By Sossity Chiricuzio, PQ Monthly
The Equi Institute has been changing the landscape of Trans and Queer health care in Portland for several years now, teaching Trans-competent seminars for healthcare providers and staff, training Naturopath and Medical students, going toe-to-toe with insurance companies and local hospitals, and providing free wellness clinics for Trans and Genderqueer patients without insurance. Most of the ‘they’ in this instance is the founder, Dr. Angela Carter, a Naturopathic Primary Care physician and Midwife who believes the health of the community has a strong impact on the health of its members. They* volunteer with the LGBTQ Health Coalition of the Columbia-Willamette, Outside-In’s Transgender Health Clinic, and Basic Rights Oregon and also works as a health advocate, teaching medical students and staff about LGBTQ health care and Natural Childbirth at Portland area schools and clinics. This radical approach mirrors the Institute’s namesake, Dr. Marie Equi, a lesbian, socialist-anarchist, feminist physician serving marginalized communities in Portland at the turn of the 20th century.
The plan has always been to expand into a full-service Queer/Trans healthcare clinic and community center, and thanks to a recent decision by the Q Center to give the Equi Institute fiscal sponsorship, they will finally have the space, the staff, and the focus to grow into that much-needed resource. The fiscal sponsorship means that they can file for grants under the Q Centers non-profit status, a big plus in fundraising, and for space within the Q Center itself, including treatment rooms, a waiting area, and a conference/workshop space. With a second doctor joining the team Dr. Annah Shapiro, and two more by the summer of 2016, the Equi Institute will be able to serve the vast and growing needs of the Oregon and Washington Queer/Trans communities. I spoke to Dr. Carter about the specifics of what the Equi Institute will offer, the current state of Queer/Trans healthcare, and the role of the Q Center, and community in this venture.
PQ: For those people who aren’t as familiar with the issues involved: what will make this experience different than a general population health clinic?
Carter: The institute is based in Naturopathic philosophy; prevention and patient empowerment are central to the work we do and herbal and nutritional therapies and other treatments that support rather than suppress the body, are our tools. We are also a clinic by and for the community. When you come to the Equi Institute, you are assured you will have a provider who is from your community, understands your needs and culture, is passionate about creating health equity and social justice, and doesn’t judge you. The Equi institute is dedicated to providing patient centered, patient driven care that is tailored to the needs of the individual. Everyone’s health needs are unique, and many options exist to choose from. I see our job as physicians help teach and empower people to find the best path for themselves to wellness.
PQ: How can other health care providers make their services/company more trans-competent?
Carter: There are lots of simple ways to make your clinic more Trans welcoming and affirming; a pamphlet in the waiting room about trans health, including a space to write preferred name and pronouns on intake documents and using those respectfully when talking to and about your patients, and getting specialty continuing medical training from the upcoming Gay and Lesbian Medical Association conference and the LGBTQ Meaningful Care Conference. The Equi Institute also offers continuing medical education for providers and agencies interested in improving their knowledge and competency in providing care for the LGBTQI community.
PQ: What is the role of the Q Center in this expansion?
Carter: Q center’s executive director dream team, Stacey Rice and Justin Pabalate learned from Equi Institute Board Co-chair, Natalia Kay-O’Brien, that the Equi Institute was seeking a larger and more community-central location to increase capacity for serving the LGBTQI community. They stepped forward in July 2015 to offer fiscal sponsorship. The plan is that we will take up residence in January, 2016 after we build the space to suit the clinic. We are very excited to partner with Q center to create a health focus in our community’s heart.
PQ: How can people help support this effort/clinic?
Carter: We will be doing a crowd funding outreach to the community to raise money for the build out of the Q center to make clinic space. Tax deductible donations may also be made in our name to the Q-Center as soon as our fiscal sponsorship is official in October. We’ll be updating our Facebook page and website regularly: @equiinstitute and equi-institute.org.
PQ: Where do you see this clinic in five years?
Carter: I am ambitious, perhaps, but I would love to see the clinic expand into a research facility and advocacy center and join forces with other LGBTQI support organizations in a large health-focused community center. Good health care has historically been out of reach for so many because of discrimination, poverty, racism, misogyny, and the like. My dream is to walk into a space where awesome queers are dancing to Richard Simmons with Transercise, where I can talk to a doctor and get clear health information on PrEP and how it might affect my hormone therapy, then go to a queer/trans SMART recovery meeting, then get a massage from a person who understands trans bodies, then have a coffee in a queer owned shop next to the Oregon Archival LGBTQI library.
PQ: Are there any other similar clinics in operation?
Carter: There are several clinics we have drawn from in terms of model and structure; we tip our hat to Callen-Lorde, Lyon-Martin and Fenway for their pioneering work in creating LGBTQI focused health care centers, and locally we have great appreciation for the work Outside In and Old Town Clinic have done in caring for the LGBTQI community. There are several conferences around the country where providers can learn and improve on the care they offer to transgender people.
PQ: Any advice on advocacy or self-care for queer/trans people who don’t have similar resources in their area?
Carter: Lots of my patients come to me from small towns across Oregon, Washington and beyond because there is no one willing to take on transgender care in their area. It’s not right that anyone should have to drive 4-6 hours to get competent basic health care.
If you can’t find a doctor in your area who is willing to give you care, go to the local hospital and demand that this need be filled. As a doctor, I can tell you, providing hormone therapy and primary care to a transgender person is not that complicated to manage.
No one, especially someone focused on endocrinology, should tell you it’s too hard, or they don’t have the time to learn. Hospitals in rural areas need to be made aware that many are failing in this area by not providing education to their providers, or insisting their providers get training. Know that it is your right and also an important way to support your community to demand excellent care, and report poor care.
*Dr. Carters preferred pronoun is ‘they.’ You can find more info about this online at: theyismypronoun.tumblr.com