Branching into Gender-Affirming Care

Russell Brown, Innovations and Strategic Partnership Director

Montgomery County sets itself apart as a leader in equity with each executive action and local initiative. That’s especially clear to LGBTQIA+ folks like me, who recognize the County’s concerted efforts to protect the community’s rights. From the passage of the LGBTQ Bill of Rights in 2020 to the recent establishment of the LGBTQ Advisory Group, our County demonstrates compassion and exemplifies what’s possible. Yet, as the results of the 2023 LGBTQ+ Community Survey revealed, there's still some work to do.

Poor experiences with health care

The survey showed that the LGBTQIA+ community faces barriers to care in Montgomery County, particularly our trans, non-binary, and gender expansive neighbors, whose feedback painted a picture of health care severely behind the times.

Among the findings in the report, several were especially troubling:

• More than 25% of respondents reported having to educate their health care provider on their sexual orientation or gender identity so that they could receive appropriate care.

• 41.1% of respondents reported difficulties finding a local provider that offered gender-affirming medical care. 41.8% said the same about gender-affirming mental health care.

• Respondents who self-identified as trans, gender expansive, or questioning were four times more likely to report experiencing harsh or abusive language from a provider.

These outcomes are unacceptable and frankly surprising, given Montgomery County’s record of furthering acceptance and safety in our neighborhoods. Thankfully, leadership acknowledges the issue and shares the concern, with Council Vice President Kate Stewart even joining CCI in a joint statement demanding greater gender-affirming care access and equitable treatment.

But action is how we’ll right the wrongs trans, nonbinary, and expansive folks continue to face. That means leaders from different sectors throughout the community coming together to put in the work. As community health leaders in Montgomery County, we know that starts with us—and we have a plan.

A place for gender-affirming care

As it stands, there are only two locations specializing in gender-affirming care in Maryland, neither of which are located in Montgomery County. The local shortage means burdening our trans, non-binary, and expansive neighbors with a commute into D.C. or Baltimore or limiting them to a nearby health clinic that potentially lacks the training required to deliver care effectively and respectfully to the population.

Recognizing the urgent need, we decided to innovate a space offering the quality health services our LGBTQIA+ neighbors deserve. Our Sexual and Gender Minority (SGM) health center will become a health care home long overdue and much needed within our community.

A look inside

Scheduled to open in Silver Spring in 2025, our SGM health center will boast ten exam rooms, lab services, and an on-site pharmacy. It’ll create over two dozen jobs and comprise health professionals rigorously trained in gender-affirming care within CCI’s established culturally competent and patient-centered framework. The comprehensive health services expected at our seven centers will be a mainstay, coupled with new services relevant to the population served, including hormone therapy and peer and same-day PrEP.

Clinicians and support personnel will build relationships with patients with the utmost sensitivity to their lived experiences, partnering to help define and attain their unique health and gender goals. Trans, non-binary, and expansive folks who choose us for care will once again take the lead in their health journeys, but this time, they’ll thrive through provider empowerment, not ignorance.

Return to safety

It’s time to dispel the harmful notion that a population earns the right to specialized care. Rather, the challenge is for health care to earn the confidence of a population. Proud allies like CCI garner inspiration and courage from the LGBTQIA+ community to commit our resources toward wellness in the name of liberation. And as we continue to partner with Montgomery County leadership and advocates to secure health justice, I wholeheartedly believe that restoration of trust in health care is on the horizon. I can see it from our health center.