We’d like to introduce Gender Affirming Care (GAC) Program Director Dr. Cassy Friedrich, based at the Sacramento B. St. health center. She has done great work in the community and is vital in helping to expand health services at the affiliate, making PPMM a leader in providing this care.
PPMM: How did you first get involved in gender affirming health services, and why do you think these services are so important?
Dr. Friedrich: I was doing my residency in family medicine and psychiatry at UC-Davis when, in 2015, I started volunteering at a Sacramento free clinic for transgender care, prescribing hormones and working closely with patients. Eventually, I was asked to be the co-medical director of the clinic, and I developed a LGBTQ health care curriculum during my family medicine residency. What really moved me were the disparities I saw in health services for the LGBTQ population in the entire medical community. There was so obviously a huge need for this kind of care that just wasn’t being filled. Even when people aren’t addressed by the correct pronouns during a patient visit, it can cause trauma and keep them from coming in for health care they need.
PPMM: What brought you to PPMM?
Dr. F: I am so passionate about this work, and it’s simply not available in many other organizations. A lot of providers don’t understand how necessary this is, or they haven’t had the opportunity to get appropriate training to provide this type of care. Just my presence here signifies PPMM’s commitment to this service and to this community of patients.
PPMM: What projects are you working on at PPMM to make gender affirming care a core service?
Dr. F: I’m working on a training plan for the entire affiliate so staff can learn about the importance of language and terminology, the disparities and discrimination that transgender people face, and the health care needs that transgender people have, with emphasis on intersectionality and trauma-informed care. Every clinician will be trained to prescribe gender affirming hormone therapy, including how to provide this care via telehealth. I am recommending that this service be primarily provided via telehealth during and beyond the pandemic. I am also working on ways to help the staff and health centers create a more gender affirming environment, such as customization of electronic health records to include patients’ pronouns at the top of their chart and creating templates that are gender-neutral rather than being separated into “female” and “male.”
PPMM: What makes you especially excited about doing this work at PPMM?
Dr. F: I’m a queer person who is really passionate about social justice in my community. I am also passionate about sexual and reproductive health, so this position was such a great match. Knowing what a lack of appropriate training for gender affirming health care there is and the lack of providers doing gender affirming work, it’s just great to be doing it here. We are one of those places where people can come to get what they need without feeling discriminated against or excluded.
At the free clinic in Sacramento, I have gotten used to seeing patients who had driven hundreds of miles to get this care. Now people will find (gender affirming) care at Planned Parenthood health centers, much closer to where they live. That’s how it should be.
PPMM: What’s next for gender affirming care at PPMM?
Dr. F: This fall I am piloting the GAC clinician training with a small group of clinicians. Over the winter, the rest of the health center staff will receive training with the goal of providing this service at every health center by late spring 2021. There will also be trainings for PPMM staff in all other departments. Aside from training, there is work to do to support a culture of gender affirming care, like creating position(s) to support the health care navigation needs of our GAC patients and being sure we are able to provide as much access to this service as we possibly can.