Pike and I met a few days before the ACT UP 25th anniversary action in San Francisco. I had just been laid off from my job working as an HIV Case Manager at New York’s Callen Lorde Community Health Center after the city’s Department of Health slashed our grant in half. Looking forward to living out the big gay dream on the dole, I sublet my place in Brooklyn and took off for the west coast. With nothing better to do, I reached out to the folks organizing the action in the Bay and was told to meet them on 18th and Castro to flyer for the next day’s events. Pike rolled up on her bike in her customary lanky layers, looking like a hard femme Joan Jett. The rest, as they say, is history.
It was no surprise that after months of late night scheming sessions, incognito public vandalism, and bi-coastal sisterhood, that she would sweep me up into yet another project. Pike and I found early common ground through our involvement in queer health centers on opposite coasts. When presented with the oppurtunity to interview her about Lyon-Martin, San Francisco’s queer health center, the health nerd in me jumped at the chance to satisfy my curiosity about the clinic:
Emma Dilemma: Could you start off by talking about what Lyon-Martin is, who it serves, and how it got started?
Pike: Lyon-Martin has been around since 1979. It was set up by members of the lesbian community as the only health center that catered specifically to lesbians because a lot of folks were facing discrimination going to the doctor. A lot of women were simply not going to the doctor because they felt unsafe and not understood. When it started it was really grassroots, then over the years it got traction and as time moved on it expanded its mission to serve trans folks and any gender variant folks too. We now serve about 2,500 patients a year of a multiplicity of genders. We’re a sliding scale clinic, and most of our patients are uninsured. We provide full scale primary care, gynecological care, and have special programs for diabetes and mental health services.
ED:So I was actually kinda surprised to find out that Lyon-Martin only serves queer women and TGNC folks and not queer folks across the gender spectrum. What’s the reasoning behind that?
P: I can’t speak for the whole clinic, but from what I’ve seen, in San Francisco there are actually lots of resources for queer cisgender gay guys. I’d say there are at least six dedicated clinics for cisgender gay men in the city and so more than anything it’s just been an issue of not ever having had the capacity to expand enough to include them. However, it’s something that’s been on the table and been considered. At certain points Lyon-Martin considered merging with other organizations which would mean starting to serve cisgender men. But honestly a lot of our patients and supporting community have said that this is a safe space for folks who identify as women or who have ever lived as women and/or TGNC folks and we’ve actually met a lot of resistance [to seeing cis men].
ED: Yeah, I guess our clinics started in different ways, right? Callen Lorde came out of the AIDS crisis and has always served poz people–even a lot of folks who are straight and poz come because they get more compassionate care within a harm reduction model which is different than a lot of places.
P: One of the interesting things is because San Francisco’s HIV prevention model is so gay-male centric, we are one of the only places that a female-bodied person who isn’t an active street-based sex worker can get an HIV test. That’s shocking to most people, but if you are not a gay cis man and you’re not having a ton of high risk sex then you’re unable to get tested because of the way funding works. We have a program for folks who are poz, and we provide lots of care and referrals for folks. Back in the 90s when the AIDS crisis was still really going full force–before combination therapies–we were a haven for women, trans folks and folks of color who maybe didn’t feel safe in the more white gay male centric health care spaces.
ED: Yeah, that makes sense. So, how did you get involved?
P: Well, first of all, I’m a patient. In January of 2011 an announcement was suddenly made that the board had voted to close the clinic because it had gotten into deep deep debt, and the board didn’t see any way out. It turned out that for the last six years or so the clinic had been pretty badly mismanaged on the fiscal end, though the medical care was stellar. Lyon-Martin is the only medical clinic I’ve ever been to where I felt so respected and so heard –like, my doctor actually cared and was taking proactive action about all of the things I was bringing to the table, and wasn’t writing me off or telling me that it was probably nothing or whatever. I have a lot of friends who say that they wouldn’t go to the doctor if not for Lyon-Martin. So all that just to say that people got very very upset when the announcement came. Many of us–the patients and community members at large who supported the clinic–banded together and literally hit the streets. We started canvassing for money and had a town meeting. There was this amazing outpouring of activism to keep the clinic open and we basically forced the board to do that. They had to listen to us and they didn’t close the clinic. We managed to raise half a million dollars in three months, which is unprecedented. And though that is amazing, it didn’t actually even begin to repay the debt.
ED: How is that even possible?!
P: That went to cover the operating expenses. The bottom line is that providing medical care is extremely expensive. It costs about 150 thousand dollars a month just to keep the clinic open. So, since then the entire board has been replaced, and we have an ED who is absolutely dedicated to seeing the clinic thrive (in fact, she’s the former Medical Director). I’m on the board now along with several of the other original Save Lyon-Martin folks. Our job now is to make sure the clinic becomes financially solvent and stays that way. We’ve got a few really great things coming up to engage the community in keeping the clinic alive. One of the most significant things I’ve noticed in watching the donations coming in is seeing how many are coming in from people who don’t even live in San Francisco–people who don’t even receive care here but have friends or lovers or family members who do receive care at Lyon-Martin, or people who understand just how important this resource is, and that people from all over come to San Francisco to get care like this. The solidarity we’ve seen has been really amazing.