Richmond's Fan Free Clinic Loses Transgender Funding - Important Policy Changes

November 9, 2011 at 10:50am


Shawn Patrick McNulty, Director of Health Outreach

1010 North Thompson Street, P.O. Box 6477, Richmond, VA 23230

November 4, 2011


For the past seven years, Fan Free Clinic has endeavored to providecomprehensive medical care to and for the transgender community of Richmond, often extending to individuals throughout the state and, insome cases, out of state. The resources for culturally competenttrans-health are limited everywhere, and Fan Free Clinic has worked stridently to try to bridge that gap in care, as is its mission to helpthose who are the least served. Fan Free Clinic is proud to serve thetrans identified communities.

In July of this year, $70,000 of funding for the Transgender (TG) Clinic was lost. These funds have enabled Fan Free Clinic (FFC) to provide services to those who would not normally be eligible to be seen through typical clinic services through the Medical Clinic at FFC. In order for individuals to be seen in any clinic besides the TG Clinic they must meet certain financial requirements and must not have any insurance.The dollars from this grant enabled Fan Free Clinic for many years to not require the same mandatory criteria for the TG Clinic. Fan Free Clinic is now paying for all labwork being conducted on individuals who are not financially eligible to come to the clinic at a cost of approximately $9,000 to the agency for the past three months. Unfortunately, the loss of these dollars and the changing climate for healthcare sustainability are forcing the Transgender Clinic to beginutilizing the requirements of financial screening which have, prior to now, gone unenforced.

This specifically means that if you have health insurance or if you make more than 200% of the Federal Poverty Level (for a single person that is $21,960/year) then you will not be eligible to be seen in the Transgender (TG) Clinic. This policy will take effect immediately but its enforcement will not become mandatory until February 28, 2012. Inefforts to help ease costs immediately to Fan Free Clinic, and in orderto allow more time for transition for those who do not have immediately accessible alternatives to care, Fan Free Clinic is proposing two waves to roll out this policy.

The first wave is a request from Fan Free Clinic to those who have health insurance, make more than 200% of the Federal Poverty level or have a separate Primary Care Physician, to volunteer to step out of the Transgender (TG) Clinic. For those who could immediately begin to receive services through other means and have the ability to do so, your exiting the program will help Fan Free Clinic buy time to assist those who do not have such readily available alternatives and who will need further assistance to transition. For those who can step out of clinic voluntarily, we ask that you please take the following steps:

1) Notify Fan Free Clinic (FFC) that you will no longer be using FFC's TG Clinic. You can do this by calling: (804) 358-6343 ext. 143.You may also e-mail us at:

2) In your notification be sure to let us know if/when you will need copies of your medical chart to take to your new provider. We will provide you with copies of your chart materials in a timely manner. Please be sure to include if you want them faxed, mailed or picked up by you.

3) If you will need prescriptions to carry you over until you are seen by your new or already existing provider, please let us know that as well. The medical prescribers working with the TG Clinic will determine if/how the order can be filled.

This first wave will continue through Tuesday, December 6th. Again, if you have insurance, make more than 200% of the Federal Poverty Level or have a Primary Care Physician with whom you can receive care, we are asking you to please consider helping Fan Free Clinic with cost cutting by voluntarily stepping out of the Transgender (TG) Clinic.

The second wave will begin the night of December 6th. From that point forward, individuals who do not meet the financial screening criteria will not be able to schedule appointments for follow-up at all. These individuals will receive a final appointment to close out their case/time with Fan Free Clinic and the agency will do its best to help case manage individuals who need it into new medical options. This final appointment will include medication extension, fulfilling any requests for medical records and final assessment by the medical providers.

Fan Free Clinic is interested in developing two programs for assisting this transition. Specifically, assistance is sought from those within the transgender (TG) community in collaboration with the two support groups who have worked with Fan Free Clinic over the years and assisted in programming - JRTS (James River Transgender Society) and Richmond Transformers. The need is 1) to help spread the word about doctors regionally who are willing and capable to take on trans health issues and 2) help provide a "buddy system" for clients who may be concerned about going to a provider who is not with Fan Free Clinic. If you areinterested in volunteering to be a buddy, please contact the Trans Health Line at Fan Free Clinic (804-358-6343 ext. 143).

Fan Free Clinic is committed to continuing to provide care to and for those of the trans population who meet the financial screening requirements. Fan Free Clinic will continue to advocate and use its voice in support of the trans community and provide referrals and information to those in need. Transition is always difficult - this will certainly be so. Fan Free Clinic is dedicated to helping ensure that no one becomes lost to care. This, however, will have to be acommunity effort - Fan Free Clinic cannot do it alone.

How can you help?

1) If you do not meet the financial screening requirements, volunteer to step out of clinic so Fan Free Clinic can better focus its financial resources to assist those who truly have no other alternative.

2) If you know a medical doctor, an endocrinologist, or a nurse practitioner who is culturally appropriate for the population and is open to assisting with hormone therapy, please share that information (even if quietly) among your acquaintances and friends within the Transgender (TG) Community.

3) Be willing to volunteer as a buddy to help someone get overtheir first appointment jitters with a health care agency outside of Fan Free Clinic.

This is a lot to take in. Again, we understand that transition is both difficult and emotional. We will do everything in our power to ensure that everyone who is in need will find their way to the door of apractitioner who will help them. For those of you who will be able tostep out of clinic immediately, my thanks in advance. Please discuss this with each other and please feel free to contact us. You may reach us with any questions you have regarding this matter or, again, if you are willing to help be a buddy, please contact us at either:


The Trans Health Line at (804) 358-6343 ext. 143.

We will respond as quickly as possible. Thank you for your time and your patience with Fan Free Clinic. We have always worked to serve those who are least served and our mission to assist the Transgender (TG) Community is as solid as ever. We may have to find new ways to navigate the obstacles that get presented to us, but together we will find the way. Again, thank you for your time and your support.


Shawn Patrick McNulty

Director of Health Outreach

Fan Free Clinic