New App: LGBTQ+ health care info & reviews!

I recently connected with Nic and Cat, a duo based in Philadelphia, who have been working super hard for about a year, creating an app for anyone who is LGBTQ+ and is looking for a health care provider. It will be simple, straightforward, user-based, and reliable.  A beta version will be available soon, and Nic says, “the more the merrier, because once we’re beta testing we want to have as many reviews on there as possible–that’s what’s gonna make the app useful.”

qspaces-hard-at-work2 qspaces-hard-at-work

 

 

 

 

 

 

 

 

 

I already signed up.  You can too!  At:  https://qspacesapp.com/qreview/

I definitely will have a lot to add, from
The first primary care doctor who proscribed me T,
The terrible consultation I had for top surgery in my area,
and, yeah, there will be much more.  I have thoughts on my current doctor.  Thoughts about the surgeon who did do my top surgery.  Thoughts about my sometimes therapist and my psychiatrist (refreshingly, those two are all positive.)

I asked Nic a few questions to get a better sense of who they are and what their project is all about…

K:  I’m curious, do you and Cat have experience in web design?  Or, what are your backgrounds?

Nic:  I have some experience with coding, but not enough to be able to pull off an app like this. I’m currently a 2nd year in medical school with a background in crisis counseling, EMS, and performance. Cat is a jack-of-all-trades. In the past, she’s used design principles to build community dialogue around social issues and is currently working for Johnson & Johnson on their TAP program, and starting her first year at University of the Arts in the Design for Social Impact Master’s program. She always has a million little projects going on, from trying to create the perfect denim work jean for butches, tomboys, transmen, and anyone else who has trouble finding a durable, well-fitting work jean, to cataloguing every queer movie in existence, and more.  When she had the idea for the app and shared it with me, I was like, there has to be something like this already out there. We looked around and there were a few options, but nothing that gave tangible results. She started drawing up some sketches and we’ve been unstoppable ever since.
qspaces

K:  Was there a specific moment or incident where you said, “We need an app to fill in this void of information.”

Nic:  We had just moved to Philadelphia so I could go to medical school and we were both trying to establish care with a primary doctor. Cat had very recently had a terrible doctor experience and she didn’t want to go through that again. So she turned to an online forum, a queer philly group. The posts were all over the place, and it was just generally inefficient. I was also meeting with a group called the Gender Interest group at the time, which is an interprofessional group for folks in healthcare who are trying to push systematic change at their home institutions around attitudes + policies affecting gender diverse folks. I was pretty blown away by how professional, dedicated, and compassionate these healthcare providers were and I realized that patients could only find out who had adequate training in LGBTQ patient issues by word of mouth.  I mean, almost 10% of the population is lesbian, gay, bisexual, queer, and / or trans. Yet we give hours and hours of lectures on the most rare of congenital metabolic diseases. I think that’s a problem. 

So there wasn’t one exact moment. It was basically a culmination of all of our experiences up until that point. Cat + I realized that 1. we could do something about it and 2. that we were actually the perfect team for this project.

K:  What has been the most rewarding parts of the process of getting it off the ground so far?  What about the most frustrating?
Nic:  So many great experiences. My favorite parts have been where people approach us and say, yeah- but have you thought of this? I love working with people, and building off of ideas, so the amount of collaboration that this has led to has been truly incredible. We’re working with a web dev team called Webjunto in Philadelphia and they’re really awesome. A good part of the team is queer and they have a lot of great insights. Even the straight, cis people have some great insights. 😉

The most frustrating part, by far, has been trying to convince straight, cis folks that there is a need for this kind of app. You can quote statistics at them all day long (like over 56% of lgb folks have had discriminatory experiences at their healthcare provider’s office, and over 70% when looking at transgender and gender non-conforming people) but they’ll just reply, ‘Well, not at this institution’ (which I know for a fact to be untrue). The institutional support matters because we need funding, we need investors in order to set up a sustainable business model. The reason some of these other sites are stalling out is because they are non-profits that run on volunteer work. Cat + I would love to devote ourselves full time to this app, and it’s important that it stays totally free for the folks using it.

Besides, we have so many other ideas, including things like having a Clubhouse- a community space for lgbtq folks to chill + hang out that isn’t centered around alcohol. Maybe one day! 
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I’ll share more info about this app as it becomes available.  This is SUPER important.  (I’ll also share updates about this magical Clubhouse as that materializes as well.  🙂 )

My insurance unexpectedly sent me partial reimbursement for top-surgery

The title says it all, but here’s the details:  Prior to surgery, I put a lot of effort into trying to figure out what I might be able to get reimbursed for.  I was on the phone with customer service for a long time one day; I scoured my insurance’s webpage; I tried to figure out codes and what they mean; my therapist called multiple times on my behalf.  I oscillated between feeling hopeful I might get partial coverage, and being convinced that there was no chance.

Ultimately it seemed like there was no chance.  I found a promising document at one point called, “Gender Reassignment Surgery Medical Policy,” followed by criteria to prove it is medically necessary.  Then I was told that that applies to some insurance policies with my insurance company, but my particular policy excludes this coverage, and that was the bottom line.

Still, people told me that it’s against the law to deny coverage, on a state by state basis, and my state should cover it.  I paid out of pocket, first for the surgeon’s fees in advance, and then for the surgical center, the day of.  After the fact, I asked my surgeon’s office to send me an itemized bill of what I’d paid for, and I submitted that to my insurance company, without much hope.  I figured it’d get denied, then I’d appeal and take it as far as I could.  Maybe I’d get some advice from my local gay alliance, etc.

About 2 weeks later, I got a piece of mail.  I didn’t open it because I didn’t care to read the bad news.  My spouse and I were leaving for vacation last Wednesday, and I figured I’d better open it before we left.  In case there was some deadline for appealing it.  I opened it up, and it was a check for $2,800.09!!!!  I yelled at my partner about it, the excitement of it, which must have been jarring because I almost never yell.  What an amazing way to start our trip!

That’s 47% of the surgeon’s fees (including 100% of the accommodations – staying at the surgeon’s guest room!)  I really could not believe it – either the person on the receiving end wasn’t paying attention at all, or they knew exactly what it was and had some strong personal beliefs of what should get to be covered!!

Now I’m just deciding if I should also get an itemized bill from the surgical center and try to get more money back…  Maybe I don’t want to push my luck…

It really paid off to just try, even though I didn’t believe anything would come of it!

Here’s a post I wrote earlier on this topic:
In February, I wrote GID: exclusion for top surgery coverage


Continued quest to find a new doctor (a good fit?)

I have been seeing a doctor that I don’t like for about a year, in order to access testosterone.  I’ll be going to his office tomorrow actually, hopefully for the last time.  For a few weeks now, I’ve been actively trying to find a doctor that I would want to go to.  My therapist thought she had a good lead on someone who works with trans* patients, but it turns out this person works with adolescents and young adults.  Whoa, when did I stop being a young adult?!!!!  According to this doctor, it’s when I turned 27.

I really wasn’t sure where to start.  As far as I was aware, I had exhausted my resources for trans* specific health care.  Ideally, what I’d have done next was turn to all my local trans* friends, and ask them who they see and who they’d recommend.  But, I’ve been out of the loop for a while now, and it felt daunting to drop in on a social group or support group just to ask about this.  So I turned to my local gay alliance’s resource webpage and wrote down the names of a couple of “LGBT friendly” doctors.  I narrowed it down somewhat arbitrarily because, hey, I gotta start somewhere.

I called the first number and left a message.  Then called again 2 days later.  And again the beginning of the following week.  And a 4th time the next day.  My faith was waning; it hit me it was probably a really bad sign I couldn’t get through to anyone.  I finally got a message back from them, but I’d started to lose interest and was already moving on to the next doctor.

I got through immediately and asked if this doctor was taking new patients?  I was told that if I’m a friend or family member of a current patient, then yes.  Or if I was being referred to her by a doctor of any sort, then yes.  Wait, you need a referral for a primary care physician?!!  I asked, “In what form should this referral take?  Like a note from a doctor or an email?”  “No, you just tell us their name.”  I said OK thanks and hung up.

So basically, I can see this doctor through the powers of nepotism and name dropping.  (Warning, I’m still highly suspicious of doctors.  Doctors, please, prove me wrong!)  I felt more determined than ever to see this doctor, just on principal, because I think this policy is fucked-up.  She should either be taking new patients or not taking new patients.  Period.

I called my therapist (technically, she’s a doctor) and asked her if she would refer me to this doctor.  She said sure, she’d do whatever, and that she’s never heard of needing a referral for a PCP.  She suggested that maybe I just misunderstood, and they just want to know how I heard about / was referred to this doctor.  So when I called back, I gave them the benefit of the doubt, but it was reinforced that yes, I need a verbal referral.

I then said that I have a therapist who will vouch for me.  (The term “vouch” was never actually used, but that’s what seems to be going on?)  I was then put on hold, and they seemed to be attempting a stalling tactic.  She (receptionist) said she is short staffed and busy, could I call back Thurs. or Fri. of this week?  I was assured that I’d be able to make an appt. at that time, and I was directed to name-drop whoever at that time.

So I followed these directions and finally got an appointment!  (For 3 months from now.)  A few days later, a packet of paperwork arrived in the mail, and I immediately opened it and started to peruse.  Their pamphlet states, right on the cover, “Designed by Women / Delivered by Women / For Women Like You.”

Whaaaaa?  Apparently, I got myself a doctor through a women’s health group without even knowing it!  I just have to take a giant step away from this situation and laugh.  And laugh and laugh some more.

Is this going to be a good fit?  I thought it through quite a bit, and decided that I’m going to try it.  And I’m going to make my decision based on the doctor, and not the Women thing.  Because really, although I am definitely not a woman, I am closer to a woman in some ways, and closer to a man in other ways.  And being at this health center is not going to mess with my identity or psyche or ego.

As long as they can understand what I am saying to them, as long as they can use my preferred name and male pronouns, and as long as I’m getting good treatment, I will be proud to go here.

(And if it doesn’t work out, then it doesn’t work out.)