Gender-Affirming Health Care at CCC

Being the community clinic our community needs 

According to the National Center for Transgender Equality, one in five transgender individuals have experienced homelessness at some point in their lives. Since many of the people CCC serves are currently experiencing or at risk of homelessness, it’s no surprise we welcome many transgender patients into our clinics.  

“We try to be the community clinic our community needs,” says Dr. Richard Bruno, CCC’s senior medical director of primary care. “When people come in and they need something, we try to address it right there when they’re in the clinic. We provide lower barrier access to hormone therapy through a team of expert providers and nursing staff.” 

Margot Presley, a CCC nurse practitioner with expertise in gender-affirming health care, agrees that hormone therapy needs to be accessible. “People should have low barrier access to these medications because they benefit people so much, physically and mentally,” she says. “At places I’ve worked in the past there was a lot of gatekeeping and red tape about having access to gender-affirming care. People could die waiting for it because suicidality was so high.” 

To get prescribed hormone therapy through CCC, new patients can call CCC health services at 971-361-7888 to make an appointment, or simply show up at Blackburn or Old Town Clinic walk-in clinics. A provider will do an assessment and go through medical history, current medications, and any other relevant information. They will then discuss risks, benefits and potential effects, both positive and negative. In many cases, patients are prescribed hormone therapy same day. If injectable hormones are prescribed, patients can choose whether they would like to get their injections at a CCC clinic or do them themselves. CCC clinics only serve patients 18 and over. 

While CCC cannot provide gender affirming surgeries, we help patients access them, often through OHSU or Legacy Health. Our psychiatric practitioners can evaluate patients and provide a letter of support (often called a WPATH letter). We also help transgender patients access the OHSU Transgender Health Program’s services if they need help with getting their names changed on their IDs or other transition-related services.  

A welcoming, inclusive place 

In addition to offer gender-affirming care, CCC strives to make our clinics inclusive for transgender and nonbinary patients, regardless of the type of care they are accessing. Patients are asked for their pronouns and for the name they wish to be called by, which are both recorded in their chart. Clinics have gender-neutral restrooms and all CCC employees are required to take transgender awareness and sensitivity training.  

Interference in the doctor-patient relationship 

At a time when a growing number of states are banning gender-affirming health care—in many cases, for youth, but in some cases for adults as well—CCC is proud to provide transgender patients with these important services.  

“People who are making these decisions [banning gender-affirming health care] aren’t making them with their feet rooted in research and science,” said Margot.  

Dr. Bruno agrees. “In general, I tend to be very disappointed when the political process interferes with the doctor-patient relationship,” he said. “It’s really detrimental when we are limited in our ability to provide the care people need. And so I really appreciate places like Oregon…a place where we can talk about issues that are important to our patients without fear that we’ll be arrested or penalized for providing care we feel is necessary.”