What would you like us to know about your experience accessing reproductive healthcare?
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Black or African American: Accessible and covered but long wait times and miscommunication makes getting procedures done in time make things delayed and harder to connect with the right people and understand where I am in the process.
American Indian or Native American Asian Black or African American Latinx White: Being trans and non-binary can be a huge barrier to getting culturally and identity/body compentent care for my health issues typically associated with women. and all too often my disabilities are seen as a a barrier to treating me for unrelated health issues, causing me to only get sicker & have compounding health problems build on each other.
Latinx: Could be to expensive to access
American Indian or Native American Latinx: Doctors lack knowledge about what I'm looking for: non-hormonal birth control. I've had to educate myself and my doctors about what I found and need e.g. Kaiser reimbursement for biometric tracking birth control app tracker and prescription for a female diaphragm. I was also judged for not wanting to take hormonal birth control without the doctor offering any medical advice of actions I could take. I also have medical trauma due to an extremely painful IUD insertion when I was younger. I overprepare and experience medical anxiety for any reproductive-related tests. It makes a difference the way that I communicate with a doctor.
Black or African American Latinx: Drs need to take sexual and reproductive health care more seriously. Stop blaming it on cramps or our periods!
Latinx White: finding actual non women's health places that aren't run by old yt women is almost impossible, let alone covered by insurance. finding ppl that recognize these types of appointments might be harder for non gender conforming ppl or neurodivergent ppl, also basically impossible.
American Indian or Native American Black or African American: Huge lack of knowledge on gender affrrming care. Lack of access and barriers in place to prevent me accessing reproductive care. Gaslighting by reproductive doctor.
Latinx: I’m happy to have OHP to help with accessibility
Asian White: I access appointments with the gender care clinic virtually which makes accessing care much more accessible. If I had to go in person for check ins it would be a lot more problematic because I would have to take time off work.
Latinx: I would like to acknowledge the great accessibility of planned parenthood where i was able to get an IUD for free
Asian: I wish there was more help from the Consulate of Japan in Portland about how to navigate the local medical system in Portland. I want more personalized, vetted information on where to go, which doctors to see. I'd like to see BIPOC (especially Asian) female doctors who have experiences with Asian immigrants in Portland for my sexual and reproductive care. Luckily, I have found a BIPOC female naturopath in Portland and she is going to test my sexual hormones, but I am still not sure when I can get sexual and reproductive routine exams. *I am a voluntary immigrant who came here to get married with my American husband.
I am not sexually active so a lot does not apply but as far as I know my insurance and pcp covers STI testing and could cover the topic of I asked.
I don't know where to get free condoms, pregnancy tests or plan b contraceptives in my area.
Asian Latinx: I go to the Gender care clinic at Kaiser Interstate Medical Center. I have OHP. I've always gotten the care that I've requested from them. My PHP is queer and he's never made me feel fearful of going to him with concerns.
Asian White: I have access to incredible fertility and endometriosis providers in the portland area. the biggest barrier is lack of insurance coverage for IVF. I am an excellent candidate for IVF and have no other options due to tubal endometriosis. i'm relatively young and have a great egg count, all my other numbers are great. all i need is coverage for IVF to be able to grow our queer family in the way my wife and I want to. IUI and other methods are not an option for us. I wish Oregon mandated this coverage for queer families. the other issue is long wait times for my OBGYN who is amazing but it's so hard to get in to see her. lastly, it took way too long to get diagnosed with endo. i saw multiple providers who did not take my pain seriously.
Latinx: I have an undiagnosed condition in my reproductive organs, that doctors and other providers haven't been able to figure out. but only ever reffer me to minimal testing/ screenings and after they "cant tell" whats wrong they don't ever go searching for deeper avenues of testing. it feels like all i get is a, I cant tell whats wrong with you, a shrug and a let us know if it gets worse. it feels as since im not dying i dont get to know whats wrong with my uterus.
Black or African American: I have found that online resources have been super helpful in finding affordable and accessible care options.
I have had amazing experiences with my healthcare provider, who listens and respects my choices.
I've had a difficult time getting HRT due to financial restraints and sometimes chronic homelessness.
Black or African American White: I haven't had any experience in Oregon yet. In Michigan all of my healthcare was covered. I just got on OHP and I'm hoping everything here is covered
Latinx: I only currently receive HRT and reproductive health does not apply to me as I'm not sexually active, but I experience many complications in the health world due to having Long COVID
Asian White: I only decide to get care when i really need it and when i know it's safe, after word of mouth referral and reading reviews. Keeping myself safe is most important but also means long wait times for appointments
Latinx: I started hormone therapy here in Oregon and the process was much easier than I anticipated, it wasn’t full of barriers or judgement just a medical professional who was helping me get what I need
Asian Native Hawaiian or Pacific Islander: I struggle with my insurance because it’s through work, and it won’t cover my HRT because I haven’t seen a therapist continuously for over a year about my gender identity. So I’m paying for T out of pocket, and it’s a lot of money. Same with the labs that need to be done to make sure I’m safe.
Latinx White: I'm a trans advocate and educator who works in healthcare, so I admit that my access and understanding of insurance, medical care, and community resources is higher than most. I also moved to OR from OK, so I'm used to navigating much *much* worse systems for gender, sexual, and reproductive healthcare. In comparison, Portland seems like a walk in the park
Black or African American: I think the questions have covered this pretty thoroughly, but I wanted to state in my own words that a huge barrier for me accessing any health services is finding this mysterious and elusive combination of healthcare providers who move through the world similar enough to me that I don’t have to catch them up so to speak. Often it’s I found a cool queer doctor but they’re white, I found a cool therapist but they’re white and young. Honestly, I’m going to stop there and just say it is nigh impossible to find a queer & Black healthcare providers who move who is around my age, or, isn’t around my age. And that’s even before I get into an any combination of that + takes my insurance. The cost is prohibitive, and the risks of having to educate my provider on what I would consider essential knowledge is too high.
Asian White: I was not taken seriously at OHSU about hormonal testing and the main doctor there said they would block my insurance if I tried to order hormone testing
Latinx: I was sexually assaulted in the past, and when I went to Kaiser ER in Sunnyside, the nurse told me I couldn't be raped because I was trans. Only cis women could be raped. I stormed out of the ER and it was 3 days until my friend took me to another hospital to get care, get STI testing, etc.
Asian: I've had horrible/transphobic experiences navigating fertility preservation at a "LGBTQ friendly" fertility clinic (ORM) about 10 years ago.
Latinx: Im always charged to take pregnancy test even when I tell them I am Queer with no possibility of pregnancy. So im spending money when i already cant afford to be at said clinic
Asian: Im an outlier in that im very lucky to be so physically okay. Ive only had an iud put in by planned parenthood and it was no cost to me for that. I had a pap smear and some std testing done but thats basically it. I was lost on how to answer since a lot was not applicable.
Black or African American: It is readily accessible but the problem is the cost of having it without insurance
It's difficult to find a decent OBGYN in the Kaiser system that won't talk about weight before anything else comes out of my mouth.
Latinx: It’s difficult to find someone who has experience and knowledge working with transmasculine people
Prefer not to say or use these categories: It’s impossible to get the care I need as an intersex person. No one knows how to care for me. No one thinks to check the prostate cells I have because I also have a vulva/vagina.
Latinx: It’s kind of expensive and you need a good insurance to cover everything
It’s the lack of knowledge of trans health that is my problem. People are not as familiar with trans needs or helping guide as trans folks get older.
Asian Latinx: Lack of QTBIPOC care providers sometimes leads to avoidance in seeking care. This holds especially true for finding non-biased mental health providers. I had to change my PCP and clinic due to lack of access/knowledge of gender-affirming care.
Black or African American White: Living in Portland has thankfully given me decent access to sexual/reproductive care, but the quality, accessibility and affordability can vary wildly because I'm reliant on OHP which is not accepted everywhere and also limits the degree of care available. For example, sperm cryopreservation is not covered, which inhibits my willingness to start HRT, ultimately leaving me in a negative feedback loop where I want to start HRT - and theoretically could start - but am hesitant due to possible infertility. This, to me, feels like a goal of the system; to force me to choose between a potential family and my own happiness.
Asian: Long wait times and high copays make me less inclined to seek out sexual and reproductive care
American Indian or Native American White: Most doctors outside of the "transhealth care" network don't know BASIC things on how to treat trans men. and inside the Transhealth care is alot of control and decsion making for me under the guise of acess. I have had many medical issue that relate to my disabilities from birth be misdiagnosed as a "trans related medical issue". its bias made to look like informed treatement of trans people. No trans people in this state are getting adequete healthcare across the board. Especially emergency services.
American Indian or Native American Latinx: My doctor was kind, but it’s has been hard to get ahold of provides that give gender affirming care. Everything has a waitlist and is very frustrating
Asian: My experiences in Oregon have been pretty good but it’s important to note that my chronic reproductive health condition (adenomyosis) has been very stable and well managed the whole time I have lived here w no need for any changes to the treatment plan. If my condition got worse, I don’t feel super confident that my current care providers would be able to help and don’t know where else I could seek care.
My provider is also queer and trans; I'm lucky to have access to a doctor who understands me, my concerns, and is able to answer my questions well without me having to be the one to educate them.
Latinx: My provider is excellent. However, the practice added to my chart and medical records "risky sexual behaviors" once I began PrEp. I am in a mostly monogamous marriage. This feels stigmatizing and "judgy." The provider is Providence Primary Care, so I feel their religious affiliation and potential personal biases caused this.
Black or African American: Often i am turnt away when i try to get care because my insurance doe not cover thr care.
Black or African American White: Often not feeling listened to or taken seriously when discussing my symptoms. Very few options to deal with issues relating to sexual health for people with uteruses.
Latinx: OHP providers are notorious for treating patients poorly - I remember a few years back, I think OHEA held a community forum online about patients with OHP and there were so many horror stories about dentists and doctors. Submitting complaints to the state of Oregon about this treatment is too hard, especially for monolingual non-English speakers, who already feel like they're not taken seriously.
One of the major barriers to accessing care (specifically pap smears) is the double whammy of being a survivor of sexual violence and agender. So getting a pap smear is retraumatizing, but the ways that my doctors have often dealt with that is by leaning hard into gendered language--it's so important for me to get a pap smear to protect my womanhood, so that I can be a mother, etc. (One PCP did a whole, like, Divine Feminine/Mother Goddess thing which would have been funny if I weren't on the verge of a panic attack the whole time.) So the combination of "I have to do this thing that is deeply physically uncomfortable and will set off my PTSD for the rest of the day" and "my provider will 'helpfully' misgender me the whole time" makes me avoid pap smears for as long as I can. Also, because I'm asexual and have never had consensual sex, providers get really confused about how to deal with me. Perhaps the most telling exchange was when a PCP asked me about the genders of my past partners. I asked if she was asking what had come into contact with my genitals in what configurations, and she said, no, she was asking about past partners. I said the genders of my partners, and then pointed out that two of the three had been trans and one of those partners I had not been sexually active with and asked again if she was asking what had come in contact with genitals. She said no again, but then was shocked when I told her that I'd never had PIV sex (after she ignored me and tried to use a regular size speculum when I said the regular size wouldn't fit). I think that some providers prefer to use more euphemistic language, but I want the most clinical language at all times to prevent stupid assumptions like that.
American Indian or Native American White: Planned Parenthood on MLK has been amazing for me and my partner. Other doctors have been callous and unsafe. I was unable to access HRT until I started going to PP.
American Indian or Native American Asian Black or African American Latinx Middle Eastern or North African White: please focus on VULVAR conditions not just vaginal conditions, such as atrophic vulvar lichen planus that is also capable of affecting anywhere there is mucosa (EVERYWHERE). also focus on lichen sclerosis for the same reasons and have sexual health providers be unafraid of the clitoris for god's sakes and check people with vulvas for ADHESIONS AND PHIMOSIS. I was told I had "just discharge" when I had a whole condition... for SEVEN YEARS.
Asian White Prefer not to say or use these categories: Providers' lack of competency navigating sexual and reproductive care with trans patients, particularly patients who are on hormone replacement therapy and have received one or more gender-affirming surgeries
Latinx: Some providers can be judgemental about polyamory and pansexuality.
Asian: something I have noticed is that it doesn't seem as if most medical professionals agree on how to tell symptoms for UTIs because so many people in my community and I have also experienced finding out we HAD UTIs only after we were actively suffeering from kidney infections
Sometimes I am not taken as seriously due to ageism (I present younger despite my actual age). Appointments are also too short (15 minutes) to address major concerns. I made a request for routine labwork that was denied because "if you're not feeling pain, you should be fine." I agreed not to pursue labwork due to the costs.
Latinx White: sometimes providers can be condescending. bad experiences in the past keep me from bringing up questions at appointments if im not at a specifically queer health space.
American Indian or Native American Latinx White: The homophobia and assumptions of heterosexuality, especially if you have birthed children from a previous relationship with a male. This has caused many issues with providers that I have sought for care. They assume I have sex with men or someone with a penis or that I will again at some point, regardless of what I say or how long it has been. This creats an unsafe environment and road blocks access to certain kinds of care.
American Indian or Native American Latinx: They made me feel dirty
American Indian or Native American Latinx White: Typically, the doctors always lead with that my weight is the cause of all my medical issues.
Asian: When I changed insurance, I tried to get STI tested with providence but I didn't know how. I signed up for an e-visit and I joined the line while at work. I waited for 2 hours and at that point, I had to leave work so I never actually got to talk to anyone. I still don't know how to set up an appointment and I got discouraged by the long wait time.
American Indian or Native American Black or African American Latinx: Yeah it's just been so hard it was so hard to get a consultation to get seen for Perry and menopause that almost gave up but you know sometimes it's just so hard to get a specialist to look at that and figure out and my Imperium menopause or not which is really important because what supplements and hormones and different things like that it does affect a lot of different things plus I have a thyroid disorder so like knowing where I am in my reproductive Health would have been really helpful to know a lot earlier and it took me a long time to find out so then it took me a long time to get my thyroid out and it just slowed up a lot of medical things