Sacramento Resources: Interview with Gender Health Center

 

In honor of LGBTQIA Pride month, let's look at what resources are out there for the queer community!

I first heard about the Gender Health Center (GHC) around 2011 or 2012, and since then it has been my go-to referral source for resources, support and care for the transgender and LGBQIA communities. However, it wasn't until about a year ago that I learned just how much they do for our Northern California community... and, I was impressed!

Some of the more known about services (as well as where GHC got started) include the counseling program and support groups. GHC offers multiple support and peer-led groups for transgender individuals, youth, their partners, their family, friends, and allies.  

In order to learn more about all that GHC has to offer, I’m talking with Finley Terhune (pronouns: they/them/theirs or he/him/his), Counseling Program Manager at the Gender Health Center.

 

 

Adriana: What’s the back story for the Gender Health Center (GHC)? Tell me about how the Gender Health Center got started as a part of the Sacramento community and how it got its roots here?

Finley: Gender Health Center was originally the vision of a woman named Danelle Saldana, an MFT who worked with our Clinical Director, Dr. Nylund, at the LGBT Center, and had seen that there was a significant need for competent mental health services for transgender folks. She reached out to community and got the process as far as getting the 501(c)(3) non-profit status before she passed away unexpectedly in her sleep. The others involved kept the vision alive, and in July of 2010 Gender Health Center opened its doors.

From the beginning, part of the vision of Gender Health Center has been that by focusing on compassionately and competently serving the most marginalized of our communities we will not only be able to make the most impact, but will also be able to provide support for other areas of these communities more easily – for example, we do not take insurance, but instead offer all counseling on a sliding scale basis, and this allows us a significantly wider ability to tailor our counseling relationships to the individual(s) seeking services, because we are not limited by a certain number of sessions, a requirement for certain diagnoses, or many of the other things that come with participating in the insurance-based model.

Since then, we have expanded to offer a great number of programs outside of individual and relational counseling. We provide 4 hours of no appointment necessary drop in counseling a week, 18 hours of Respite programming over three days each week - and the Respite program also serves dual duty for many community members as a community space in general. We have a needle exchange and Harm Reduction Services program, a new PreP Clinic, a stop-gap hormone clinic, healthcare enrollment, CalFresh enrollment, a medical legal partnership with Legal Services of Northern California to help people with medical and insurance related legal concerns, and a fairly extensive advocacy program in general. At this moment we are even branching some of these things out in new areas, so there will be more to come!

A: As a clinician myself, I’m most familiar with the counseling program GHC offers, providing low-cost, affirmative and empowering therapy to all community members, while specializing in meeting the needs of the queer community. What do you see are the strengths of the counseling services at GHC? How do the GHC’s counseling services differ from the other providers around town?

F: I think that there are a few important areas where GHC’s approach to counseling is different than many others. First, using a queer informed Narrative Therapy lens allows more movement in the therapeutic relationship; what I mean by that is it focuses on helping clinicians to try and level the power hierarchy in therapy as much as possible, while centralizing the community member(s) in session as the experts of their own lives, who have already been living and coping with whatever concerns brought them in to counseling - even if they haven’t yet noticed that fact.

The other way I think we do things very different is in the way we utilize the intern model. Many agencies utilize an intern model to provide services, and at GHC all of the therapy we provide comes from interns or volunteer clinicians in the community. What is different, in my opinion, is how we do this. We offer extensive trainings to our interns and trainees, starting with 30-40 hours of training before they ever sit with a community member. We cover standards like HIPAA, workplace procedures and policies, but we also cover things like a thorough introduction to transgender terminology and experiences, queer competency, and provide a speakers panel for oncoming interns and trainees to ask questions of and listen/learn from.

During the year, we provide weekly Narrative Seminars designed to help burgeoning clinicians develop a thorough understanding of Narrative Therapy, and how it might fit in with their practice. We also recently launched a new portion of our program focusing on clinical support; in addition to the group and individual supervision our interns and trainees are provided, we offer an hour a week of small group, cohort style space to explore our growth as clinicians with other interns, trainees, and mental health staff. These various types of support for our counselors are pivotal, I believe, in the way we are able to create a wide support network not just for clinicians, but for their community members as well.

A: Now that I’ve gotten more familiar with the Gender Health Center, I’ve learned about the wealth of other programs (beyond counseling) that you offer. Let’s start with the hormone clinic… tell me about how the hormone clinic works and the services offered.

F: The Hormone Clinic was one of the first programs at GHC outside of counseling. It is technically a “stop gap” clinic, which means it helps people to stay on their hormone replacement therapy (HRT) in the face of barriers to getting these through “traditional” medical arrangements.

At Clinic, folks are able to get their initial prescriptions for HRT, as well as refills and the periodic lab work that is generally done. Additionally, there are advocates who work with every clinic participant to help identify and, when possible, move towards remedying barriers the people coming to Clinic may be facing.

A: Harm-reduction services are a key component of GHC. GHC offers rapid HIV tests, provides a variety of condoms and lube, a syringe access program, and PrEP programs.  How would someone gain access to these programs?

F: Our Harm Reduction Services (HRS) counter is in 201 (our old front office) now, and anyone can walk in and go there to get access to our syringe access program and, during most hours, rapid HIV testing. Folks can also come here to pick up latex condoms, latex dental dams, and lube. The HRS counter collects very basic information when handing out needles – age range, zip code you identify as living in, drug of choice. It’s a very accessible space, and we’re definitely working on developing it even more fully.

Our PrEP clinic is relatively new – our first one was this month! In order to get access to the PrEP clinic, you must be trans identified, and have a desire to take PrEP. If you meet those “qualifications”, you can schedule an appointment with the PrEP Clinic, and you will be given lab work orders to have done five (5) days before your appointment. You’ll come in for your appointment, meet with the doctor, and as long as your lab work is done and comes back in a range that works for the doctor, you’ll leave your appointment with your prescription for PrEP!

A: Also, can you tell me how PrEP works?

F: My favorite response for this is this video on Demystifying HIV Pre-Exposure Prophylaxis. 

Basically, HIV is a fairly weak virus in terms of shelf life outside of cells with which it has bonded. Much of the power of this virus comes in its ability to reproduce, which requires bonding to cells in our bodies. As the video notes, the enzyme that is necessary for this reproduction is inhibited by PrEP – much like scent receptors in our nose (different “shaped” receptors cause us to experience different “smells” when they are activated – AKA when properly “shaped” molecules set up shop in those receptors), PrEP bonds to the places on cells where the HIV virus would bond, and then reproduce from. If it can’t bond, it can’t reproduce - and then it dies relatively quickly.

It’s also worth noting that the company mentioned – Gilead Pharmacies – can sometimes offer discount/copay cards for people to help them access PrEP or HIV treatment medications.

A: What types of assistance are offered through the legal and advocacy programs?

F: In terms of advocacy, the majority of what we do relates to healthcare. Advocates can help someone enroll in health insurance, designate/change a primary care provider, provide support around educating providers on how to properly serve transgender individuals, and more. While there are certainly limits on what a given advocate can do in a one hour appointment, every advocate brings different strengths and knowledge to the table. So while I can’t say something like “we do housing advocacy”, it is still an area that some advocates and/or peer advocates have valuable knowledge around.

The legal services are actually provided through our medical-legal partnership with Legal Services of Northern California (LSNC). They provide a drop in space from 4pm-6pm on the 2nd and 4th Wednesdays of every month, and are also reachable via phone. Most of what LSNC does with us revolves around assisting people in filing complaints, appeals, or other medical related legal services. There are limits on what LSNC can do, but they are a great starting point in many situations, and have helped plenty of us in navigating the hazardous realm of the American medical system and health insurance.

A: Tell us a bit more about the respite program.

F: When Respite launched, GHC presumed it would function much like a standard mental health respite – folks would come in in acute crisis once, perhaps twice, we would provide support and resources, and they’d go their own way. We learned pretty quickly that that was not what our community needs for respite. Now, Respite looks most like a community space where members of our community can come to eat, exist, and generally be safe – and many community members come every week, sometimes multiple times a week. The space definitely still serves people in acute crisis, but it is not the majority of the energy in Respite.

Respite has also been a wonderful place for community members to transition into volunteers. Many of the folks who routinely attend Respite also serve as a volunteer to provide peer support during some of their time at Respite. We are currently looking critically at the lack of volunteer opportunities that GHC has had to offer the community, and working on developing some appropriate spaces for people to grow into.

A: GHC is now entering its 7th year. Congratulations!  Since opening its doors, GHC has expanded from a small counseling program to numerous health and advocacy programs to meet the needs of the underserved in Sacramento. What is the vision for GHC over the next few years? Where do you see GHC heading in the future?

F: Gender Health Center has always operated by first responding to the needs of the most marginalized of our communities – when we can best support them, we can generally support others pretty well, too. The programming at GHC develops from what the community tells us they are needing, and often changes to meet these needs as well (Respite is a great example). Gender Health Center recently received a five year grant from the California Reducing Disparities Project to evaluate our services impact and efficacy, with a long term aim of identifying community contributed best practices to the process of providing mental health services to transgender individuals. It’s in its early phases, but it’s a very exciting time for us.

A: What is the best way for someone to get in touch with GHC?

F: Calling our main number is a great way – 916-455-2391. It offers several options to self-direct your call to various staff areas, or you can elect to speak to the person staffing the front desk at any time. We offer such a variety of things that it can sometimes be a bit of a guess for people who don’t know GHC as to who they should be speaking with, but it generally gets where it needs to go fairly quickly. We’re still “hella grassroots”, but one part of that I appreciate most is the interconnected nature of the various service areas at GHC, and that helps us be able to direct folks to the right place relatively quickly in my experience.

A: As we wrap up, is there anything else you’d like to add? 

F: One of the first things I learned about GHC when I came on as a volunteer in 2015 is that it is an organization by trans folk for trans folk. Ben Hudson, our Executive Director, works pretty hard to make that work, regardless of outside sociopolitical environment or pressure. When I was first coming into my own as a trans person, I really didn’t think there were any options for me where I could live my ‘me’ authentically and openly – and I am a white, transmasculine person, with a Bachelor’s degree, advantages that offer me more opportunity than many others.

GHC has offered me a space where people believed in my ability to succeed when I did not, supported and validated my existence when no one else ever had, and the opportunity to live my authenticity. Not just as a community member, but as a practitioner and clinician – something I spent my entire graduate program being prepared to give up for the sake of helping others. Another thing Ben says that always stays with me is this – our community survival is our survival. And it’s true, in a way that I probably could not have even comprehended before coming here. Gender Health Center saves lives, and I am fortunate enough to know that very intimately. While I was privileged enough to be working with community members in counseling as a therapist, those same community members were saving my life - by existing, thriving, and coming into their own. My survival very much relied on their survival, and that’s a fact I hope I never let migrate too far from my heart.

 

 

I want to sincerely thank Finley and their openness and honesty in this interview. The more I learn about and connect with GHC, the more impressed I am with not only the services they offer but how they go about meeting the needs of the LGBTQ community. 

To get in touch with the Gender Health Center to take advantage of their services or just to find out more information please call them at (916) 455-2391 or check out their website to learn about the programs and groups they offer.

Adriana

 

Adriana Joyner, LMFT, is a Sacramento area therapist specializing in helping people lead authentic lives.  Adriana’s most passionate about supporting individuals exploring their gender and sexuality, and advocating for the LGBTQIA community. Her office is located in Gold River, CA located off Highway ‪50 at Sunrise Blvd. For more information or to schedule a consultation, please call ‪(916) 547-3997 or email adriana@adrianajoynertherapy.com.