Throughout the years, many of our clients at Gender Wellness of Los Angeles (GWLA) have tried to navigate the Transgender Health Care system in Los Angeles.  What better person to ask then our own Grace O’Connor, MA, AMFT.  We decided to sit down and discuss her experience of finding quality Trans-affirming care in the LA area.

Hi Grace,can you share a little bit about your transgender health care experience?

Well, I began my transition in approximately 2015, when I finally decided to explore this thing that had been on my mind for about as long as I could remember. I first went to the Los Angeles LGBT Center and met with the doctors and endocrinologists, got my levels tested and got prescribed T-Blockers and Estrogen for the first time. I had a couple of false starts in 2015 and 2016. I don’t think I was really ready to begin medically transitioning at that time, although I was socially transitioning. However, in December of 2016, I felt really ready to begin the next phase of my transition [HRT]. The timing was perfect for me and I stayed with the Los Angeles LGBT Center until 2017 when I switched to Kaiser’s Transgender Wellness Program.

Grace, can you tell us about the pitfalls you’ve experienced along the way?

Sure, there were many pitfalls along the way that occurred for me regarding issues around my health care. I don’t think people understand how difficult it is to find good providers that understand our needs, work with our insurance companies and support us throughout our transition.  It seems so complicated and you really have to fight for yourself and stay on top of everything.   The needs of the Transgender community are unique in that our mental, emotional and spiritual well-being are inextricably linked to the quality of care we receive. While I was insured at the Los Angeles LGBT Center my office visits, which included having a primary care physician, were included.  In addition, they covered office visits, prescriptions, endocrinology, and surgery.  Then this past year I switched to Kaiser and got so excited because I had a surgery date set.  Because I changed jobs and changed insurance plans, I no longer have Kaiser and I am now in the process of finding new providers and that has been challenging. I am looking at Cedar-Sinai’s Transgender Surgery and Health Program, under the direction of Maurice Garcia, MD, as well as UCLA’s Gender Health Program, under the direction of Amy Weimer, MD. Gender Dysphoria can be a real issue when surgery dates go away or need to be changed. And as anyone who has ever dealt with dysphoria can attest, it impacts daily functioning.

Grace, have you found better quality of care at some places as opposed to others?

That’s an interesting question.  I would have to say that most of the care I received at the Los Angeles LGBT Center has been pretty good. I think the Kaiser Transgender Wellness Program is pretty great. The doctors were culturally competent and very responsive. Rarely did I wait longer more than  24 hours to hear back from a doctor whom I had contacted for a health-related issue.

Grace, tell us,have there been out-of-pocket costs for you?

Well, every plan is different. Initially when I was with the Los Angeles LGBT Center I had MediCal and almost everything was covered. I know they have a sliding scale based on income so it’s a real blessing having this option.  Kaiser also covered many of the services I needed. There were some out-of-pocket costs for electrolysis, and prescriptions but it was really a great plan. Unfortunately, the one thing Kaiser doesn’t cover is Breast Augmentation, which was disappointing.  I try to focus on the positive but do hope that Kaiser will add this benefit to their plan so that Breast Augmentation will be paid for.

Grace,overall, have you been satisfied with your Transgender Health Care experience?

That’s a good question.  There have been a few disappointments along the way, but overall, I have been satisfied. I think it’s important to do one’s research as well. For example, I had been taking estrogen for the longest time in pill form. It wasn’t until last year that I discovered I could be taking it via injection, which has made a big difference. I reached out to Cedar-Sinai and UCLA about their programs and UCLA got back to me the next day. It has been a challenge emotionally to switch programs but I am looking forward to meeting with the team at UCLA.  I know it will take a few days to figure out what my insurance covers but I feel hopeful and excited to get started.   It sure has been a journey!

Thank you Grace, I hope this will be helpful to our readers.  If you have any questions for Grace or GWLA, please contact Grace O’Connor, MA, AMFT  at grace@genwell.org  or Casey Weitzman, MA, LMFT at caseymft@genwell.org.