 ThinkTecAway, civil engagement lives here. Aloha, I am your host, Winston Welch, and delighted you are joining us today for this session of Out and About, where each every other week we explore a variety of topics, organizations, events, and the people who fuel them in our city, state, country, and world. As a disclaimer, any views or opinions expressed by me are strictly my own and not connected with any organization. So with that said, joining me in the studio today, I am especially delighted to have Sam Hawk and Renee Rumbler to talk about the wonderful and vital work of the Lavender Center and Clinic. Welcome to my show, and thanks for being my guest today. Thank you for having us. So the Lavender Clinic, it's an amazing thing. I just want to read a very short thing here so that people can understand what we're going to talk about. But the Lavender Center and Clinic is a partnership of an employee owned and non-profit health care center for all communities, and we'll discuss what all communities is in a minute, all genders and LGBTQAI+, so we'll get to that alphabet in a minute, supportive care, counseling services, support groups, HIV prevention and treatment, hormone therapy, youth programs, and educational training on transgender and gender non-conforming health care. It's a mouthful, but the Lavender Clinic is the only clinic in Hawaii that specializes in the mental, emotional, and physical well-being of the LGBTQI community with special emphasis on transgender health. Is that fairly accurate of what we're looking at? Yes. Yes, but what's great is that there's more and more clinics now coming forward and offering more services to the communities. So it's been a wonderful revolution in the last couple of years of seeing more and more clinics coming on board with opening their doors to the LGBTQAI communities. You mean here in Hawaii? Yes. Oh, that's great. You mean on this island or also on the other islands? Well, kind of everywhere, yeah. Not so much on the other islands, but there are a few pockets that are opening up, but yeah, more so here in Anahuahu. I'm guessing you all had some major hand in that with some physician training or another type of training? A lot of it has just kind of naturally come about. A physician moved from the Boston area to Maui, and so he has taken up a really big leadership role, very passionate about transgender and LGBTQI medicine. So naturally some people are moving into Hawaii. Of course, we end up meeting them at different conferences and then working together and kind of trying to connect our resources and also broaden them. So there are more opportunities with more providers on more islands every day. And so you've had, what kind of forum would you gather together and to share this information? Is it just like a family medicine forum? Various different conferences that go on, like the Department of Education had some conferences that we've met people at youth conferences, HIV conferences. That's the main one, the Hawaii to Zero HIV initiative. Hawaii to Zero, okay. H2O. Okay, okay, H2O. And getting Hawaii to Zero new HIV cases diagnosed in one year is the goal. And so by utilizing more and more practitioners, more and better statistical analysis, getting more health care-friendly information out there, that's the goal. Okay, so you're working with the HHHRC, right, the Hawaii Health and Harm Reduction Center, which was a combination of the child project and the Life Foundation. Yes. And how many cases are we looking at just for HIV getting down from what it's at now to zero? What would that be? So last year there were about 112 cases, but this year that is much lower. So we're not sure, of course, till the end of the year, but with the new prevention efforts with PREP as well as different informational kicks and condom use, other things educationally that are filtering out, it seems like that's also helping quite a bit. Well, and that's it, isn't it? It's education and outreach, and we have a real shortage of information on, I think just good personal care and knowing even how, when we don't have things like, and some people say, oh, we shouldn't have needle exchange because that's just encouraging. Well, I mean, what are we doing here? We're looking for harm reduction, but more importantly, we're looking for vibrant health and health, emotional, physical, spiritual, I would say spiritual health on a fundamental level. So when did you start the lavender clinic? What's its trajectory since you started and where are you at right now? Well, right now, so right now, we're kind of the combined center and clinic, and so it's actually, it's two organizations that have partnered up. So initially, Hawk Health, which is now the lavender center part of it, started about six to seven years ago. Okay. I moved here after residency and hung out a shingle, and I was a one-man operation for about a year and a half. Okay. And then there were some referrals and claims and all that fun stuff. Yes. Which I don't recommend because it's not fun. But, and it's just exploded from there. It's just, you know, when I moved to after residency, I looked for opportunities at other clinics, but the idea of getting to spend five to 10 minutes with a patient did not feel like quality medicine. No. And I refused to practice that way. So I hung out a shingle and I said, well, we'll just see what happens. And so we have long appointments. We have 30 to 45 minute appointments. We meet directly with a provider for the entire time. And it's really about having a dialogue and meeting the person where they're at. And about three years ago, we started, I started a lavender clinic and contacted my friend here from residency to come down and help me get this project started. And it's just been a whirlwind of enjoyments and tears and all sorts of emotions. But, you know, to see it, to see our services going out to the community and to see the impact on the community is just brings me to tears. It's just so rewarding. And it is. And it's so important. It's so vital the work that you do, that you're feeling this need that, you know, we're in a society where maybe traditional doctors really don't even know how to address these issues or address a patient population or that may not even be comfortable with it for whatever reasons or they don't feel any competence in it. It might be even more fundamental where they think. Yes. And that's actually the place where Sam and I met. His med school was in the desert. So was mine. University of Arizona, I graduated with my doctorate of medicine. Our University of Arizona in Phoenix. And in Tucson, that was me. Tucson, I'm sorry. It's ASU in Phoenix. And I was in Vegas. So I was at Toro University, the osteopathic school. This one was on the MD side. I was on the DO side. And then we met in Anchorage, Alaska. Okay. For residency in the same year. We're in the same class. Don't know anybody up here from the desert. I was the one that wore scarves all year long in the hospital because I was freezing. He saw this on me and he said, what is that? And I've had this rainbow caduceus since I started med school. And the caduceus, the two snakes sit together. Yes, the symbol for medicine with the rainbow on them. Because everybody deserves access to care. Yes. Every single person. Yes. And it's not that difficult. Yes, it takes a little bit more time. Yes, it takes a little bit more training, but everyone is human. And you start from that point and you check the lungs in the heart and you check all of those things. And then you move outward. And it's just for some reason we get stuck on this, oh, we're this Victorian society. We can't talk about that even as a medical doctor. And it gets really difficult. Yes. And during our training in residency, we received none additional training. All the stuff that we've done has been because we sought it out. Self-study. Yeah, self-study. Self-rotations, rotations that we've chosen to do into self-study and what we wanted to pursue. So you both went to residency at like Anchorage Hospital or the University of Anchorage? Yep, in Anchorage, yep. Alaska Family Medicine Residency Program. Okay. And I completed eight months of a 12-month residency. I got ill and had to withdraw at that time. So with those four months left, we certainly have been working towards licensure for me. Haven't found the door yet, but we're not giving up. No. And in the meantime, I'm working with Dr. Huck as a postdoctoral student, as well as being clinical director and, oh my goodness. You do all our professional liaisons and professional conferences and yes. But one of my most favorite things that I get to do and I'm really honored with that is I get to go out and present educational talks. So people will ask us to come. And so me along with our other staff and other people to represent the community come with me and we educate people on how to have your place be a little more LGBTQI friendly. How do you approach the population? How can you be kind when you have to use your EHR? When you have to put your legal name here. When you have to do this, have to do that. How can you structure your day to honor the person? It's really important and not just for LGBTQI folks but for all folks and I think physicians are just feeling the crush and probably why we got a huge shortage. What's a EHR? I don't know. Oh, electronic health record. Oh, okay. Yeah. So yeah, it's only been like just this last year or two that we've seen EHRs now come out with being able to choose something besides male and female for gender and a place to put preferred names. So for years we've had to have it somewhere else and so our staff has had to look for stuff to know how to interact with a patient that's calling or so forth. And so now the EHRs are finally coming online to put the appropriate gender markers on and for names on the EHRs. And that's a reality and that's a nationwide platform and we would understand that as what's the, we call it, it's the privacy policy that the masses would understand it as a HIPAA. Yes, it's kind of a HIPAA thing at the same time but your end of the HIPAA thing maybe. Well, because for insurance it has to be billed under legal name or whatever, right? So whoever you are, however you present your legal status may not represent that in any way, shape or form. And so when you come to us, we're honoring you as who you are, not what it says on the form. So important and we've just come out of a fabulous pride here. And when we talk about the community, did you start out this, the Lavender Clinic with an intention to serve the LGBTQIA community? Absolutely, yeah. Cause when I was in primary practice by myself and I was reaching out to the community of like what services you need, what services do we have, what's lacking, where can I help fill in? And that's what born the Lavender Clinic was talking to all of my patients coming in and being like, what can I do? What kind of services do you need? How can I help? And then also reaching out to community members of seeing who has what and what services to try to fill in some gaps. So right now, how large is your total staff that you've got? 26? It's a lot. Somewhere around there. Between the both, between both of them, yeah. And some people are adjunct or, that's not the proper term, but. Part time. Part time and they come and they do different services. Maybe it's counseling services or group work facilitation and that sort of thing. Can you explain to the masses who may not understand because I was watching a fantastic show on Netflix with Katie Couric on a National Geographic Special about an LGBTQIA population. And Katie was, she was just a great American going, a human being saying, I don't really understand it. Can you help me understand this? And walked people through a really well done journey. I recommend it to everybody out there. Look at Netflix, Katie Couric, NASA Geographic, TRANS, something, just type that in, it'll pop up. And it was 2016, I believe, or 2017. Very recent, very trendy. Chimely, what does LGBTIAQ plus mean? Well, I mean, certainly each letter stands for something, but really, I mean, it's unfortunate that we have to even have a designation. Like why can't we just be a community of people? Yes. Instead of having to make, and unfortunately, you know, we're still at this point where we're having to make these designations because there's still underrepresented communities or communities that are still being discriminated against. So I'm hoping at some point we can just be like, hey, we're all in this together, we don't need a letter. But until then, all the letters include sexual orientation differences, it includes gender differences and the fluidity and the spectrums that go with that. Which I have to say, that was one of the things that kind of blew me away a little bit. The lesbian, gay, bisexual, got that, no problem. Transgender, okay, kind of got that. All right, you can switch that, totally makes sense. Intersex also makes sense. You may have different genitalia, different medical parts, totally got it. But then this gender non-binary thing. What do you mean? There's something in between, there's anything. The fluidity. You can actually choose something, you can be who you are, that's not one box or another. And that could be anything and you can express that anything. That was an amazing thought to me. And I think it's especially true for the younger people today. And the freedom with that. Because 20 years ago, dealing with transitioning then back at the old Harry Benjamin standards that were very strict if you were gonna transition. Very different today. To what we have now, which is the world professional association for transgender health called the WPATH, it's an international council that puts together some guidelines. And I think the millennials really help with this movement of non-binary, which is so amazing. Maybe they're leading the way. Right, absolutely. Because like 20 years ago, you had a pick-a-box. You were forced into one or the other. And so some people were forced into having surgeries or hormones when maybe they didn't want both. Maybe they just wanted hormones or just surgery or maybe they wanted neither and just transitioned legally. There's so many different options, but back then it was, there was more of a forced direction. And I think we're seeing that freedom break out here. As a subject that I would like to pick up after our break, we do take a short break here. And as you can see, it's a very topic that you may not have ever heard about before. Maybe you do know about it and you're happy to finally have someone talk about it here on Think Tech Hawaii. I am your host Winston Welch and delighted to have Renee Rumler and Sam Hawk of the Lavender Center and Clinic, which is lavenderclinic.org. Nope, so we have a new website. It's lavendercenterandclinicallspilledout.org. Lavender Center and Clinic, allspilledout.org. Okay, we'll be back in a minute here with more on the show. I'm Jay Fidel, Think Tech. Think Tech loves energy. I'm the host of Mina, Marco and Me, which is Mina Morita, former chair of the PUC, former legislator and Energy Dynamics, a consulting organization in energy. Marco Mangostorf is the CEO of Provision Solar in Hilo. Every two weeks we talk about energy, everything about energy. Come around and watch us. We're on at noon on Mondays, every two weeks on Think Tech. Aloha. Aloha, I'm Wendy Lo, and I'm coming to you every other Tuesday at two o'clock, live from Think Tech Hawaii. And on our show, we talk about taking your health back. And what does that mean? It means mind, body, and soul. Anything you can do that makes your body healthier and happier is what we're gonna be talking about. Whether it's spiritual health, mental health, fashion health, beautiful smile health, whatever it means, let's take healthy back. Aloha. Hey, welcome back. I'm Winston Welch, and this is Out and About on the Think Tech Live streaming network series. We are talking with Sam Hawk and Renee Rumbler, the Rumbler of the Lavender Center and Clinic. And again, welcome back, and thank you for being here at this. You're a really important topic, and timely too, because you know, our national scene is kind of crazy with even the president deciding that trans folks don't exist, and, you know, intersex doesn't exist because, you know, he's a great scientist, and probably a lot of people are thinking too, like, well, you know, it's like Katie Couric said, one of the people said, I don't let my children decide what they're gonna have for dinner. And here, this one lady was letting her child say, Mom, I'm really an opposite gender, or I'm neither gender, or something, and that journey was so interesting and real, and so I encourage people if they want more information about this, do self-study, like with everything, but that Katie Couric show makes it easily digestible, something you could show your parents, you know? But I think that also speaks to how fundamental of an identity this is. It's not about picking socks. It's not about wearing a TRO one day. It's about a true deep internal sense of who you are. And it's been in every culture throughout recorded history. Multiple species. Throughout times as well. So it's a very, we don't have the genetic testing right now. We don't have the capability. I think someday we may, but there already is MRI evidence that the brains of people who are transgender actually match their preferred gender more closely than their sex assigned at birth gender. So the function in the MRI of the brain shows that. So while there's not one test, you're not gonna get a blood test to be like, yep, here you are. Here's your spectrum code. Here you go. That isn't how that works. But there is evidence that it is a real thing throughout time. And NIH is actually, I think Dean Hammer did a lecture on it, and NIH about... It's just a couple of years ago. A couple of years ago, yes. It was a couple of years ago, absolutely. Just mentioning that NIH was starting to show that there's a genetic disposition of what your gender is, that we are wired a specific gender and how our body turns out can be a crapshoot. Or as we were saying earlier, maybe it's not one or the other, but it's both and or neither. It's this concept, like you were saying it blew your mind. And even for those of us of a certain age, the idea that you were gay was hard enough, right? I mean, we could still be fired, of course, for being gay or lesbian or transgender and half the states in the nation. So this is not ancient history. This is right now. I don't like you because you don't even have to be gay. I can just think you're gay. You act too gay or you're too blue or whatever, so you're fired. And that's legal in our nation right now. So folks, if you didn't know that, it is true. Go ahead and Google it. And even if there isn't any biological basis, even if we end up whatever, this is a movement about compassion and kindness to everyone around us, regardless of their gender identity, regardless of their sexual orientation, regardless of whatever their eye color, their hair statue, their cultural background. This is just another thing for us to be able to like, hey, let's find some love here. Let's find some love. Let's embrace our full humanity. And if my full humanity says I am this or that or the other or none of the above, I wanna be respected and loved just for that human being that I am. And that allows me to bring my full self to the table because when I have to say, oh no, you're not this, you're that, it's like even the healthcare records. When we couldn't use our preferred name or even a preferred pronoun, and I'm starting to see this actually in conferences that I go to. My name Winston, my pronouns are he, him, his. And I think that's important. And it's up to all of us to respect the other individuals rather than the other way around because we don't realize how hard it is for someone in those other shoes. And when we can put ourselves even in a simple pronoun placement where someone might prefer a pronoun of they, they, them, theirs as a singular pronoun, then we can realize, wow, this is really different and have some sympathy for our fellow humans. And I think that's been one of our challenges medically as well is because most medical places are very, we have to be very formal. We have to meet this standard, that standard, this standard, which we meet all of those standards, of course, because you have to. But also you can do it in a way that is connected humanly. Yes. And that's one of the things that we strive to do in our clinic is actually talk to the person and find out what your wellness goals are. Yours won't be the same as mine. And so that individual goal of not just, like you said, basic health, but actual exceptional wellness is a really different philosophy that I love that Dr. Huck has supported all of his practitioners in really supporting and finding. And of course the LGBTQIA and the IA may be people that are Q, I mean, queer or questioning and I is intersex and A is maybe a gender or. Allies or. Allies and plus. And that's why I love you say all communities and all genders because like you said. It's gonna get more and more letters. Let's just embrace everyone. Let's embrace everyone. That's what our goal is, yeah. But we do have a historically underserved and non-served community inside of this with our letters as we're dealing with right now. And we see staggering rates of, I think mental health issues because of the intense rejection and difficulties that we have in society. So people can come to a place like your clinic and not only get the mental support, the physical support that they might need, but the mental support as well and the social support. So tell us about a little of those services that you offer like that that might go beyond the medical. Either one of us can take that. Go ahead. So for, we do have groups, they're all free. We have right now trans feminine, trans masculine adult. We also have transgender teenagers and a group for all people who identify as something not straight, basically. And that those groups meet either weekly, bi-weekly or monthly and they're all run by licensed therapists. People come in, they hang out, talk about different things. There are some social activities that have happened. And then there's also the reach program, which is kind of new. So talk about reach. Yeah, the reach program is our new youth program that we started earlier this year. So we did kind of a pilot run of the program this year and we're planning to launch it into a kind of full production next year. But it reaches out to all the youth, all genders, all orientations. Of course, we make sure that the LGBTQAI community feels very safe in this program, as that's our goal of making sure we're very inclusive to that population. And it goes through recreation, healthcare, arts, science, education, cultural aspects. I got a key sheet here. Thank you, yes, that's great, yeah. And it's a reach, it's for a youth program. What does youth mean in these terms here? Is this for 13 to 18 or six to 13? Yeah, it's like 12 to 18. 12 to 18, yeah. Because what I was seeing on the Katie Couric show was that very young children know and they're telling their parents that maybe we always did. And we said, mom, I feel like a girl when you were assigned male at birth, which we call, what do we call it when we're assigned male at birth, that was our... Sex assigned at birth male. Okay, sex assigned at birth male. But we feel differently. And then the parents now, enlightened parents, are saying, you know, when my child is coming to me and saying these things and having real issues with this, this is not just a, I wanna dress up as a girl. And when you're three years old, this is when you're seven and you say, I'm a girl on the inside, but you're outside as a boy and I wanna be called Mary, but my name is Thomas. And you're really understanding this and in this day and age, the kids can go on the internet and say, that is me. And the interesting thing was it said millions of Americans are suddenly, it's doubled the number of what it was five years ago. And obviously this is not just suddenly something in the water, it's just something that we're feeling like we can be more open and out. There at least was starting to be a safer feeling to be able to come out with that, of course, until a recent administration. But there's still more and more coming out. And studies have shown over and over again how harmful it is to youth and adults to suppress who you are, regardless of what that is. And so I do most of the youth that come in in the transgender community. And so I sit down and have long conversations with the parents, with the youth, and find out where we're all at, where we're all going with things and stuff. And I almost always cry in all those meetings because it's just, one, it's so great that parents even show up because there's still so many LGBTQI youth, and particularly the trans youth that are kicked out of homes and are homeless. And so it's still heartbreaking. So when I see parents come in, I'm just like, thank you. Thank you for showing up, regardless of what you end up doing. You came here today for some education and to try to help your child. And that's so important. And these are by and large millennial parents that are coming in now, or older millennials, and they're realizing, yeah, I don't wanna be part of suppressing my child. I need to respect and honor my child and love my child for who that child is. Well, I think they also see the suicide rates. Yes, that's... One in two, I mean, that's like 50%. And we are, that is unacceptable. We are getting rid of that. You are absolutely part of that solution. Your clinic, your center, it's vital. So obviously a lot of people are gonna be touched by this. They're gonna share this with their friends and family and say, hey, this might be your kid or this might be your brother or whatever. So where can they go for more information to find out about this? It's the Lavender Center and Clinic, and it's on screen, okay, right there. Lavender Center and Clinic, all spelled out.com. Org. Dot org, dot org, okay. Yeah, but we have both. We have both, okay, dot com or dot org. Yeah, all works there. You know, we have so many more things that I would love for you to come back and talk about again, some of the specific programs. And you know, we're always out of time, but I just wanted to really thank you and I just so respect the work that you do as human beings, just bringing some love and light to all of us. And especially in this time, like you're superstars. And so, you know, really thank you. Thank you so much. And thank you for coming on my show today. Thank you, Winston, thank you so much. So I look forward to coming, you guys coming back again in the future. Absolutely. Okay, okay, and we'll discuss more of this. And as you can see, this has been a very important discussion and show of Out and About on Think Tech Hawaii. And it just underscores that we're all humans. We're all on this journey together. We need to love, and we need to love some more. So if you've got people that are LGBTQIA, love them. If they need some support, send them over to the Lavender Center and Clinic and love them yourself. So until next time, I'm afraid we are out of time. We've been talking with Sam Hawk and Renee Rumler of the Lavender Center and Clinic. Hope you have been inspired like I have with this amazing duo and the work that they and their staff do for us in our community. Thanks for tuning in. Thanks for Robert McLean, our great broadcast engineer and Eric Calander, who has been our floor manager today. I'll see you in two weeks on Out and About. Aloha.