LGBTQ Healthcare w/ A.G. Breitenstein
PRIDE
PRIDE

Episode · 1 year ago

LGBTQ Healthcare w/ A.G. Breitenstein

ABOUT THIS EPISODE

Finding health care as a queer individual can be terrifying. Sometimes it can feel impossible. The system is often ignorant to the LGBTQ community. And any queer-competent healthcare providers can be hours away by drive or months away by appointment. That’s why A.G. Breitenstein sought to make healthcare accessible. She’s had first-hand experience with poor medical care and knew there had to be a better way. So she started Folx Health, the first digital-native health platform designed specifically for the queer community.

Be sure to follow FOLX Health on IG! Your host is Levi Chambers, co-founder of Gayety. Follow the show and keep up with the conversation @Pride. Want more great shows from Straw Hut Media? Check out or website at strawhutmedia.com. Your producers are Levi Chambers, Maggie Boles, Ryan Tillotson and Edited by Sebastian Alcala Have an interesting LGBTQ+ story to share? We might feature U! Email us at lgbtq@strawhutmedia.com. *This podcast is not affiliated with Pride Media. Learn more about your ad choices. Visit megaphone.fm/adchoices

Straw media. You know, we all, I think, can reach into our memory and and reflect on a moment where we were very demonstrably treated like shit by the healthcare system. That just it is a routine occurrence for us. Finding healthcare as a queer person can be terrifying. Sometimes it can feel impossible. The system is often ignorant to the LGBTQ plus community and any queer. Competent healthcare providers can be hours away by drive or months away by appointment. That's why a G Brightonstein sought to make healthcare accessible. She's had firsthand experience with poor medical care and knew there had to be a better way. So she started folks health, the first digital native health platform designed specifically for the queer community. I'M A G Brightonstey. This is pride. I am thirty year veteran of Health Care and the Sea Yeo and founder of folks health. I grew up in, like you know, bedroom community in Connecticut. As a kid, AG was a classic Tomboy. She was tough and not afraid to get her hands dirty, usually scraping around in the dirt, you know, usually shooting bows and arrows and chasing dogs and and running around the woods as a feral animal for the most part. But young age was completely sheltered from the LGBTQ plus community. None of her peers were gay, at least not openly, and nobody in her neighborhood talked about queer people. As far as she was concerned, they didn't exist. Went to a high school where there was not a single out person, including myself. I was completely, you know, unselfaware in so many ways, but also knew that, like as I think so many of us do, like, I can't stay here because one of these things is not like the other, but I'm not exactly certain what that is. She got her first taste of queer culture when she watched the one thousand nine hundred and eighty three horror film, the hunger was Susan so randon and Catherine Deneuve. What have you done? It's natural you don't know what's happening too, but there's nothing to be fine enough as long as you put your face in me, give me time, trust me. That's so that movie, and I was like, Oh wow, okay. For anyone who isn't familiar with the film to New plays a Vam hire who gets caught in a love triangle between her former vampire lover David Bowie and her new love interest, Sarah, played by Susan so randon. After in you something you knew it did fema what everlasting life. I remember being completely freaked out and completely like didn't know where to go to to be able to get closer to that. But her freedom to explore her sexuality didn't come until after she left home. It wasn't really until college that I was like, okay, there's other people around like me and maybe I can go off and explore this. While AG was going through a journey of her own, the HIV AIDS epidemic had just started making headlines. By the end of one thousand nine hundred and eighty four there had been well over seven thousand AIDS cases and over three thousand AIDS deaths in the United States alone. But instead of focusing on the fatal impact the disease was having on Queer lives, the coverage of...

...the pandemic was extremely homophobic. You know, there was just a lot of fear and a lot of just unbelievable stigma. But on top of all of that there was a sense of community. When I got out of school and had moved to Boston. There was a real sense of people taking care of each other across the spectrum of the Queer and Trans Community and a real sense that nobody else was going to do it for us. So we really had to to, you know, cross lines that, you know, a lot of hadn't been crossed. You know, lesbians and gay men didn't interact all that much. The Trans Community, you know, wasn't included in the way that we think of it today, and and and, but there was a real sense that if we didn't take care of each other, it was going to be a hullable lot worse than it than it was. When a queer person comes out to their friends and family there's always a fear that they won't be accepted, but for young LGBTQ plus individuals, not being accepted can mean losing their family and even their home, forced to live on their own, many end up experiencing homelessness and they're more vulnerable to diseases like HIV. This community was, you know, at far higher risk for HIV because it you know, a lot of folks just had no support system to go to. They would essentially lose family friends, the entire infrastructure of their lives in that vulnerable of a situation, that the cops were just doing sweeps of the streets on just a continuous basis and harassing people and and giving them no quarter, and then the shelters wouldn't let them in. I mean it was just there was so so everybody was getting swept up. When AG saw this happening in Boston, she knew she had to help her community. So she teamed up with others who were passionate and motivated to make a change for food and for housing and for medical care. And you know, the piece that I was putting in this legal, legal support for folks, because, you know, everybody was legally involved. And these kids on the streets, they're not all there because they made a bad decision. It usually has to do with them being queer and that's it. A young lesbian whose parent was actually on the city council at the time, and this kid was an honor student and couldn't, you couldn't tell a story that wasn't like, you know this, this kid just checked every box that a parent could possibly put up for their kid. And Parent was, you know, in quotes, pillar of the community and this young person just, you know, their whole family situation imploded all in a single night and then they were suddenly homeless and and that, you know, that to me was always like very poignant, because this was the kid that did everything to be the good kid. AG says. It all comes down to a single moment in these kids lives where they came out or something was discovered and and their lives just changed sort of instantaneously. That was always the shared experience and across, like I said, every denomination of of of life, experience and and and, you know, race and ethnicity and, you know, income. All of it came back to this, this moment when you know, the ideal of who you are in your parents eyes suddenly shifts so dramatically and they just can't they couldn't process it, and then they'd be a catalytic event and kids would suddenly find themselves in the streets. But but it was, it would every time. It took my breath away,...

...like everything is still does to this day, take my breath away. Lgbtq plus homelessness has been an issue for a long time, but people haven't always cared. AG says. There has been an increase in awareness over the years, but not enough action. In a two thousand and twenty report, more than half of homeless individuals found in Arizona, Arkansas, California, Nevada and organ were unsheltered. We had a few allies at the Department of Public Health and a few allies at the Department of Social Services. We had no allies in in the any any of the law enforcement or, you know, judicial system. The judges didn't give a crap that. I think there's more awareness, I think there's more sort of general understanding that that this is an issue. But but I don't see the tide changing all that much. LGBTQ youth aren't all always kicked out of their homes for being queer. Sometimes their parents implement strict rules in an attempt to stop their kid from being queer. Situations where their parents are like, you know, not under my roof. Will you do fill in the blank. You know, you are not starting hormones. You are not going to do that. You know long list of you know, be what you are, but but don't be that in front of me. But when they can't be themselves in their own home, they decide to leave this scenario in particular, can be very harmful to the transgender community. When I was working in this in this area, the resources were almost nothing and and today, you know, there is, I think, a better understanding on the healthcare side of you know, what we can do for for, you know, Younger Suba Team Trans Youth and what that looks like if you have a supportive family, which which you know, most people, I would say, probably don't, or if even if they do, they probably don't have folks that have access to information and resources. And if you, you know, if you're lucky enough to live, usually in a city with like a large academic medical center and and really progressive resources generally, you may find a small cadre of clinical professionals who are willing to support the family and willing to support the young person in terms of of what the you know, what proper care in this situation looks like. Very few people have these kinds of resources at their discretion. More often than not, individuals are forced to deal with uninformed pediatricians and categorical ignorance about, you know, what the treatment looks like for for youth, as opposed to folks that are considered legal adults whatever that means. So so that the profile today is better, but access to it is is still really, really inequitable in terms of what people can get, depending on where they live in the country. When we come back Queer Health and medicine and how ag Brightenstein is changing at all. Welcome back. Today we've been talking to AG Brightenstein, a healthcare veteran and the founder of folks health. My mom was a researcher at at Yale and so I grew up like literally under her science bench, trying to be a little science nerd. And Yeah, and figured out I couldn't do science and so went to law school, went to Boston to try to fix healthcare. Started a nonprofit for Queer and Trans Kids on the streets of Boston. It was one thousand nine hundred and ninety four and it was the height of the HIV crisis. Age continued to work with the legal service organization to improve the...

...livelihoods of homeless lgbtq plus people for five years, but she soon realized that the only way to fix it was from the inside. Just felt like the health care system itself was broken fundamentally for this community at just so many levels. Didn't know how to, you know, work with young people. Didn't know how to, you know, certainly didn't how to work with the Queer and Trans Community. And and then was fundamentally broken for every everyone and in a lot of other ways. So so she went to Harvard University School of Public Health to get her master's degree. There was like, well, exactly how many Queer and Trans people are there in the world? And we are always like, we don't know. If her team wanted resources and funding, they needed to retrieve the proper data. After receiving her degree, AG started another nonprofit, followed by another for profit business, all trying to figure out how do we get like just numbers and data and information to sort of say what what's the manage the problem, and it was through that that I learned a bunch of stuff. I learned how to, you know, start businesses, which I think, if we think about our community and we think about making real change in the world, understanding the lovers of power in this country is really, really important, and particularly it's all about following the money. Where's the money going? WHO spending the money? WHO CONTROLS THE MONEY? And if you follow that equation you figure out why systems look the way they look and how they function. The way they function. And in healthcare. The way reason healthcare sucks is because, you know, we have doctors, they get paid by insurance companies that get paid by the government and nowhere in that equation is the person and what they need and what they want. And so that the system keeps talking about, you know, the pat the patients, the center of it all, and we're all, you know, really concerned about the patient. And when you really put peel it back and you say well, actually, when the people who pay the bills say jump, the whole rest of the system says how I and so you know doing going to public house, school building. These companies working within the healthcare system, got to peel open the engine, their whole engine, and really look inside and say, Oh wow, this is why this system is broken. Is because we are not anywhere close to the center of the lovers of power and and so that really was the very long, I mean like Home Eric, journey through healthcare to sort of come back and say, all right, the only way we're going to build something that works for this community is if we control the money and if we do something that allows, you know, we make it affordable for a person to pay out a pocket and then we can just dismiss government regulators and, you know, insurance company functionaries and you know, and and and to keep saying, you know, we're not going to cover this because it's an elected procedure, you're choosing this and so we're not going to cover it, which is, you know what the vast majority of folks for a long time, with a chart gut told so so doing that so that we take control. And I know that's very abstract, but it turns out it's very true. If we take control of the situation, then we get something that looks like, feels like and reflects us, and that's the only way. Like that is that's the only way. Otherwise you're asking somebody else to do it for you and unless they care about what you want, is in healthcare, it's not going to happen. HRT Is a hormone replacement therapy. Estrogen and TESTA strain are therapeutic for folks at all kinds of stages of life. It can be used to treat menapuzzle symptoms in women by replacing hormones they're at a lower level. Human hormones are good are good things for most people, depending on where you are in life and what's going on.

So so, you know, keeping those in balances always a really good thing. But HRT is also used to help trans or gender nonconforming individuals align their bodies with their gender identity. Ag Calls this a life giving therapy. But, as we've said before, the queer community doesn't always have the best luck when it comes to finding good healthcare. Then you have, you know, seven percent of lgb people and twenty two percent of Trans People reporting being, you know, shown the door, actively discriminated against and some even physically assaulted. Even for a g who is white, who understands the healthcare system and who lives in Boston, Massachusetts, a fairly liberal state, seeking healthcare still has its challenges. I remember I went to a particular appointment and, you know, I have a lot of tattoos, I do not present as as female or my I'm very non binary and my presentation and the woman who came in like literally treated me like a germ, like she did not know what to do with my body. She, you know, was like draping me with two fingers, as though I was like covered in something, and she was clearly not okay with me and not okay with with how I looked and and I just stared her down because I'm kind of that way. And but but it was, you know, you really know when someone just is like just disgusted, and I could feel what she felt and it was and it's awful, it's horrible and you know, in certain sort of that's that's like the best you can you can hope for. Just rampant ignorance, I mean just the dumbest questions by people who are like, you know, are you on birth control? No, are you sexually active? Yes, and then, you know, they're like, well, do I need to? And I'm like no, figure it out, like what would be the next question to this? It's extremely frustrating and discouraging queer individuals struggle to find someone that understands their specific situation and is willing to help them access the care they need. And that was the Genesis of folks are saying we need to do this by us, for us. It needs to be a healthcare platform that is, you know, Queer and Trans competent practitioners. It needs to be people who don't just accept our lifestyle because to me, that's not enough. I want to be I want for this community, for us to be seen, I want us to be heard and I want us to be celebrated, that we should not be just tolerated. This not good enough for us. AG says a lot of this mistreatment is rooted in our history and she breaks it down into two facts that shape how the LGBTQ plus community is treated even to this day. One, there's historical backdrop to this that's really important to consider, and there's two pieces of it. One, you know, the HIV pandemic in this country put the whole Queer and Trans community into a bucket of risky right, and you know, you people, you people do risky things, right, that's the best we get, and so that that that feeling is still tracking with this, with this community. And then if you go back even further right, the roots of the health care system and like hospitals, actually trace to the church and the vast majority of hospitals in this country still today are run by religious organizations. And so there has always been a backdrop of health being tied to morality and we fall well out of that and always have. And so, you know, then our health becomes our fault and we are, by definition, there for immral so so there's a really deep current under all of these experiences that isn't just the typical homophobia and...

...transphobia that we're actually used to dealing with our regular basis in healthcare. It's even deeper. So now let's talk about folks. The Healthcare Platform AG created for the Queer Community, she meete. It available online, which is convenient during the pandemic, but that's not why she chose to go virtual. We can meet most folks where they want to get most things today, like we get everything on our phones and our computers, like health care should be no different, and a lot we can do a ton of things virtually without ever being a person. By making these services available online, they're able to provide care to people all over the country. We're still getting licensed, but but we're already in thirty three states. We have a lot more to go, but but we can do that in all fifty states and that's a huge thing. And the best part is they actively work to make it affordable, particularly for folks. A lot of them and our community don't have insurance. So can make it affordable at a self pay now I am note, by no means diluting myself into thinking that what we do is cheap. It's not cheap, but but you know, certainly not. It's not going to be, you know, five thousand dollars to walk into a doctor's office, which it is in certain places for certain things. So so trying to make things affordable at a self pay rate. What that does is it allows us to build a queer and transcompetent practitioner network, and that's the center of what we do, so that when you see somebody on a telehealth visit or, you know, asynchronous chat or whatever, you know you're talking to somebody who doesn't just quote tolerate you, but knows you, is part of this community, works with this community every single day and isn't going to ask you stupid questions, isn't going to judge you and and is is going to you know, the the the the kind of watchwords of the company. Company are see here and celebrate you. We're going to see you, we are in to hear you, we are going to celebrate you. AG's mission is to provide the services that the healthcare system refuses to prioritize, like hrt and prep also known as pre exposure profile access, which is a medication used to prevent HIV. We need that for the Trans Community. You know, this is the thing that it is just so hard to find somebody who knows what they're doing, get access to them, get access to the therapies and get it reliably. We talked to hundreds of people who would tell us. You know, it took me years to find a provider. I finally found them, I started therapy and then they moved and then I was back to square one. So we wanted to build something again that would see you here, you celebrate you and then be here for you, you know, day in a day out, and that was crucial. And then would do it for you beautifully. You know, we actually we we send the medications to the home. We repackaged them in a beautiful bottle or box, and that's for a reason. It's because this should be a moment of celebration. It shouldn't be, you know, all of healthcare like generally looks bad, smells bad and feels bad and it doesn't have to so. So again, let's make it something that's really enjoyable and change the whole experience. End End, this service is essential for people who live in less progressive areas or rural parts of the country, where access to this healthcare is scarce, where access to any health care is actually difficult. But access to Queer and Trans competent healthcare, you know, the people that we talked to it's three, four or five hours away at best and most of them just avoid it entirely. But AG says even in progressive cities like Los Angeles and Boston, find in queer healthcare is time consuming.

You know, it's a six week wait to get even into the you know, Queer and Trans Health Centers in Boston and La so so it is true that there is more in the cities, but but we pay in other ways. We may pay by waiting, we may pay just by again, people do move around. So so yeah, the healthcare system, you know, there isn't enough primary care in the whole country for anybody. If there was an outcome that you hope comes from it, what is that outcome? I hope that we create an entirely new experience for people in healthcare in a way that just makes them feel joyful and that we finally put healthcare totally and completely in the hands of the person so that it serves their their goals for their life and their health and their body. If we can do that, and we can do that in a way that makes them feel joyful, I think we will have transformed the experience because, like I said, when we think about most, most people's experience of health care is they go to the doctor and they get told they're not going to die. That's like the best outcome is either yeah, either we can fix this thing you have or you're not going to die from what you have. Like that's your best day and it's usually, you know, smelly and wear it and you where, you know, pay for Johnny and all the sort the stuff. So that's the best. If we can actually make healthcare like a joyful moment and we can put it in service with people so that they're like, oh, this is going to help me be and become and feel, you know, fully myself and and and and fully embodied and, you know, support me in that and see me and celebrate me, that to me is going to be is the best thing we could possibly do. Where can everyone learn more? Folks, healthcom, FO, l x healthcom, and where can people connect with you? Is there anywhere that they can, you know, stay uptodate on all the things you're doing. Follow us on our instagram. We are all over the place there, and and and I make an appearance there as well. And, yeah, the whole team. You can see all of our practitioners, you can see the whole crewit so yew, we're all there. Thanks for listening. Pride is a production of Straw hyte media. If you like to show leave us a rating and a review on Apple podcast spotify will wherever you're tuning in front. Share us with your friends, subscribe and follow us on Instagram, facebook and twitter at price. Pride is produced by me LEA, by chambers, Maggie Bowls, Ryan Tillotson and Caitlyn mcdaniel, edited by Sebastian Alcola and Daniel Ferrara. Sound mixing by Sebastian Alcola. People who I think will benefit from this a lot, and I'm probably wrong in this. My count wants in the bedroom. Hold on, she's behavioral issues. She's one of my bottle babies. So like when she wants in, she was jumping up on the door. Why over, good, no, I have a pit bull does the same thing.

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