In San Francisco, it looks like the Lyon Martin Clinic may be closing due to financial troubles. This is a real loss and I don’t mean to make any less of that loss with what I am about to say here.
I’m pissed off by how I hear the situation being described and I’ll admit that some of my anger has to do with old resentments. A Lot of it has to do with class stuff. I’ll try to describe the situation as I see and have seen it.
Lyon Martin’s early history is that of a second wave feminist health clinic focusing on women’s health. I am a big fan of the feminist health movement. My mother’s involvement with the movement was critical to my later ability to question the traditional trans medical narrative and make choices for myself that were not based on some sexist doctor’s notion of what would “make me a woman”. I believe that the original mission of this clinic and clinics like it is still necessary and important. That has nothing to do with my irritation with the things I have heard this week.
I have heard things like “The truth is that if Lyon Martin Health Services shuts down, it will be a major step towards San Francisco becoming entirely uninhabitable for low income queers and trans people. It is imperative that our community fights to keep this resource”. This is bullshit. There are other resources. There is one in particular. There is the Tom Waddell Health Center, run by the San Francisco Department of Public Health.
I was a patient at Tom Waddell for many years. All of the low income trans folks I knew were. The TWHC waiting room was the site of community organizing and social exchange. It was our community center too. It was the place where trans folks of very diverse backgrounds were all shoved together and had to experience each other at least a little. There was often screaming and crying. There was no escaping the desperation of some people’s lives. I witnessed college educated activist types raising the political consciousness of girls who worked the street. I also witnessed heavy reality checks being issued in the opposite direction of the same conversations. Everyone learned and we were all in it together. A lot of the time it sucked, but there were good things happening.
I remember when Lyon Martin (women’s clinic, remember?) started treating trans men. First, I heard a few complaints about the folks at LM not knowing how to deal with the guys respectfully, but it got better. I knew it was getting better because the number of guys in the waiting room at TWHC went way down. I was well aware that I wasn’t welcome at LM. I felt betrayed by the guys who left. I hated that they would take trans related medical care from people who would not serve their sisters.
The TWHC had a mission that was different from that of Lyon Martin, but there was some overlap. TWHC developed a treatment protocol for trans women and trans men. TWHC provided additional support beyond ‘mones; there were a full range of healthcare services available in a trans sensitive environment. There was group therapy. There was individual therapy. There was substance abuse counseling. The hoops one had to jump through were minimized. The model of care was harm reduction. TWHC also served people with non-binary identities before there was even good language for those identities.
Some time later, LM started treating trans women. I never went. I can’t say too much about how they do things. I do know this: Lyon Martin has become the place you can go if you’re too good to sit in a Public Health waiting room. It has taken on the position of purgatory between having insurance and having to live like real poor people.
To hear Lyon Martin referred to as the only option makes me sick.
The care at TWHC is fine, but it might be much better if there was a larger patient base (public health funding is often influenced by utilization rates).
The quote I referred to earlier talks about low income queers. It does not really mean that. What it means is women and trans folks. Lyon Martin does not serve cis men queer or otherwise. It also refers to San Francisco as becoming “uninhabitable”. I guess “uninhabitable” means you have to, for an hour, waiting to see the doctor, as often as once a month, sit next to someone who sucks cock for a living and gets high sometimes.
I’m sorry for the lousy analysis and lousy writing. I’m just too fucking mad about this and it hasn’t gotten any better as I’ve given myself time to think about it.
If Lyon Martin does close, it will be a loss, but nothing like the loss being described by a bunch of privileged spoiled brat assholes.