USPATH 2023 Mini Symposia
Growing What You Sow: Gender Affirming Competent Care Without Silos in Fresno, California
The goal of our symposium is to present a follow up from the 2021 symposium, which will show the impact that our projects have had on our community while presenting new data on mental health access as well as sociodemographic data of the transgender population in the Fresno metro area. At the last USPATH conference, we showed that through education and community support, small projects, across many disciplines, have a big impact in communities that are struggling for basic gender affirming services.
Centrally located in California, Fresno is a city with some of the highest rates of poverty and economic disparity in the state and across the country. Through hard work and dedication, we are proud to have added two family medicine physicians to the community, whom have both completed an elective rotation in gender affirming healthcare and are working on WPATH GEI certification. We have continued our outreach to other historically erased communities, partnering with groups such as the Black Wellness and Prosperity Center to extend our intersectionality. We have completed a retrospective chart review to help us identify from which communities patients were coming from in order to fine tune the delivery of our services. We added to our previously presented reports on housing and access to healthcare with the recent completion of a master's thesis by Crow Fitzpatrick ACSW, which highlights barriers to accessing gender affirming mental health care, biopsychosocial experiences of trans and nonbinary individuals in the Central Valley and identifying 12 recommendations to expand gender affirming mental health services. Our local PFLAG chapter has been taking the outreach further with education and advocacy, including culturally appropriate training for healthcare and mental health providers, as well as resource sharing regarding affirming providers with the community at large. Finally, in our continuing efforts to break down silos and foster community collaboration, we are anchoring our work within a local nonprofit organization, the Fresno Economic Opportunity Commission’s LGBTQ+ Resource Center with our “tranager” Jess Fitzpatrick.
The lessons learned in this symposium demonstrate how a more rural, economically and socially stressed, and historically conservative-leaning community can rise to the challenge and create a foundation of equity for a population that often finds itself further marginalized and isolated when away from larger urban centers.
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![Julie Nicole, MD]()
Julie Nicole, MD
Dr Julie Nicole (she/her) is a board certified OBGYN physician in private practice. She is a clinical instructor at UCSF Fresno where she teaches gender affirming care to Family Medicine and OB/GYN residents and leads the Anti-Racism journal club. She is the Chairperson of the OBGYN department at Clovis Community Medical Center in Clovis, CA. She is also a WPATH SOC 8 medical mentor.
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![Crow Fitzpatrick, ACSW]()
Crow Fitzpatrick, ACSW
Crow Fitzpatrick, ACSW (he/they) is a recent graduate in Social Work at Fresno State University where their thesis “Barriers to Accessing Gender Affirming Mental Health Care in California’s Central Valley for Transgender and Non-Binary Individuals'' provided critical research on improving access to intersectional mental health services. Their thesis also won Outstanding Thesis from the Department of Social Work Education and the college of Health and Human Services at Fresno State. They are an outspoken activist for liberation for LGBT+ people and people with disabilities in Fresno. Their advocacy was critical in expanding gender affirming services at Fresno State Student Health and Counseling Center.
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![Drew Harbaugh, RN, CCRN]()
Drew Harbaugh, RN, CCRN
Drew Harbaugh RN CCRN (he/him) is a Registered Nurse with over 20 years of bedside experience primarily in medical/cardiac ICU. As a proud out trans man, he serves as the chapter president of PFLAG Fresno. PFLAG is the nation’s largest organization dedicated to supporting, educating, and advocating for LGBTQ+ people and those who love them. In this role, his focus is on forging community connections and creating paths leading to collaborative efforts, which will directly improve the lives of LGBTQ+ people and our families here in Fresno and surrounding areas.
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![Jess Fitzpatrick]()
Jess Fitzpatrick
Jess Fitzpatrick (he/him) is a Community Outreach Educator and affectionately known as the “Tranager'' at the Fresno Economic Opportunities Commission (EOC) LGBTQ+ Resource Center. He provides workplace awareness training and helps to curate gender affirming resources in Fresno County. This includes managing the Trans Medical Needs Fund, a community driven grant that provides direct financial assistance for medical needs relating to gender affirming care. As a queer transgender man, the bulk of his work life has been in Fresno, CA as an activist and community organizer for LGBTQIA2 needs & interfaith events for over 15 years.
