With the recent confirmation of Amy Coney Barrett to the United States Supreme Court on Monday night, many Americans will most likely lose their access to affordable health care in the near future. And this is particularly disturbing to North Carolinians because, for almost a decade, Republican leadership in the states legislature has refused to expand Medicaid, despite support from voters on both parties. The Center for American Progress, an independent, nonpartisan policy institute, and NORC at the University of Chicago conducted a survey with 1,528 LGBTQIA+ identifying individuals in June.

In states that have not expanded Medicaid, the rate of LGBTQIA+ adults who are uninsured is 20 percent, the results state, adding that LGBTQIA+ adults making less than $45,000 a year are the ones most prominently affected. According to this survey, transgender folks and people with disabilities bear the brunt of the high cost of health care, as 51% of transgender individuals and 40% of people with disabilities who needed medical care postponed it due to cost, and 40% of transgender individuals and 30% of people with disabilities postponed preventative screenings due to cost.

A Greensboro-based virtual clinic with a focus on LGBTQ health hopes to support those living in the margins of society by providing virtual health care services to anyone living in North Carolina. Founded by Chief Operating Officer Jamie Clarke and Chief Medical Officer Dr. Subrata John Guha, the LGBTQ Clinic was conceptualized specifically with the health care needs of LGBTQIA+ people in mind.

If you have a phone, iPad, or computer, you can come see us, Guha said. You dont have to go anywhere just be seen where you are comfortable, and take a proactive approach for your health.

According to Clark and Guhas research, there are approximately 420,000 people that identify as LGBTQIA+ in North Carolina, and of those, 30,000 identify specifically as transgender. Clarke is one of those 30,000. Unfortunately, Clarke knows all too well the barriers that other trans people face when seeking health care.

I had a lot of problems getting comfortable, comprehensive medical care, she said. Not just about [Hormone Replacement Therapy] or sexual health, but about Jamie as a whole person, which encompasses all of those things and my day-to-day medical needs.

She said that the LGBTQIA+ community, as a whole, are not very trusting of doctors. As a transgender woman, she has experienced first-hand what that is like to be treated differently because of her gender identity. At age 35, Clarke decided that she wanted to begin transitioning by starting HRT, so like any other patient, she asked her doctor for more information.

I was dealing with a local doctor and asked to have my hormone levels checked, as I was getting bloodwork done anyway, she said. And they were like, well, why would you want to do that? And I was like, so I can start HRT, and she said, Oh, I am not comfortable doing that.

This experience led Clarke to switch to Dr. Guha. During her interview with him, she felt comfortable enough to ask about starting HRT because he was honest, straightforward, and extremely easy to talk to.

Clarke said when she told him that she was interested in starting HRT, he told her that he wasnt too familiar with it, so he had to do some more research to make sure he was doing it properly.

As we got to know each other, I was explaining to him that sometimes, I was at the point where I wanted to go online and figure out how to do it myself. But he was like thats probably not safe, Clarke said. And there are a whole lot of people that are in that exact boat. So, we are trying to take the stigma out of LGBTQIA+ health.

With The LGBTQ Clinic, Clarke and Guha said they are trying to create a movement toward community-based, equalized health care by building relationships with clients in a convenient and accessible format.

In the telemedicine space, typically what you get is a five-minute visit, sometimes not even by video but as a phone call, Clarke said. Our visits are 15 minutes long, and we strongly encourage getting to know your doctor, and vice versa, because you always get the same care provider.

Clarke described the LGBTQ Clinic as everything one would expect at a visit to their regular health care provider, only virtually.

One of our marketing specialists was like, think about it as going to the doctors office, not getting deadnamed, and you dont have to sit on the crunchy paper in a germ pool, Clarke said.

Guha explained that the LGBTQ Clinic could basically replace ones primary care doctor because it is all-encompassing and that everyone, not just LGBTQIA+ people, could receive health care services.

I can write a virtual prescription to your pharmacist, any pharmacist we are basically like walking into your doctors office but all virtual, Guha said. We cant administer shots, but if it can be self-administered, then I can prescribe it, and you can pick it up.

However, Guha said he makes sure he is thorough with each patient he sees.

When someone comes in, I dont just write a prescription for testosterone, he said. I want that lab work, and I would want to see the patient again after the lab work [results came back] to go over it and then provide the prescription.

The LGBTQ Clinic isnt Guhas first foray into providing fast and accessible health care services to people. Guha said he helped start FastMed back in the ancient ages of 2010, but sold out of it in 2014-2015 after the business was acquired by a venture capitalist. As a heterosexual, cisgender man, Guha said he believes that everyone should have the same access to health care and be treated equally, which is why he was more than happy to help start this clinic.

Guha takes pride in his informed approach to LGBTQIA+ health, as he follows the guidelines put out by the University of California at San Francisco and its Department of Internal Medicines sub-department, which is specifically tailored for the LGBTQIA+ community.

In the last five years, this premier medical center started putting out clinical protocols that established guidelines and state of the art, the scope of practice protocols, he noted.

Launching the LGBTQ Clinic hasnt been easy but has been a labor of love for both Clarke and Guha.

We are really excited about it, she said. Being in Greensboro, and with it being such a large college town, the need is absolutely there. One of the hardest things we are having problems with is trying to have conversations with influencers or people that can get the message out for us. I dont want to be a sponsored ad; I want to be a trusted resource.

Clarke said North Carolinas 2016 controversial Bathroom Bill was a big part of their discussion, and it was a driving factor as to why we would create this clinic specifically.

We dont have time for the noise, Clarke said of the recent politicizing of health care. We just want to provide quality health care to as many people that need it as we can...Its also about bringing some respectability to a state like North Carolina, where there is a lot of uncertainty about this particular issue.

Whoever is elected president in November, we will still be here, she added.

Clarke said each 15-minute virtual session costs $78 per visit, which she said is cheaper than the $150 that is usually charged by the local larger medical centers.

We are looking to do a subscription plan, but because we are so new, we are still testing the market, Guha said, adding that The LGBTQ Clinic will soon accept insurance coverage from Blue Cross Blue Shield of North Carolina, Cigna, United Care, and others.

We are actively pursuing the credentialing process, and its just a waiting game, Clarke said.

I am guessing in the next 30-60 days, and the reason why it is taking so long, as you probably already know, is because of COVID, Guha added.

Presently, there are two doctors (including Guha) and one nurse practitioner on staff at The LGBTQ Clinic. Clarke said she is looking for support from local LBGTQIA+ community leaders but makes it clear that they are not trying to buy their way into the community. Clarke and Guha said they arent in the business of just making a quick buck; they want to establish the LGBTQ Clinic as a long-term resource.

Health care should not be any different or any less quality because you are in the LGBTQ community, she said. We are trying to provide and be a voice to the movement. With a 30-veteran of the health care industry to say that your health care is no different or more valuable than anyone elses, that is the real distinction here."

For more information, visit the website and follow The LGBTQ Clinic on social media (Instagram and Facebook, @lgbtq.clinic)

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New virtual clinic aims to provide accessible, inclusive health care to LGBTQIA+ North Carolinians - Yes! Weekly

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