“I regret not doing it sooner.”

Mitch del Monico waited until he was in his 40s before coming out to his family as transgender and beginning his transition. He wasn’t sure how some family members would respond. Luckily most of them were supportive, though throughout his life, that wasn’t always the case.

But at his core, del Monico always knew the person he was. 

“I don’t feel like I was one way and then became another,” he said. “This is who I was born to be. It was the rest of the world that needed to catch up.”

Finding his place

When del Monico, an independent filmmaker and author, decided to begin his transition journey, he had been a patient of Venice Family Clinic for a few years. The Clinic didn’t offer transgender medical care at that time, so he sought help elsewhere.

But after beginning hormone therapy elsewhere, del Monico realized that the Clinic was a better fit for him. So he came back, just as we officially rolled out our transgender medical care in 2017.

“Venice Family Clinic is a place where people really care,” said del Monico, who now serves as a member of the Clinic’s Board of Directors. “There are health care needs that are unique for a transgender person, and they can be uncomfortable to talk about. So many transgender people forgo health care altogether because they fear they won’t be accepted, or they may have had a bad experience in the past. The fact that Venice Family Clinic offers gender-affirming care is crucial for the health and wellness of the community.”

Providing support to a community

Gender-affirming care approaches a person’s physical, mental and social well-being without judgment, both recognizing and respecting their gender identity. At Venice Family Clinic, most of our staff clinicians have experience caring for transgender, nonbinary and gender-nonconforming patients in primary care. For people 18 years and older who would like to begin the transition process with hormone therapy, we use an informed consent model, just as we do with any other kind of therapy, treatment or procedure: patient and clinician discuss the options, risks and benefits of a specific treatment path and decide together the best course of action for care.

Our in-house pharmacy can fill prescriptions for hormone therapy. We refer people to specialists outside the Clinic for other transition services, including those for surgery, vocal coaching and laser hair removal.

“In the past, when someone wanted to start hormone therapy, patients were required to obtain a medical diagnosis from a psychiatrist,” said Lisa Cederblom, FNP-C, who leads Venice Family Clinic’s transgender medicine program. “Now, as there are well-established diagnostic and treatment guidelines, primary care providers are well-suited to care for transgender patients without requiring a mental health evaluation prior to initiating hormone treatment.”

Encouraging overall well-being

Cederblom said that our clinicians refer transgender patients to the Clinic’s Behavioral Health department only if they have experienced trauma, such as abuse, or if they request mental health services – not as a matter of course.

“We know that people who have experienced a lack of support or discrimination in their lives are at higher risk for depression, suicide, homelessness, not thriving in school, and a host of other traumas,” Cederblom said. “Gender-affirming care is important for this community that hasn’t been treated well historically by the medical establishment.”

This past summer, our Behavioral Health department launched AFFIRM group therapy for LGBTQ+ youth ages 12-21, combining evidence-based behavioral therapy and identity-affirming techniques to help participants manage stress, enhance coping skills and validate their strengths. The groups, which meet for 8 weeks at a time, are open to patients and community members alike. The latest group starts in November.

Caring with respect

For del Monico, seeing the Clinic develop new supportive programs is gratifying, especially as a board member.

“Knowing I can walk into a reassuring medical environment changes the game for me,” del Monico said. “For years I didn’t feel comfortable getting medical care at all. Knowing I can get the care I need and feel accepted makes a big difference, especially in a world where that isn’t always the case for people like me.

“Everyone wants to be treated with dignity. Venice Family Clinic is a place where that happens – regularly and with intention – and that means everything.”

To learn more about our AFFIRM groups for LGBTQ+ youth, contact Jennifer Amaya Gonzalez, LCSW, at (310) 664-7745 or JAmayaGonzalez@mednet.ucla.edu.