Transgender patients report obstacles since Golden Valley’s takeover of Modesto clinic
Since summer, when Golden Valley Health Centers took over the Paradise Medical Office — formerly operated by Stanislaus County — members of the transgender community have reported challenges accessing their regular healthcare.
Specifically, patients say they have struggled to schedule appointments with The Rainbow Clinic, a gender health clinic at PMO. The clinic, staffed by family medicine residents, provides essential gender-affirming care, such as hormone therapy and surgical referrals.
The Rainbow Clinic continues to operate at the PMO, now under the management of GVHC. The attending physicians have remained the same, with the addition of Dr. Danielle Myers, a GVHC physician specializing in gender health. The clinic also has expanded its hours to include Tuesday mornings, the second and fourth Thursday mornings, and the first and third Friday afternoons of every month.
Despite this, Veronica Ambrose of MoPride said the community has been unable to get in touch with the Rainbow Clinic following the transition. She said she’s been on hold for over five hours and is unsure who people are supposed to contact to schedule appointments with the clinic.
Some community members have reported lost medical records and being required to register as new patients with GVHC. A Golden Valley executive confirmed that all patients transferred from the Stanislaus County Health Services Agency had to register as new and admitted that records transfer was “not 100% successful.”
Other patients have shared that they were denied refills on standing prescriptions, despite having received gender-affirming care for years.
“It’s really frustrating, and it’s gonna end up killing people, honestly,” Ambrose said.
According to Ambrose, a Discord group chat with over 50 local transgender community members has become a space where individuals seek out surplus medications from others who have extra.
“It’s really putting our trans community in this very dangerous position because we should not have to be trading medications in order to continue cohesive care,” Ambrose said.
MoPride typically refers community members to the Rainbow Clinic because it is one of the few local providers, alongside Planned Parenthood, that offers gender-affirming care. Otherwise, patients are left with the burden of traveling to the Bay Area or Sacramento to access care.
However, MoPride has been hesitant to make referrals since it’s been unable to reach the clinic. Even MoPride’s community health workers, who assist with appointment scheduling, health insurance applications and patient advocacy, have been unsuccessful in making contact.
“We’re not gonna try to send [community members] down that rabbit hole,” she said.
Ava Price, a transgender woman from Modesto, began receiving gender-affirming care at the Rainbow Clinic in the summer of 2022. She said the staff was always supportive and eager to help, with minimal issues accessing the care she needed.
“It felt like a kind and understanding atmosphere that I didn’t feel like I had to jump through hoops to get what I needed,” Price said.
The transition to GVHC occurred while Price was overseas during the summer. Shortly after her return, she discovered that her previously auto-renewal prescriptions for gender-affirming care had stopped.
When Price called GVHC to schedule an appointment with the Rainbow Clinic, she said the office staff seemed unfamiliar with the clinic and instead booked her an appointment with the center a month out.
On the day of her appointment, Price was informed that her medical records hadn’t been transferred and that she needed to register as a new patient. Her appointment was with a regular GVHC doctor, not a physician from the Rainbow Clinic, who was uncomfortable prescribing her gender-affirming medication, despite Price having been on it for years.
Unable to get her medication filled in time, Price said she soon began experiencing the effects of being off her treatment, including irritability and shaking. She turned to friends in the community who had extras of her medication.
“I had to really rely on my friends to get medication that I needed in order to feel like myself,” she said.
Eventually, Price turned to Planned Parenthood, where she was able to have her prescriptions filled and lab work ordered on the same day as her appointment. While she was relieved to have that option, she expressed concern about the organization’s future, particularly under a second Donald Trump administration, which has advocated for defunding the reproductive health care provider.
Price believes the transition of the Paradise Medical Office to GVHC also reflects a broader trend of defunding and dismantling public health systems in favor of privatization. She said that while the transgender community is being directly affected, this issue is part of a larger crisis undermining the public health system as a whole and will impact others.
“We’re easy because we’re marginalized,” Price said.
An adjustment period
Some challenges during the Rainbow Clinic’s transition to GVHC have been attributed to an adjustment period.
According to Amy Collier Carroll, GVHC’s vice president and chief communications officer, all patients transferred from Stanislaus County HSA to GVHC this summer were registered as new patients.
“During the transition, our IT teams worked together to directly transfer as many records as possible from the county to GVHC. During this IT transition, and despite everyone’s best efforts, the record transfer was not 100% successful because we had two very different computer systems attempting to share electronic medical record data across platforms,” Carroll said in a statement.
Regarding prescription issues, refill requests are sent electronically from pharmacies to physicians. GVHC informed all local pharmacies about the Paradise Medical Office transition in advance, and pharmacies have been submitting refill requests as usual.
“If prescription requests are not making their way to GVHC in the computer system, patients are welcome to message their physician directly in the MyChart app [or] stop in at the Paradise clinic location, where staff can assist them. Former county patients who have yet to be seen by GVHC can call and schedule an appointment to establish care with us,” Carroll said.
According to Carroll, GVHC served nearly 8,500 patients at the Paradise clinic in the first 90 days of the merger.
Patients seeking gender-affirming care at GVHC can call 209-722-4842 to request an appointment. No referral is required for the Rainbow Clinic. They can also be seen at any GVHC clinic by a primary care provider, who can then refer them to the Paradise clinic for gender-affirming care.
One of the advantages of places like the Rainbow Clinic and Planned Parenthood is that they provide care based on informed consent, allowing patients to access services without additional barriers.
Jorge Fernandez, director of behavioral health at GVHC, said trans individuals need letters of support for their gender-affirming surgeries. Oftentimes, patients want one after having just one appointment with the center. However, GVHC likes to have multiple appointments to maintain its quality of service and to get to know the patient better, Fernandez said.
“How do we find a good balance between we don’t want to delay them for a year, but we don’t want to write a letter in a one-time session,” Fernandez said in June.
Community members can also access care through Valley Streetz, a Modesto-based harm reduction program that hosts an evening clinic at MoPride on the second Thursday of each month. The clinic will help patients access gender-affirming care, hormones and other family medicine services.
This story was originally published December 17, 2024 at 1:01 PM with the headline "Transgender patients report obstacles since Golden Valley’s takeover of Modesto clinic."
