Connecting the Transgender Community to Care: ‘I’m Human, You’re Human’
Talia Vaughn and Trust Robinson, who are outreach and enrollment coordinators at SelectHealth, a part of VNSNY CHOICE, where I work, look forward to a time when society does not need an International Transgender Day of Visibility. One March 31 in the future, they hope, people who transition genders will be seen and heard and experienced every day for who they are: people. People with their own talents and challenges, friends in your community, colleagues in your workplace.
“The thing that is most rewarding is the people who see you without any labels,” says Talia, a singer by avocation, who recently joined our team at SelectHealth, a specialized Medicaid plan administered by CHOICE, which is a part of the Visiting Nurse Service of New York (VNSNY). As an outreach and enrollment coordinator, Talia, who goes by Tia, helps connect the transgender community to vitally needed health care. “I appreciate people who don’t just look at me and say, ‘Oh, that’s a trans person,’” she explains, but rather those who say, “‘I’m human, you’re human, how can we work together?’”
Like Tia, Trust just lights up with that humanity, his broad, constant smile an outward sign of his inner positivity, no matter his struggles, which have included homelessness and being estranged from family. “No matter what I go through, it’s going to be a reward to me,” says Trust, who is also a SelectHealth outreach and enrollment coordinator. “I’m going to make it a positive, because I’m learning every single day.”
While this is the world that people like Tia and her colleague Trust are working to create, for now they know that people of trans experience too often face challenges and barriers to full acceptance. One area where they face particular disconnection is in health care. Studies show that 31 percent of transgender Americans lack regular access to health care, and that transgender individuals also carry a disproportionate burden of HIV, depression and anxiety, substance use and suicidal ideation. In addition, there is often a lack of access to medical interventions such as hormone therapy and gender affirmation surgery, as well as the compassionate physical and emotional care needed after the clinical procedures themselves.
That’s why Tia and Trust are enthusiastic about the work they do connecting people in the transgender community to all-important health care where and when they need it most — in the home and in the community. The SelectHealth plan was created to serve certain at-risk populations whose needs weren’t being addressed by mainstream health plans, helps people manage not only their physical and mental health but also the social determinants that surround health.
At the heart of SelectHealth’s member-centric concierge plan is a personal relationship with a care manager who stays in touch, checks in with reminders and is invested in each member’s health and well-being. Gender transition surgery with specialized support and culturally competent after-care, along with tailored approaches to mental health care and addiction treatment, are of course a part of the plan, in addition to making sure that people are educated and empowered about their health conditions and can connect to community resources that help them live life to the fullest. This inclusive one-on-one relationship between member and care manager creates a sense of trust and understanding and is the framework for truly personalized holistic care — no matter where each person might be in their own life-journey.
By connecting members of his community with care they need to be who they want, Trust is living out one of his core values: to embrace individuality and difference. He brims with delight in his own difference: “As you can see, I’m not your typical VNSNY employee,” he says. “I have a lot of tattoos, even on my neck and forehead, and piercings everywhere. I’m a guy who gets his nails done.”
But here’s the thing, says Trust: “You want different. That’s what VNSNY provides: We give ‘different’ the chance to be seen. I don’t care if I have to push down brick walls — I’m going to make sure ‘different’ is seen.” Embracing what makes each of us different is central to the SelectHealth mission, which is to bring people who are too often marginalized back into the fold of care and on the journey to holistic health and well-being.
Enrollment coordinators like Tia and Trust, who are themselves members of the trans community, play an invaluable role in helping our SelectHealth team meet people where they are, understanding where they want to go next, and helping them access the care and coverage they need to reach their goals. For Tia, the rewards of the job come in helping people become who they most want to be. “What’s most important for me is to help people get to the next step, to have someone say, ‘Tia got this insurance for me, and I was able to get surgery, or other care, to affirm myself.’ I feel like I have a voice here.”
Empathy — deeply understanding what it is like to walk in another person’s shoes — is one of VNSNY’s core values and it’s a big part of what makes SelectHealth special. “Feelings,” says Trust, when asked what sets the SelectHealth experience apart. As he explains how the plan seeks to take care of people not just physically but also mentally and emotionally, he says that he wants, “to give people what they thought they were never going to get. I want them to think, ‘Wow, this is here?’ I want people to feel what we’re here to accomplish.”
It has always been VNSNY’s mission to provide holistic care to vulnerable populations and address health disparities to improve lives. This cannot be achieved without being particularly sensitive to communities that have historically been left behind when it comes to health care access. That’s why both VNSNY and VNSNY CHOICE Health Plans have provided specialized SAGE cultural competency training to every one of our employees to ensure their awareness and attention to sensitivities and best practices around sexual orientation and gender identity.
International Transgender Day of Visibility provides the opportunity to reflect on how we value people of trans experience and how we are always asking what more we can do to provide the care they want and deserve — on their terms. If we are successful here, says Tia, maybe there will come a time when the greatest celebration of the transgender community will be no special celebration at all. “I am excited to move to a point where we are all seen as one,” she says. “I’m thankful that the world recognizes us on this day, but I hope there will come a day where we don’t need it anymore.”
