For four months, Samuel Davis could not afford his hormone medications.
Without them, he plunged into a depression that made it difficult to get out of bed. Just as he was considering deleting social media, he stumbled upon FOLX Health while scrolling through Instagram.
Davis connected with FOLX — the first all-digital provider focused on medical needs of LGBTQ people — and from the first phone call with his clinician “everything plopped into place.”
“The minute [my clinician] said she was putting in my prescription the tears just started falling,” Davis said.
FOLX is a new healthcare company with curated providers who know how to treat LGBTQ people, and many of the providers identify as part of the community. For LGBTQ people, speaking to providers who identify similarly brings “a lot of comfort,” said Luna Lovebad, a California-based musician who uses FOLX’s hormone therapy services.
FOLX was founded by A.G. Breitenstein, who saw gaps in the healthcare system that disproportionately impacted LGBTQ community while working as a lawyer in Boston at the height of the AIDS crisis.
Years later, she said that the “horrible experiences” she watched the LGBTQ community go through have not changed.
“[The LGBTQ community’s] experience is characterized by a lot of discrimination, a lot of violence, a lot of negative experiences,” Breitenstein said. “Building something that reflects who we are [and] the way we think about ourselves, celebrates us and enables access on a digital platform made all the sense in the world.”
The advancement of telehealth and at-home care, which accelerated during the pandemic, created “the tools and systems to build a fundamentally better healthcare platform,” Breitenstein said.
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It’s common for LGBTQ people to experience discrimination in healthcare settings, according to the Human Rights Campaign’s 2020 Healthcare Equality Index. FOLX is “revolutionary” because LGBTQ people avoid “many barriers” they face when trying to get medical care, Lovebad said.
Another virtual health provider, Plume, focuses exclusively on gender-affirming care, like filling hormone prescriptions, for gender-diverse people. FOLX offers similar services, but also provides care for the full spectrum of LGBTQ identities.
That care includes shipping medications, like hormone replacement therapies, that come in unmarked boxes if members request so, and a hotline that offers encouraging recorded messages. The company guarantees transparent pricing, and has an initiative in place to provide services to some people who can’t afford them.
Lovebad used to take buses and trains from her home in Compton to the Los Angeles LGBT Center, about an hour trip one way, for transition-related appointments. She said she felt she couldn’t “maneuver in public without people saying things or making it seem like [she’s] not allowed to take up space.”
“From accessibility, providers misgendering patients or a lack of awareness on part of medical providers, it all takes a serious toll on someone,” Lovebad said. “A lot of [queer trans] people fear being out in public. Providing these services and having them delivered to your door it makes it all so much easier.”
Discrimination in healthcare against LGBTQ people sometimes comes down to lack of knowledge; a Journal of the American Medical Association article reported medical schools nationwide spent on average five hours across four years on general LGBTQ topics. Some LGBTQ fear being treated unfairly enough to avoid seeking care altogether.
The number of people who called Trans Lifeline, a hotline and microgrants nonprofit that supports transgender people with medical-related crises, skyrocketed in 2020, Public Relations Director Yana Calou said. Many complained about provider discrimination or inability to access care. Calls from people who could not access treatment spiked 132% in January 2020 compared to January 2019. In the first month of 2021, the hotline received 42% more reports of medical trauma than it did in January 2020.
Trans Lifeline partnered with FOLX to further reduce costs for some patients. The organizations plan to provide 100 people with free hormone replacement therapy services through FOLX for at least a year, though it could be longer depending on how much money they raise, Calou said. Grant applications will open on FOLX’s website on March 1.
Like Davis, affordability of doctors visits and medications added roadblocks to getting adequate care. Transgender workers are nearly four times more likely than the population as a whole to have a household income of under $10,000, according to a National LGBTQ Task Force report.
FOLX’s website promises no surprises in its pricing. Hormone replacement therapy subscriptions start at $59 per month for ongoing treatment and $119 monthly payments for people starting hormones. It offers other products at varying prices.
FOLX launched a hotline, 1-888-FOLX-FAM, with recorded messages of love and support for LGBTQ people from activists, artists and influencers. These figures also recorded “letters to my younger self,” and a user–generated component encourages people to record their own messages.
FOLX is the first major LGBTQ company to receive venture capital funding, Breitenstein said. It raised $25 million in investments with support from Bessemer Venture Partners. That support will meet FOLX’s goal of reaching all 50 states by the end of the year and rolling out more services, including mental health care and family creation.
LGBTQ people default to practices like surrogacy or IVF to get pregnant, many of which cost thousands of dollars “as soon as they step into the clinic.” FOLX practitioners could assist people with tasks like at-home insemination, Breitenstein said.
“Being able to do that virtually, having the tools to do it, that’s all part of the strategy,” Breitenstein said. “We’re really excited about it because its almost like a tax on being queer for us to get pregnant … and that doesn’t make sense.”
FOLX started out slow and welcomed customers from 12 states in November, about a year after Breitenstein founded it.
Breitenstein said “it’s timely” both to launch something like FOLX and for an LGBTQ business to receive major financial support.
“[LGBTQ people] never had a brand that’s really directed to us, so for us to be the first national brand that speaks to the whole queer and trans community is an honor and a privilege, [also] scary as hell and exciting,” Breitenstein said. “In some ways you’re like ‘how has this never been the case before?’ We are a huge consumer constituency … its about time.”
Davis has received hormones and worked with a clinician through FOLX for almost two months, and said the service has “followed through” on their promises. There was a “weight on [his] spirit” when he went without hormones, but since then FOLX has helped relieve that burden.
“[FOLX’s] concern, more than anything, is getting us healthcare the way that we need it,” Davis said. “They gave me back a sense of self. They gave me the chance to really rise up again.”