A Letter from PPMM CEO Stacy CrossDear Friends, I look forward to every opportunity to show how your support of Planned Parenthood Mar Monte is improving your community. Today, I’m especially excited to tell you that since the beginning of April, gender affirming care, including hormone therapy, is now available at all 35 of our health centers. In this newsletter Dr. Cassy Friedrich, PPMM’s Gender Affirming Care Program Director, answers questions about the innovative program she leads. Patients who benefit from this program often face judgment and discrimination when trying to get care elsewhere. Next you can read about the Family Medicine Patient Navigators (FMPNs) who help patients enroll in the MediCal health insurance program – a critical service at a time when so many have lost their jobs and their health insurance.
On behalf of the nearly 250,000 people who received medical and education services from Planned Parenthood Mar Monte last year, thank you. With gratitude,
Stacy Cross
It’s been a year since Dr. Cassy Friedrich came to PPMM as Gender Affirming Care Program Director. Since then, we have seen a steady increase in the number of patients seeking this care, which addresses health disparities that transgender and non-gender conforming patients face by equipping staff with the tools and knowledge to meet their needs. Dr. Friedrich has launched a training program in health centers to expand gender affirming hormone therapy to all health centers. We caught up with her to hear the latest. PPMM: What gender affirming care services is the affiliate offering now? Dr. Cassy Friedrich: In April, we are integrating gender affirming hormone therapy into services at every health center. Also, in addition to being trained to teach patients how to give themselves hormone injections, staff is creating a gender affirming environment across the services we provide because transgender and non-binary people come to us for all of our services. It’s our goal to provide affirming care in our health centers for people of all genders. This is so important because a lot of communities, including some remote regions in the Central Valley, don’t have access to these services. We have telehealth appointments with patients who live really far away because they can’t get this care where they are. PPMM: When did you begin the affiliate’s gender affirming health care?
PPMM: What materials are you using in your training webinars? Dr. F.: We’ve shown several videos, including of one trans man describes what it was like for him to develop breast cancer and then be denied treatment. There are many ways that our medical system doesn’t practice gender affirming care, which means people are denied health services they need and deserve. PPMM: What are examples of appropriate language in gender affirming care? Dr. F.: Well, in general, never assume someone’s gender and pronouns based on their appearance. Understand that people must be called by the name and pronouns of their choosing. Use neutral terms as much as possible, and, once you know someone’s pronouns, make every effort to use them. PPMM: What are you most proud of about PPMM’s gender affirming care? Dr. F.: The feedback from staff and patients is incredible. We heard from a patient at one health center who came in to be started on Depo (birth control). They expressed such gratitude for how they were treated, especially in comparison with their negative experience at another community clinic. At our site, the staff made an effort to ask for and use the patient’s chosen name and pronouns, and the patient said it was the first time they felt like they could return to a health center for care. You can really see the impact, and I’m so proud that we are providing it at PPMM. Because of your generosity, this program is leading the way in expanding health equity.
Thanks to your support, Planned Parenthood Mar Monte continues to be a leader in providing health care to our communities during the pandemic, innovating to serve patients and families. Recently, four of our Silicon Valley health centers that provide family medicine began a partnership with Santa Clara County to help patients with low incomes enroll in the state Medi-Cal health insurance program. Our family medicine patient navigators (FMPNs), who work with clinicians to connect patients to outside referrals and other resources, are expanding their role in the county. “One of the main issues we’re seeing now are people who have lost their jobs because of COVID and are scrambling to find health care,” said FMPN Eric Pineda, who works in San Jose. “A patient recently told me she had been calling Medi-Cal a couple times a week and waiting for two-plus hours to get through,” he said. “When she came in for a Pap test, I was able to enroll her in Medi-Cal. She called to say how relieved and appreciative she was to finally have that insurance.” Luz Robles, another FMPN in Silicon Valley, said a patient had asked if her son could be enrolled in Medi-Cal after losing his job. The patient said her son was so profoundly depressed and anxious that he was unable to leave the house to enroll in person, but he needed coverage. “I was able to sign him up for Medi-Cal, and a very short time later he had to be hospitalized for a health situation related to his depression,” Luz said, “We were also able to connect him with our behavioral health services so he could have therapy and help with medications.” If the health centers’ Medi-Cal enrollments stay at their current pace, PPMM hopes to enroll hundreds of new Medi-Cal patients in Santa Clara County by the end of this year. It’s another way our FMPNs, whose work you make possible, are able help patients navigate a complicated health care system, spending extra time discussing their health care beyond the actual appointment – whether in health centers or via telehealth. “As FMPNs, our goal is to keep people healthy and away from the ER. Getting them access to Medi-Cal is another great way to do that,” Luz said. “It brings me so much joy to be able to help patients by talking to them about their health goals and what’s happening in their lives – and get them coverage they really need.”
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No matter where you live, people in the Planned Parenthood Mar Monte affiliate area – from Monterey to San Jose, or Fresno to Sacramento, and on to Reno – are able to access health care services and education programs because of you.
Dr. F.: I started the training back in November, talking about the foundations of gender affirming care, including language and terminology. All Patient Services staff are receiving this training, including Response Center staff. I’m also discussing the discrimination that so many folks have experienced when trying to access this health care. 
