To put it plainly, the health care system in the U.S. is failing the LGBTQ+ community. Many doctors remain uneducated about how to educate patients on having safe queer sex, or on other topics including reproductive health and fertility. More than half of all LGBTQ+ people face discrimination while seeking medical care, one in five trans people are refused care outright, and 42 percent of trans women report being verbally or physically assaulted in health-care settings.
There have been many LGBTQ+ health-care providers dedicated to providing affirming care to their patients for decades, including The Center in New York City, UCSF Transgender Care in San Francisco, and others around the country. But the telemedicine boom has been slow to serve this community. Launching today, Folx is the first health startup to provide customized medical treatment and care specifically for the queer and trans communities through telemedicine, with brick-and-mortar clinics to open in the future.
What Folx offers
Founder A.G. Breitenstein—a 30-year veteran of the health-care system—says Folx is 20 years in the making. “The seed for the idea was planted when I was an attorney working with queer kids in Boston,” she says. “Most of them had been thrown out by their families and were working in the sex trade. I had a front-row seat to what their lives were like.” Breitenstein says she saw first-hand the ways health-care providers weren’t there for her clients, and that they didn’t feel safe going to the doctor.
“This is a community that’s really underserved,” Breitenstein says. “There’s so much about health care that’s very specific to us,” she says. [Breitenstein includes herself as she is genderqueer and nonbinary.] She explains that STI testing hasn’t adapted for the way LGBTQ+ people have sex (for example, existing testing guidelines only provide specific recommendations for cisgender straight women and cisgender gay and bisexual men). LGBTQ+ folks also must approach family creation differently from heterosexual couples, specifically regarding IVF or surrogacy. “Then, in terms of the trans community, access to hormone replacement therapy is an important part of the conversation and is a topic many primary care physicians just throw up their hands and say that they don’t know how to do it,” Breitenstein adds.
Folx was designed intentionally to address and mitigate those challenges. First launching as a telemedicine platform, Breitenstein explains that Folx is a direct-to-consumer model where members will pay a subscription fee (starting at $59 per month) and then appointments are free. While Folx doesn’t accept insurance, Breitenstein says the cost of any lab testing or medications will purposely be kept as low as possible so people can better afford them. Starting now, Folx will offer gender-affirming hormone therapy, erectile dysfunction treatment, at-home STI testing, one-on-one consultations, and prescriptions. Breitenstein says all of the providers at Folx have specifically voiced interest in working with the LGBTQ+ community and have educated themselves on how to best treat this population.
Tailormade products—and what’s coming next
Besides the telemedicine services, Folx is also launching its own STI testing and hormone therapy kits. “Because queer and trans people have sex differently [than cisgender heterosexual people], most STI testing kits only do two test sites, but we really need three test sites,” Breitenstein says. “Also, the instructions for traditional tests are completely gendered and don’t address the queer population in an inclusive way. The language the Folx kits use is completely different and really tracks with the community we are serving.”
The telemedicine services and products Folx offers represent just the beginning of Breitenstein’s plans for the company. She is hoping to open brick-and-mortar Folx clinics in the “not-so-distant future.” She explains that the clinics she has in mind will in no way feel like a traditional doctor’s office. Instead, they’ll look like places people will actually want to hang out; a truly welcoming environment. While the timeline for opening these clinics is still under wraps, they’re certainly front of mind for her as to where she wants Folx to head next.
While the launch of Folx is exciting—and severely needed—it doesn’t mean that mainstream health care doesn’t need to adapt to better serve the LGBTQ+ community. But besides meeting an underserved need, Folx is setting the example for what more inclusive health care can and should look like. So while it may be one of the first to offer services such as more inclusive STI kits, hopefully it won’t be the last.
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