has been the case for for a long time and

646
00:33:46,840 --> 00:33:49,960
Speaker 5: it only continues to be a factor when when considering care.

647
00:33:50,400 --> 00:33:53,960
Speaker 3: Absolutely it's really important to ask ask your friends that

648
00:33:54,000 --> 00:33:57,200
Speaker 3: that's that's really solid advice, in part because whether I

649
00:33:57,280 --> 00:33:59,640
Speaker 3: like it or not, a lot of organizations are taking

650
00:33:59,640 --> 00:34:02,560
Speaker 3: the stuff that says, hey we treat trans people down

651
00:34:02,600 --> 00:34:04,560
Speaker 3: off their website, off their marketing materials.

652
00:34:04,600 --> 00:34:06,080
Speaker 2: We are not trying to draw that attention.

653
00:34:06,320 --> 00:34:08,239
Speaker 3: It doesn't mean we don't do it doesn't mean we're

654
00:34:08,280 --> 00:34:11,280
Speaker 3: not skilled and trained and educated and smart and passionate

655
00:34:11,280 --> 00:34:11,680
Speaker 3: about it.

656
00:34:11,680 --> 00:34:12,879
Speaker 2: It just means we.

657
00:34:12,840 --> 00:34:15,640
Speaker 3: Don't really want to totally fly a trans flag on

658
00:34:15,640 --> 00:34:18,359
Speaker 3: the roof right now because it's just going to cause

659
00:34:18,360 --> 00:34:21,120
Speaker 3: everybody harm. So talk to your friends, talk to people

660
00:34:21,120 --> 00:34:23,680
Speaker 3: in your community. They know us, we know them. I

661
00:34:23,719 --> 00:34:26,680
Speaker 3: have a lot of activism experience outside of my work,

662
00:34:26,719 --> 00:34:29,279
Speaker 3: and it's amazing how many of those people end up

663
00:34:29,280 --> 00:34:32,200
Speaker 3: being the same people that are in this conversation because

664
00:34:32,239 --> 00:34:33,680
Speaker 3: of the way that this all works.

665
00:34:33,840 --> 00:34:34,080
Speaker 2: Yeah.

666
00:34:34,160 --> 00:34:35,920
Speaker 4: Yeah, I was just going to say, I think, unfortunately,

667
00:34:35,960 --> 00:34:39,160
Speaker 4: it is the norm, and evidence shows that, like large

668
00:34:39,200 --> 00:34:44,000
Speaker 4: evidence of studies show that trans people are treated pretty

669
00:34:44,200 --> 00:34:48,520
Speaker 4: horribly by the healthcare system, and most of my patients

670
00:34:48,560 --> 00:34:51,279
Speaker 4: have experienced that in some way or another. But like

671
00:34:51,400 --> 00:34:54,160
Speaker 4: I was talking about before, a lot of trans healthcare

672
00:34:54,280 --> 00:34:57,840
Speaker 4: kind of comes from a DIY community, and there's a

673
00:34:57,920 --> 00:35:01,560
Speaker 4: lot of really good community information about, you know, kind

674
00:35:01,560 --> 00:35:03,120
Speaker 4: of who to trust and who you can go to

675
00:35:03,840 --> 00:35:06,200
Speaker 4: in terms of finding an allied provider.

676
00:35:07,239 --> 00:35:09,000
Speaker 1: Yeah, yeah, I think that's really good.

677
00:35:09,719 --> 00:35:10,680
Speaker 2: I think that was really great.

678
00:35:10,680 --> 00:35:10,799
Speaker 4: Guy.

679
00:35:10,840 --> 00:35:12,839
Speaker 1: Thank you so much for your time and for your

680
00:35:13,239 --> 00:35:15,759
Speaker 1: words for people is there anything else you want to share,

681
00:35:15,880 --> 00:35:18,880
Speaker 1: or perhaps if people want to support your efforts somehow

682
00:35:19,000 --> 00:35:21,279
Speaker 1: or support people's access to care, there's an organization you

683
00:35:21,320 --> 00:35:23,960
Speaker 1: could direct them to, or maybe like the way people

684
00:35:24,000 --> 00:35:26,279
Speaker 1: coming shout out to you, or I know a lot

685
00:35:26,280 --> 00:35:28,120
Speaker 1: of people. There are people in my family who are

686
00:35:28,120 --> 00:35:32,440
Speaker 1: healthcare providers who have substantially changed their outlook on the

687
00:35:32,480 --> 00:35:35,360
Speaker 1: world and politics by how terribly their trans patients have

688
00:35:35,440 --> 00:35:38,600
Speaker 1: been treated. So like, if you know, like some of

689
00:35:38,680 --> 00:35:41,400
Speaker 1: us have been organizing for a minute, some of us

690
00:35:41,760 --> 00:35:44,239
Speaker 1: have been organizing for like literally a minute, and like

691
00:35:44,960 --> 00:35:47,640
Speaker 1: how do those people access these networks? Like how can

692
00:35:47,680 --> 00:35:49,880
Speaker 1: people who are not in healthcare support you and what

693
00:35:49,960 --> 00:35:51,000
Speaker 1: you're doing and reach out.

694
00:35:51,280 --> 00:35:55,160
Speaker 4: The gender liberation movement is incredible. They're doing a lot

695
00:35:55,200 --> 00:36:00,279
Speaker 4: of work, kind of public feasing to really get point

696
00:36:00,280 --> 00:36:03,799
Speaker 4: across on why this is so essential and also why

697
00:36:04,080 --> 00:36:06,920
Speaker 4: everybody should have the right to their own bodily and

698
00:36:07,040 --> 00:36:12,080
Speaker 4: gender autonomy. I think I mentioned earlier, but Lama, if

699
00:36:12,160 --> 00:36:15,880
Speaker 4: you're on the healthcare side, and you know there are

700
00:36:15,960 --> 00:36:18,640
Speaker 4: also kind of if you're in an academic setting looking

701
00:36:18,680 --> 00:36:24,200
Speaker 4: to wpass the World Professional Association for Transgender Health, kind

702
00:36:24,200 --> 00:36:27,359
Speaker 4: of going to the experts in this field and really

703
00:36:27,440 --> 00:36:29,399
Speaker 4: following and mirroring what they're doing.

704
00:36:30,560 --> 00:36:34,560
Speaker 3: I think if you're looking as a SIS person who

705
00:36:34,640 --> 00:36:38,360
Speaker 3: gets your care somewhere that might get federal funding, but

706
00:36:38,480 --> 00:36:41,160
Speaker 3: this is the thing that you care about, would encourage

707
00:36:41,200 --> 00:36:44,120
Speaker 3: you to sort of make people get on record about

708
00:36:44,120 --> 00:36:46,960
Speaker 3: this kind of stuff, right, It's been the most distasteful

709
00:36:46,960 --> 00:36:48,239
Speaker 3: piece of all of this is the kind of like

710
00:36:48,360 --> 00:36:50,600
Speaker 3: weasel hiding in all of this.

711
00:36:51,320 --> 00:36:53,279
Speaker 2: So force them on the record. Ask them.

712
00:36:53,320 --> 00:36:55,839
Speaker 3: If they don't tell you, send them an email. If

713
00:36:55,840 --> 00:36:57,800
Speaker 3: they don't know, respond to the email, send a follow

714
00:36:57,920 --> 00:37:00,800
Speaker 3: up email, Like make people we'll get on the record

715
00:37:00,840 --> 00:37:03,400
Speaker 3: about this so that we know where their values are

716
00:37:03,440 --> 00:37:05,080
Speaker 3: and if their values don't align with yours, take your

717
00:37:05,120 --> 00:37:07,120
Speaker 3: business elsewhere, because at the end of the day, healthcare

718
00:37:07,160 --> 00:37:09,320
Speaker 3: is a business because the United States sucks, and so

719
00:37:09,640 --> 00:37:12,120
Speaker 3: we have to use those dollars in the ways that

720
00:37:12,239 --> 00:37:14,239
Speaker 3: we can, and it matters in a lot of ways.

721
00:37:14,719 --> 00:37:17,160
Speaker 3: I don't know that anyone will care to and I

722
00:37:17,360 --> 00:37:19,480
Speaker 3: certainly don't want to present us as the people with

723
00:37:19,520 --> 00:37:21,720
Speaker 3: all the answers here because we just like are figuring

724
00:37:21,800 --> 00:37:24,400
Speaker 3: this as we go to But you can email us

725
00:37:24,520 --> 00:37:28,200
Speaker 3: at Community Health Resistance at proton dot me and maybe

726
00:37:28,280 --> 00:37:30,160
Speaker 3: let's have a conversation. Maybe there's like a ton of

727
00:37:30,200 --> 00:37:32,640
Speaker 3: people in the FQ world who want to do like

728
00:37:32,760 --> 00:37:36,080
Speaker 3: an Amazon or a Starbucks like diy union project where

729
00:37:36,440 --> 00:37:38,600
Speaker 3: we're all working on this together for the politics rather

730
00:37:38,680 --> 00:37:41,840
Speaker 3: than the pay as the primary sort of reason for it.

731
00:37:41,960 --> 00:37:44,799
Speaker 2: Let's let's let's be a red union and get something going.

732
00:37:45,320 --> 00:37:46,040
Speaker 2: I don't know that we can.

733
00:37:46,120 --> 00:37:48,640
Speaker 3: I don't know that it's the right call, but I

734
00:37:48,760 --> 00:37:50,600
Speaker 3: imagine there's more of us out there feeling this way

735
00:37:50,680 --> 00:37:50,880
Speaker 3: than not.

736
00:37:51,120 --> 00:37:53,800
Speaker 1: So yeah, and like whatever it is, we're stronger together

737
00:37:53,840 --> 00:37:56,920
Speaker 1: than we are apart, So like talking is how we

738
00:37:57,040 --> 00:37:59,719
Speaker 1: fix this. Thank you so much, guys, I really appreciate

739
00:38:00,360 --> 00:38:02,759
Speaker 1: you being so open about this. And yeah, I hope

740
00:38:02,800 --> 00:38:04,759
Speaker 1: that you succeed. You'll be able to keep taking care

741
00:38:04,760 --> 00:38:05,120
Speaker 1: of people.

742
00:38:05,800 --> 00:38:06,400
Speaker 2: We hope so too.

743
00:38:09,520 --> 00:38:12,000
Speaker 5: It Could Happen Here is a production of cool Zone Media.

744
00:38:12,200 --> 00:38:15,200
Speaker 4: For more podcasts from cool Zone Media, visit our website

745
00:38:15,320 --> 00:38:18,839
Speaker 4: coolzonmedia dot com, or check us out on the iHeartRadio app,

746
00:38:18,960 --> 00:38:22,520
Speaker 4: Apple Podcasts, or wherever you listen to podcasts. You can

747
00:38:22,600 --> 00:38:24,880
Speaker 4: now find sources for It Could Happen here listed directly

748
00:38:24,960 --> 00:38:27,200
Speaker 4: in episode descriptions, Thanks for listening,