For people seeking transgender health services in Peoria, Illinois, chances are the first person they’ll talk to is Dana Garber.
Garber is the transgender hormone intake coordinator at the Peoria Planned Parenthood, the only clinic in the area that offers hormone-replacement therapy for people seeking gender transition.
During a recent shift at the clinic, wearing a blue sunflower-print dress and a hot pink manicure, Garber explained that she began her own transition just a few years ago, at the age of 55. Now she helps other people work through the process.
“It makes me feel good,” she said. “I like to help people. I like to make things easier than it was for me.”
A year ago, this Planned Parenthood was the first place to start offering hormone replacement therapy in Peoria. When Garber transitioned, she had to drive three hours to Chicago for her appointments.
Now Garber said, she’s seeing her own patients travel from neighboring states.
“When you get a surrounding state like Missouri, they have nowhere to go,” she said.
It’s still rare to find clinics outside of major cities that offer transition-related medical care. But Planned Parenthood has started offering these services at several locations in Central Illinois. The organization now offers transgender services in 16 states.
Last year a group called the Peoria Transgender Society—which works to expand health care services for trans and gender nonconforming individuals— invited area hospitals and providers to a health care summit and told them about the need for transgender health services.
Planned Parenthood was the only one to show up, and respond to the need, said Kristen Haley, co-founder of the Peoria Transgender Society. She said she hopes the other health care providers follow Planned Parenthood’s example.
“There’s such a growing need for all services, for all age groups, from young children to someone my age, and older,” she said. “We have the same health care needs as everybody else, plus specific needs for transgender issues.”
Haley said she appreciates that Planned Parenthood has narrowed the health care gaps for transgender people in rural and suburban areas. As a Catholic, she initially felt conflicted about the organization.
“I’m pro-life. But I can’t stand in a position to judge people for the decisions they make,” she said. “I appreciate that they are the only ones who have stepped up to help us, instead of judging us.”
The availability of this care is not guaranteed. Planned Parenthood’s funding is at risk from Republicans in Congress, said the media liaison at Planned Parenthood Illinois, Julie Lynn.
"Defunding efforts block people from getting care, either their preferred method of care, or because it's the only option they have," she said.
Even with Planned Parenthood providing hormone therapy, Haley said there is more unmet need for transition-related health care in the area. She said she knows of as many as 500 transgender or gender non-conforming patients from downstate Illinois who commute to Chicago for additional care, like surgeries or pediatric services.
“There is a strong business case that could be made economically, ethically, feasibly that Central Illinois, as a major medical presence, has the ability to launch into this, relatively easily,” she said.
But change is slow to happen, in part, Haley said, because many providers don’t recognize transgender people’s unique medical needs.
“There seems to be little interest in meeting with us, or at least talking with us,” she said. “Is it because there’s so many other issues on their plate that this is very minor to them? Or is it something they don’t want to, for other reasons?”
That lack of support is one reason Dana Garber feels so passionate about her role at Planned Parenthood. The clinic, welcomes transgender patients and treats them with dignity. Garber said she doesn’t want fear to be an obstacle to seeking medical care.
“A lot of clients that’ll cancel, because they get scared. I’ve had to call some clients before, they might cancel two or three times,” she said.
Garber said at Planned Parenthood, she and other staff always use a patient’s preferred name and gender, instead of what may show up on legal documents. Garber says it can be traumatic to be misidentified, but it’s common in medical settings.
She remembered a recent dermatology appointment when the nurse called her by her male birth name.
“I’m presenting female, and everybody looked at me,” she recalled. “That’s humiliating to a trans person, to get “dead-named” like that, or called ‘he,’ when you’re a ‘she.’”
Garber said among the 50 or so patients she’s seen this past year, what her clients most fear is being judged during that initial visit. She said, often when she goes out into the waiting room to call in patients, they have a strong reaction to her.
“They say, ‘I’m really glad I saw you because I thought I was not going to be dealing with another trans person,’” she said. “So I think it’s comforting to them to be able to come in here and talk to me because they know I’ve been through all of this.”
Younger patients call her, sometimes in tears, just asking for support. They even call her the “trans mama of Peoria.” Garber said she doesn’t mind taking their calls.
“When you find support, you just embrace it,” she said. “And people do that. They’re looking for support. That’s what our trans community is looking for.”
This story was produced by Side Effects Public Media, a news collaborative covering public health.