Launched in January of this year, FOLX Health is one of the first healthcare companies dedicated to providing customized medical treatment and care specifically for queer and transgender communities. The current state of healthcare is abysmal for trans people, with 42% of trans women reporting mistreatment or abuse by healthcare providers, reports the National Center for Transgender Equality. Nearly 1 in 5 transgender individuals have been refused healthcare, notes the National LGBTQ Task Force. At FOLX, everything is done virtually, including one-on-one telehealth visits with LGBTQ-competent providers, and prescriptions for hormone replacement therapy (HRT). FOLX will soon provide prescriptions for Pre-Exposure Prophylaxis (PrEP) and at-home STI kits.
We spoke to A.G. Breitenstein, founder and CEO of FOLX Health, to learn more about how the company is revolutionizing the medical landscape for the LGBTQ+ community.
Men’s Health: Where did the idea for FOLX come from?
AB: First, you’ll have to learn a bit of my trajectory. I graduated from law school and started a little nonprofit for kids working on the streets of Boston in the sex trades in 1994, at the height of the AIDS crisis. I really got a firsthand look at how broken the system was in so many ways, but particularly the healthcare system for our community. That set off the arc of an extremely Homeric journey through the healthcare system. I went to public health school and worked in startups around data. I learned how to do venture capitalism. All the while, I was frustrated with the medical system where everybody’s view was being represented—because they had the money—except for the patient’s. The last person who’s asked about what they really want is the patient. And then, with the queer and trans community, it’s difficult to find queer-competent healthcare.
Doctors don’t know what it is to be on hormones or know what it is to even have gay sex. If you go to the average medical school, they will give you anywhere from zero to six hours of training over four years on queer and trans health. So that was the backdrop.
How is FOLX changing healthcare for trans and nonbinary individuals?
FOLX Health is the first queer and trans health platform that is created for and by the LGBTQIA+ community, removing barriers and stigmas that have previously existed. It is pioneering a new standard of healthcare that serves this marginalized community in a way that has never been available before. FOLX offers medical plans for testosterone and estrogen hormone replacement therapy, as well as erectile dysfunction. In January, FOLX is also launching services such as PrEP and at-home STI testing in order to become an all-in-one queer healthcare service increasing access to care for all.
Many members of the queer and trans community have dealt with a healthcare system that claims inclusive care but is far behind on delivering. The current system includes care providers who don’t understand queer health needs, prescribed routines that treat people as problems to fix, endless government hoops, and millions of people left to defend their bodies, sexual choices, families, and goals.
FOLX was founded as a digitally-native platform designed to reach the wider community, not hindering access based on location. All medication is delivered directly and discreetly to the patient’s home, democratizing the health journey for the LGBTQIA+ population.
Can you talk about the current difficulties people face finding LGBTQ-competent providers and gender-affirming healthcare?
Today, most queer and trans folks experience a unique system of barriers that makes great care inaccessible. The current system is confusing, expensive, and discriminatory. This is made worse by an insurance system that often does not cover essential queer and trans services such as gender-affirming surgery or reciprocal IVF. Add to that, the fact that many doctors won’t prescribe the medications we need, don’t understand our bodies, and if they do, they require many layers of unnecessary gatekeeping. And insurance compounds the problem. Much of the care we want isn’t even covered, and when it is, we often have to go through elaborate pre-approval processes and bureaucratic barriers. And even if we get through that, our meds may still get changed at the pharmacy without our consent, and on top of that, we may end up paying most of the costs out of pocket because of high co-pays and deductibles.
What are some of the biggest things that people outside the LGBTQ community don’t understand about what it’s like to seek healthcare as an LGBTQ person?
One in five trans people are refused care and 42% of trans women have faced abuse in healthcare. I have worked in healthcare for over 30 years and over this time, I realized how broken the healthcare system was in terms of access but also heteronormativity. The current healthcare system focused on diagnosing and treating but for those in the trans and queer community, this is not always the case. We want to provide a platform where members of the community feel supported to freely explore gender and sexuality.
FOLX has only been around for a few months, but what feedback have you received from patients so far?
We have already heard feedback from a number of our members who have told us how refreshing it is to have healthcare providers who understand their needs but also understand them as people.
What are some of the challenges you’ve faced?
Recruiting enough clinicians that know this community and are connected to it. Then the regulatory landscape (i.e., trying to get FOLX approved in each state) is a total nightmare. It’s really not made to keep patients safe. It’s really much more to protect the practice of medicine from state to state. All you’re doing is filing a bunch of paperwork and paying a bunch of fees. You’re not demonstrating that you’re a better clinician in Idaho than you are in Wisconsin. That’s why we have to roll out slowly state by state as we have to go and bow before the bureaucratic gods.
What’s the pricing like to be a FOLX patient?
The goal in all circumstances is to price below what you’re going to pay for your copay and deductible. The national average is a 25 dollar copay and a 1,644 dollar deductible before your first dollar of insurance even kicks in. We’re always going to come in or below that. Our pricing is pretty simple right now. Right now you buy a product, like a subscription to HRT. We will evolve this into something that’s much more membership-based so that as you add multiple prescriptions, you just have a single membership fee to manage. We’re going to keep it really simple and accessible.
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