Plume, the Denver-based startup that provides hormone replacement therapies and medical consultations tailored to the trans community, could not be launching at a time when the company’s services are more needed.
It’s no hyperbole to say that transgender citizens in the United States are under attack. Whether from government policies that are intended to defund their access to insurer-provided medical care, or actual physical assaults, transgender Americans are living in physically and politically perilous times.
That’s one reason why Matthew Wetschler and his co-founder Jerrica Kirkley founded Plume, which provides telehealth services tailored for the transgender community.
The two doctors met and became friends in medical school. From the earliest days, the two were inseparable, Dr. Wetschler recalled. “She and I spent nearly 12 hours a day together,” he said.
After medical school, Wetschler moved to the Bay Area to finish his residency at Stanford and then went on to run a consulting firm that worked primarily with digital health startups. Kirkley, who is transgender, focused on gender therapy in the trans community.
A little over a year ago the two began to discuss the potential for creating a primarily telehealth service for the trans community, Wetschler said.
“We have always shared a belief that the healthcare system can do better for patients and doctors,” he said. And almost no population is quite as exposed to the shortcomings of the current healthcare system as the transgender community.
“I had been increasingly interested in the telehealth space and the emerging trend of leveraging mobile technology to provide unparalleled access to clinical care at the touch of a button,” said Wetschler. “And many of the problems [Kirkley] was seeing with her patients involved finding doctors with expertise and safe sources of medications.”
In many instances, despite the duty of care that physicians have to maintain, transgender patients are subjected to discriminatory practices and even the denial of care. Roughly 20% of transgender patients who seek care are either denied that care or harassed because of their gender identity, Wetschler said.
Many patients don’t have access to the medications they need, which can lead to up to 30% of patients seeking out the medications they need on the black market.
It’s an issue for the more than 1.4 million Americans who identify as transgender.
Plume provides a safe, on-demand service for patients that need it, said Wetschler. And does it for $99 per month.
The company doesn’t perform gender reassignment surgeries, but that’s about the only limitation on the care that the company offers. It can recommend local surgeons who will perform those procedures and it will provide consultations for patients or potential patients considering various hormone-related or surgical therapies. A majority of the Plume care team is transgender, according to Wetschler.
“What we’re proud of with Plume is that we offer a way of accessing this way of trans-specific care regardless of policy or insurance coverage,” said Wetschler.
At the heart of Plume’s services is access to gender-affirming hormone therapy. “This is the fundamental medical treatment for the trans community,” Wetschler said. “The trans experience is unique in that for most it involves navigating a gender and cis-normative healthcare system that may not understand their experiences. It can be highly traumatic.”
Plume offers a medical evaluation, ongoing monitoring and lab assignments and prescriptions. Soon, the company will also provide medication delivery, as well.
For most Americans, there’s a presumption that medical care will be delivered in a non-judgmental and safe way (both psychologically and physically). For many trans Americans there’s a lack of comfort and risk that’s inherent in the end-to-end care experience. Plume is trying to solve for that.
Investors from the nation’s top venture capital firms, General Catalyst and Slow Ventures, believe in the company’s vision and have backed it with $2.9 million in seed financing. Springbank Collective is also an investor in the company.
“What I was drawn to with Plume is the commitment and conviction Mathew and Jerrica operate with in providing the trans community — a woefully underserved group with access to the health care they deserve,” wrote General Catalyst partner, Olivia Lew, in a statement. “The rollback of healthcare protections for the trans community this past week have only heightened awareness for the dire need for this company. One of the things we’re most excited about in the next wave of health innovation are companies that are using modern platforms like telehealth to serve people’s individual needs with more consumer friendly, personalized experiences.”
These personalized services become even more important for populations at risk, like the trans community, and they’re also more valuable.
“When people take hormone therapy… there’s an opportunity to have an ongoing longitudinal relationship and that’s something that’s highly valued,” said Wetschler.
Currently the transgender population spends around $4.5 billion to $6 billion on medication. And there’s an opportunity to provide better emotional and behavioral support to patients, as well, according to Wetschler.
Plume began providing services in Colorado a year ago, and is now available in California, New York, Florida, Texas, Colorado, North Carolina, Virginia, Oregon, Maine and Massachusetts.
There are roughly 700,000 transgender patients who can now avail themselves of the services Plume offers, but the population, and therefore the need, is growing.
“The estimates on the size of the trans population since a decade ago has been growing 20% year over year,” says Wetschler. “And Generation Z is five times more likely than baby boomers to identify as trans. The full visibility of the trans community is yet to be realized.”
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