Speaking Out About HIV in Transgender Communities
An Interview With Dee Borrego -- Part of the Series This Positive Life
April 1, 2011
That's amazing. And it sounds like you have a good relationship with this person.
I have a very, very good relationship with my doctor. We've been open and honest with each other from the get-go. I think that honesty with your doctor especially is important as an HIV-positive person. Because they need to know what's going on. You know, they need to know what aches and pains you're having when you do your physical. That's certainly one thing I've had to get used to, especially not being on meds, I get physicals about three times a year. You know, just to make sure everything is still working the way it's supposed to be working.
It takes some getting used to go to the doctor as much as I do. And, like, getting blood work done every three months, it can be a lot. But I think finding the right doctor, and finding a doctor you have a really good rapport with is really important. If you can't talk to them, if you can't talk to your doctor about whatever it is you're doing sexually, or if you're using drugs, what you're doing for drug usage, you need to find another doctor.
So now you mentioned that your doc is an endocrinologist as well. So are you taking hormones now? And if so, is there anything you all have talked about, as far as, are there any additional considerations once you start taking HIV meds, and their interaction with the hormones? Or what do you know about that, basically?
OK, my doctor is also my endocrinologist, because I do take hormones. I take injectable hormones. They also come in pill form, and a patch form, for estrogen, that is. I believe testosterone only comes in patches and in injectable form.
I, unfortunately, don't know all that much about how HIV meds and hormones interact. I know HIV meds are broken down by the liver, and I know some hormones are broken down that way, as well, especially hormones in pill form. So I know there can be some concerns with how a person's liver is functioning when starting hormones and HIV meds. But I'm not on HIV meds yet, so I actually don't know that much about it.
I know it can present certain challenges, especially in people who begin to transition at an older age than I did. I started fairly young. I started in my 20s. So I know it can cause complications for people who are older. But I can't really speak too much on that, because I do not have that experience, unfortunately.
I hear you. That's totally fine. So now how do you access your health care? Is this through a community clinic that you have your doctor? Or do you have Medicaid? Or is it private insurance? How do you get your health care, basically?
I get my health care through the State of Massachusetts. I have MassHealth, which is the state-subsidized insurance. So they pay for my medical visits, my therapy visits, all of that. They cover most of my prescriptions, with a copay, I think, that's only a dollar. It's a very reasonable copay, when I have one.
I also have ADAP here in Massachusetts, the AIDS Drug Assistance Program, that helps cover some of my other meds costs. So sometimes ADAP covers some of them, but not all of them. So my medical care is actually really well covered here in Massachusetts.
I see my doctor and my therapist at the same community health clinic that serves primarily GLBTQ youth, 13 to 29, that's associated with a larger hospital and a larger community health organization that specializes in GLBT care. So my doctors are a smaller set of a bigger set, which is really nice to have such great care and access to higher up care in different areas that I might need.
I get my care at the Sidney Borum Junior Health Center in Boston. It's part of the Fenway Community Health Center, which is also associated with Beth Israel Deaconess Medical Center, and the Beth Israel Deaconess Medical Hospital. I really like the Borum. They're an awesome, awesome place with really good care.
The nice part is they specialize in care to GLBTQ youth, age 13 to 29. So my doctor really has a lot of experience working with youth. They work a lot with homeless youth, and a lot with young queer people living here in Boston. And it's nice because they're part of Fenway, which is a larger community health organization here in Boston that runs clinics. Fenway also does a lot of work with the GLBT community, in general. So it's really nice to be going to a clinic where I can have access to more services, and services that are sensitive to my community's needs.
Sorry to stop. This might go in the other back part. The only part of my medical care that really is a challenge for me is my access to hormones. The hormones, I unfortunately have to pay out of pocket for, which can be really expensive. My insurance covers one of my hormones, because it's a medicine called spironolactone, which has multiple uses, besides the primary use for me, which is hormonal, as an androgen blocker. But it has other functions so it is covered.
As I said, I smoke, so I need to take aspirin. And that is also covered. But the actual estrogen is not covered by my insurance, so I have to pay for that out of pocket every month, which can be very expensive.
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