Sherry Barkas

The Desert Sun

Desert Hot Springs Community Health Clinic is helping to bridge a gap in medical care for transgender people on Medi-Cal or other public insurance plans.

“Most of the transgender persons I know are buying medications illegally or from Mexico or driving to Los Angeles to receive treatment,” said Thomi Clinton, director of TDOR — Transgender Day of Remembrance — Palm Springs who helped open the door for more treatment options for the valley’s transgender population.

Clinton has private insurance and hasn’t had trouble getting treatment, but for those on Medi-Cal, Inland Empire Health Plan or the Medically Indigent Services Program, coverage is difficult, if not impossible to find locally, she said.

Desert Hot Springs Community Health Clinic, which specializes in the treatment of HIV and Hepatitis C patients, opened about a year ago on Palm Drive and within the last two months began offering services to the transgender community, thanks in large part to Clinton, who started her transgender process in 2006. The former Los Angeles area resident moved to Desert Hot Springs three years ago where she bought a home.

While Riverside County knows it is home to an estimated 7,237 same-sex couples, it’s hard to know how many transgenders live in the county — or anywhere — let alone what is lacking in medical care, said Aaron Gardner, a research specialist for Riverside County who authored a 2014 LGBT health and wellness study for the Department of Public Health.

“One thing the study showed is a lack of information for the transgender community,” Gardner said.

Much of that is due to how gender is addressed in health and other surveys, including Census questionnaires, which ask if a person is male or female, but not about gender orientation, Gardner said.

“There are a number of ways to approach gender ID, including what was your sex at birth and how do you identify now,” Gardner said.

“Health information on all lesbian, gay, bisexual and transgender populations was always traditionally poor; very poor,” Gardner said. “But now it’s getting a little better for the lesbian, gay and bisexual individuals. Having a little more information about these groups helps highlight the (transgender) population being left out.”

Efforts are under way to get state and county health departments and other agencies to change health forms to add transgender-related questions, but that’s a process that can take time, Gardner said.

In addition, TDOR Palm Springs is helping create a committee called Riverside County Healthcare Forum which will be working with Transgender Day of Remembrance Palm Springs and other organizations to create the first transgender specific survey for Riverside County to begin providing services, Clinton said.

Clinton attended The Desert Sun’s Political Pop-Up event where she met Dr. Glen Grayman, a director of the Borrego Health clinic in Cathedral City. She said she voiced complaints about lack of options for care in the transgender community and he was eager to help. They met with Dr. Clayton Barbour II, a general internist and HIV/AIDS and Hepatitis C specialist at the Desert Hot Springs and Centro Medico Cathedral City clinics and director for all the Borrego clinics in Riverside County.

“One of Borrego’s primary missions is to serve the underserved wherever we can,” said Barbour, who worked for 171/ 2 years at Desert AIDS Project before joining Borrego Health.

One thing Barbour stressed repeatedly is a priority to make transgender patients feel comfortable coming to the clinic. Staff underwent a lot of training to ensure a relaxed environment before patients were received, Barbour said.

“We don’t want people to have a bad experience,” he said.

Many transgenders are low income and having access to medical care where they can get their hormone medications is crucial, Clinton said

“When you deal with a trans community that’s not getting hormones; not getting proper medical treatment … it’s difficult to get them situated where they can get into gainful employment,” Clinton said. “Hormones affect everything, from your moods to your aggression to your depression and memory. Without them, one minute you’ll be laughing and the next minute you’ll be crying and you can’t do that if you’re working,” she said.

The medications are inexpensive if you have insurance, costing $3 to $5 a month vs. $50 and more each without insurance, Clinton said.

But the medical needs go beyond medications, she said.

“Having a doctor qualified in transgender and inter-sex persons resolves the patient training the physician,” said Clinton, 43. “As an example: A male to female transgender must be checked for not only breast cancer like most women do but prostate cancer like many men do.”

Borrego also has a transportation service for people who qualify, which is helpful for people living in Yucca Valley or elsewhere and can’t get to the clinic on their own, Clinton said.

“It seems to be a positive thing and it’s working out for the trans community here in the valley,” she said.

The Desert Hot Springs clinic isn’t yet licensed to take patients enrolled in the county’s Medically Indigent Services Program but they can be seen in Cathedral City, Barbour said.

Staff at the Cathedral City clinic is also undergoing training but one of the dangers there is that it’s a general medical clinic that sees patients from a variety of communities whereas the Desert Hot Springs clinic specializes in HIV/AIDS and Hepatitis C care with a large gay and lesbian clientele, making it more comfortable for transgender patients, Barbour said.

As patient volume builds, more medical staff may be added and additional training offered to make the care available in other Borrego clinics throughout the county, Barbour said.

“This is a place that (trans) can come and be treated respectfully. Staff is friendly and respectful and they can begin the process of becoming more complete as a person,” said Angela, a Desert Hot Springs Community Health Clinic patient who requested her last name be withheld.

Desert Sun reporter Sherry Barkas can be reached at sherry.barkas@thedesertsun.com or (760) 778-4694. Follow her on Twitter @TDSsherry