A Long Overdue Check-Up
A few weeks ago I was searching for healthcare and came across the Dimensions Clinic. It’s actually part of the Castro Mission Health Clinic in San Francisco’s Castro-Mission neighborhood, but Dimensions is the queer youth division. Since it was also recommended by someone else as a solid option to get trans-friendly medical care, I gathered up my courage to go check it out with my girlfriend. We strolled in on a rainy Saturday afternoon, not knowing exactly what the expect, and we walked out with appointments for the both of us.
At my first scheduled appointment I got a full suite checkup. Wow, in less than 5 days after setting foot in Dimensions I had already received appropriate and comprehensive care. In less than two weeks I got blood tests (to regulate my hypothyroidism) and a follow-up appointment for the blood results. Moreover the doctor scheduled another follow-up for 6 weeks later so we could check on the progress of the adjusted dose. This pretty much goes against every other medical experience I’ve had in this country, where, despite having comprehensive health insurance, it has taken me at least 3-6 weeks to get an appointment with a doctor, and let’s not talk about follow-ups.
But it wasn’t just the excellent and on-point care they gave me that gets me all giddy when writing about this. It was the trans-friendly atmosphere. Actually, more than that, it was trans-affirming.
Trans-Affirming
Everyone in the waiting room was trans, and even some of the nurses and staff are trans. (And anyone who is not trans is Mexican/Latino – actually some are both – which is double the fun for me!) You see, I haven’t interacted much with other trans-people – in actual, real life – so just sitting in this waiting room made me feel a part of a group of real people who actually exist outside of blogs. Not to mention that the staff is setting a great example of transgender people who are out in the workforce and successful at what they do. I felt like part of a community, somewhere I belonged.
The forms you fill out ask you for your preferred name along with your legal name, which will be kept confidential, and everyone kept asking me my preferred pronoun. Nowhere in real life has this happened to me, and I am not expecting to see this anytime soon in any other medical forms, or any other non-trans-specific place for that matter. During the hour-long intake with the nurse attendant, I got to explain my entire gender and sexual identity. It was just that, explanation – no confrontation or comments or excessive clarifications. Both the nurse and the doctor had never heard of agender or neutrois, and they were intrigued! And I got compliments on my new chest!
Everyone is super duper nice, like extra nice with sugar and spice. It quickly becomes evident that their top concern truly is your well-being.
But There’s Always a But…
The only downside I see in all this is that it’s a queer-trans-YOUTH clinic. I turned 25 about a week after showing up at their door, and had I been a few weeks older they technically could have turned me down. While I understand the need for youth-specific clinics, I have a harder time understanding what I would’ve done had I waited a few weeks, or had I been 26, or worse yet, 36 (and let’s not go to 46)! But there are transgender people of all ages, transitioning at all ages, confused and in need of medical care at all ages. So why aren’t there services targeted at them? What do they do?
What Next?
It’s been 6 weeks and I went in for my blood draw Friday morning (although I got poked twice because my veins are the size of a three year olds’), with a follow-up in a week. Just the thought of going back brightens my mood. I’m thankful I discovered this place. If you are anywhere near the San Francisco Bay Area you should definitely check it out.
And if you know of any trans-affirming health-places around your local area, please share.
Last Minute Update
It turns out my insurance is… [insert adjective of choice here]… and now I have a huge medical bill, just from blood tests! While the clinic is sliding scale, I probably don’t qualify. Yet the issue is not whether I can pay it or not, it’s that I’m already paying for insurance, so why won’t the insurance pay for this? Like I said, my experience with the US healthcare system has been less than stellar. Since I’ve already said how everyone is so nice there, I’m sure they’ll help me sort it out when I go to my follow-up on Saturday. In the meantime, /end rant.
genderqueer.me 
Great that you found such a good facility! But it sucks that your insurance isn’t covering your blood tests, which I know are expensive. I’m sure your doctor must have attached a diagnosis. Did they give a reason for leaving you stuck with the bill?
What you’re experiencing is the divide between the actual health care system (excellent) and the insurance system (insert adjective of choice). In the US, I don’t know if that will ever be improved.
So after submitting an appeal with the insurance (and getting a second blood test and a second bill, though not as big), I have to pay up. I went “out of network” and the clinic does their labwork through the hospital, who billed my insurance, and the insurance has other requirements for “hospital out-patient and out of network” (though I never went to the actual hospital). There’s not much else I can do except get my blood tests elsewhere and have the doctors at the clinic evaluate them. It’s so sad because the nurses are always so nice, especially when they realize they have to use the children’s needle to take my blood. But yeah, lesson learned, very very expensive lesson, but it could’ve been much worse and now I know to triple check these things.
Right now I’m holding off on switching to a well-regarded neutrois-friendly doctor (who is at CPMC Davies Campus) because he’s not within my old job’s crappy insurance network. My new job’s insurance is WAY better, though, so in a month when the new insurance kicks in I will definitely be seeing him and making recommendations accordingly.