A 14-year-old teenager from Duluth walked into the Family Tree Clinic in St. Paul a few years ago, shy and sad, bewildered and bullied, looking to get hormone treatment. Today she’s a confident young woman, certified as a nursing assistant, and is soon going to school to become a registered nurse.
That’s just one of many stories that makes Nathalie Crowley smile. Crowley, associate executive director of Family Tree, is a transgender woman who’s been connected with the clinic for five years and involved with the LGBTQ+ community for 25 years.
For now the clinic is located at 1619 Dayton Ave., but will move to a new location at 1919 Nicollet Ave. in Minneapolis in October. In the past, the clinic has served 22,000 people a year, ranging from all ages and coming from the seven states surrounding Minnesota. With the new clinic, she estimates 30,000 people will be visiting the clinic each year.
According to Crowley, the LBGTQ+ community lacked services, which were desperately needed in the Twin Cities, especially for transgender youth. The clinic is working to meet the needs of the community by education, HIV testing, birth control, gender-affirming hormone care and referring people to counseling.
Crowley explained gender-affirming hormone care is “for transgender people who want to align their hormones with the gender they feel comfortable with.”
According to Crowley, the clinic was one of the few to offer an informed consent model. The model informs patients of the risks and benefits of receiving the hormones, then they decide if they want to proceed with it. When paying for appointments ($200-$400), the clinic has a sliding fee scale based on the person’s income. It also offers medical assistance if qualified and accepts state or private health insurance.
The process for dealing with youth varies depending on age. The clinic provides resources to parents whose children have not reached puberty to support decisions on their child’s gender identity. The clinic will not get into hormone and medical discussions until the child is old enough to accept a more solidified gender identity.
In addition to the clinic, Family Tree has a comprehensive sexual education program for high schools and people of all ages. It also offers a sex ed program for people who are deaf, deafblind or hard of hearing.
“Treating them as human beings, talking about their bodies, their relationships, different gender identities to different sexualities are all centered in our education,” Crowley said.
In order to make clients feel welcomed, Crowley said staff are representative of the people they’re serving. The clinic employs LGBTQ+, Black, Indigenous, people of color and Spanish-speaking staff.
“When someone goes into the doctor’s office and looks around and sees people who look like them or share experiences that they do, they’re going to go and tell their friends,” Crowley said. “That’s really going to be our strongest way into different communities.”
Dealing with criticism for the clinic has remained peaceful on site, but online it’s a different story. The clinic has received criticism for giving hormones, but according to Crowley, “there is nothing that we are giving children that you wouldn’t give a child in another fashion.”
Crowley believes the trans community is in a time where they have been able to express themselves to an extent they haven’t seen before.
“At some level we should love everyone, no matter how they are,” she said. “We’re not harming other people, there isn’t recruitment going on.”
Crowley thinks the Family Tree Clinic is a safe place to go.
“I kind of challenge people to think of the last time they felt joy when they went to their doctor,” she said. “Family Tree can be a refuge for folks.”
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.