Respect and Equity

Nathalie Crowley, 2021
Nathalie Crowley (ThreeSixty Journalism/Christine Nguyen)

A 20-year-old walked into the Family Tree Clinic in St. Paul, wanting to begin gender-affirming hormones. They were expecting to pay out of pocket, which can be anywhere from $200 to $400, depending on the person’s income.  

After the clinic looked into their background, it concluded they were eligible for medical assistance, meaning they wouldn’t have to pay a dime.  

“He broke down crying in my office, because he was so happy. It was life changing for him,” said Nathalie Crowley, the clinic’s associate executive director. 

Crowley has been working with the LGBTQ+ movement for more than 25 years, including more than 10 years in health care. Crowley talks about her own experience beginning gender-affirming hormones and said that is the part of the reason she left Duluth for the Twin Cities.  

In Duluth, Crowley said, there were not enough options for the LGBTQ+ community. She traveled back and forth for health and wellness care almost two years. Luckily, she had a job that allowed her to travel and pay her health care bills.  

She’s worked for Family Tree for five years and is proud of the options they offer for transgender people. This includes everything from birth control and rapid HIV testing to trans hormone care and sex education. The clinic now sees about 22,000 people in St. Paul and expects to see about 30,000 when it moves to Minneapolis in October. 

The clinic helps transgender people who are deaf, hard of hearing or blind and has clients ranging from age 6 to 80. 

“The youngsters are accompanied by their guardian/parents,” Crowley said, adding sometimes puberty blockers are used to delay the process until any changes will align with a youngster’s new identity. 

“Our staff are representative of the people we’re serving,” she said. “So we strive really hard to make sure we have LGBTQ+ people on our staff, that we have BIPOC books, and we have Spanish-speaking folks on our staff because these are the communities that we want.” 

Those communities come from seven different states, and they benefit from all of Family Tree’s programs, including education services for high schools and the medical community. 

“Most people support the programs, but there are critics,” Crowley said. “They say we’re doing awful things to people, or that we’re forcing hormones on people or that we’re part of this movement to kind of destabilize masculinity. That’s not true.”  

She notes the LGBTQ+ youth have received a lot of hate and disrespect.  

“These are human beings that live life differently,” she said.  

Currently there are more than 100 bills restricting the rights of LGBTQ+ community members throughout the country. These bills range from limiting LGBTQ education, the banning of trans people from sports and the restriction of health care. In many parts of the country, trans youth are facing more barriers than ever before. 

Even with all this criticism, Crowley will continue to help the LGTBQ+ community.  

“There’s a basic level of respect and dignity that we owe them,” Crowley said. “I like to think of the Family Tree as a refuge for people.”

These reports on health equity were created by ThreeSixty Journalism’s summer 2021 News Reporter Academy high school students. The Academy and its theme of racism as a public health crisis were supported by Center for Prevention at Blue Cross Blue Shield, which connected students with story topics and sources.