On April 30, Lyon-Martin Health Services will serve its last client, bringing to close a 40-year run of one of the country’s pioneering centers for transgender and queer women’s health care. That is, unless someone takes dramatic action to save it.
It’s an excruciating coincidence. Last Thursday, April 9, Phyllis Lyon, its namesake and longtime client, died at the age of 95.
Lyon-Martin is one of a handful of places in the country where a trans person can get a COVID-19 test without worrying about being misgendered. “I think that our space is very special,” JM Jaffe, the clinic’s former trans health manager, tells NewNowNext.
The San Francisco clinic has long been hailed as a pioneer in medicine for queer women and transgender people. The clinic opened in 1980 as a volunteer operation to serve lesbian women largely failed by health care providers ignorant of their needs. Today it offers everything from primary care and mental health services to community education, laser hair removal, and hormone therapy for trans people.
“Through our advocacy and our appeals, we've really changed the landscape of what it looks like to try to access gender affirming surgery,” says Jaffe.
But serving marginalized people, many uninsured, comes with a big price tag. Like many LGBTQ-affirming clinics, Lyon-Martin has long struggled to keep its doors open. In 2011 the clinic faced such economic hardship that it nearly shuttered. A campaign to save the clinic kept the lights on until 2014, when Lyon-Martin joined forces with a consortium of clinics called HealthRIGHT 360.
“They came to us with a proposal of merging with us and allowing us to have a separate space and maintain our identity as a clinic and even our self-governance as a clinic,” says Jaffe. “They would manage our finances and payroll and HR.”
The partnership turned out to be costly for both parties. Lyon-Martin drained HealthRIGHT 360 of millions, says Lauren Kahn, HealthRIGHT 360's vice president of communications and government affairs.
“Since the time that we merged with Lyon-Martin, I think we've lost over $5 million,” Kahn tells NewNowNext. “We're tracking right now to lose about $800,000 for this fiscal year. So we've never had an ability to fundraise ourselves out of the structural issues, and we haven't been able operate the clinic in a way that it covers the cost.”
Lyon-Martin staff say that its clinic often went overlooked by its parent organization, which failed to fully grasp its trans and queer and trans clientele.
HealthRIGHT 360 told staff in February that it would consolidate Lyon-Martin into its Integrated Care Center at 1563 Mission. While Lyon-Martin’s services would remain intact, this would ultimately mean a 90% reduction in its capacity. Kahn says that HealthRIGHT 360 has done everything it can to pull Lyon-Martin back from the brink.
Jaffe sees it another way: Lyon-Martin has never had its own fundraising director, someone who really understands the clinic’s community and its needs, they say.
“The development department barely knows who we are and can barely string two sentences together about our services,” Jaffe says. “That means that we don't get city money or private donations or foundation grants.”
Advocates for Lyon-Martin accuse HealthRIGHT 360 of absorbing smaller clinics and then systemically consolidating them. They point to closures like the original Haight Ashbury Free Clinic in the Tenderloin last year.
Kahn argues that HealthRIGHT 360 has simply taken on clinics that were already facing demise, making every good faith attempt to keep them going.
“You might say, why did you take on a clinic that had insurmountable financial losses and then act surprised when five years later it has insurmountable financial losses?” says Kahn.
Without HealthRIGHT 360, Lyon-Martin advocates have turned to city officials seeking a save for the clinic, which needs around $1.4 million over the next two years to stay operational, they say.
But help may be on the way. In a statement to NewNowNext, the San Francisco Department of Public Health indicated they were pursuing a solution.
“The Health Department supports and recognizes the importance of health care for members of San Francisco’s queer, trans, and gender non-binary community,” the statement reads. “We are working together with HealthRIGHT 360 on a path forward to ensure that care continues.”
Kahn declined to comment on the statement and whether the city had reached an agreement with HeathRIGHT 360 to keep Lyon-Martin operational. She did say the organization had not stopped searching for a way to stay open: "I would say we follow every single lead and every single idea that we get."