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How One Colorado Startup Is Changing Transgender Health Care

Plume, a Denver telehealth company, proves that gender-affirming care is a smart investment.

The doctor’s office should be a place of healing. For a transgender person, it’s often the site of trauma, where quality of care can run the gamut from microaggressive to downright discriminatory. “Physical and emotional safety in a health care setting is a big deal for a trans person,” says Denver physician Jerrica Kirkley.

Which is why she co-founded Plume in August 2019, along with her medical school friend Dr. Matthew Wetschler. One of the first known telehealth services exclusively for trans and nonbinary people, the Denver startup provides virtual access to gender-affirming care in 33 states. And that’s just the start. With $14 million in new venture capital funding announced this past February, Plume has likely become the largest trans-specializing health care provider in the country, if not the world. “The fact that we were able to raise that much money,” Kirkley says, “and dedicate it entirely to the trans community—I get chills every time I think about it.”

The latest round of funding, led by Craft Ventures, a San Francisco–based firm whose portfolio has included everything from Facebook to SpaceX, represents a societal shift: Investing in underserved populations is no longer just philanthropic. It’s profitable. There are an estimated two million trans Americans, and Lainy Painter, a principal investor at Craft, notes that most of them face multiple barriers to health care access, from finding insurance that will cover hormone therapy to tracking down a provider with expertise in trans health. “[The investment was a] clear vote of confidence in Plume as the leader in this sector,” Painter says.

Dr. Jerrica Kirkley, co-founder of Plume. Photo courtesy of Plume

Kirkley has seen both sides of those institutional barriers as a transgender woman and physician. “All the pain points you experience in the health care system are amplified as a trans person,” she says. “It’s like going to a doctor for high blood pressure, and there’s only two in the city who handle it, and you have to teach them how to treat it based on what you learned off the internet.”

For $99 a month, Plume members gain daily access to a care team—via phone, text, and video chat—that will create a personalized health plan including consultations, lab testing, prescriptions for hormone therapy, and letters of support for surgery. While the cost is still high for some, according to Plume it is about two to three times less expensive than paying out of pocket, a reality for the 10 to 20 percent of trans people nationally who are uninsured.

The value of affirming care is not just monetary; it’s lifesaving. A 2014 study from One Colorado, a queer-advocacy organization, found that nearly 40 percent of transgender Coloradans said they did not have an inclusive provider, and they were almost twice as likely to have contemplated death by suicide than their peers with trans-friendly doctors.

Plume now serves some 5,000 members. Such proven potential for growth may be good news for investors, but Kirkley says her primary focus over the next few years is simply to fill the gap in trans health care by improving the quality and expanding the types of services Plume provides. “The goal,” she says, “is excellence.”

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