without simultaneously giving an education to my provider. at lyon-martin when i sought medical care, the things that make me medically interesting or not of interest to my provider. my doctors treated my body as it was, not my identity, and i got a diagnoses, treated, and i can move on with my life. transgendered people, will not always visible, are in transit part of the san francisco committee. we are your brothers, sisters, health care workers, and our health care should be a priority for the city. second, i am advocating for lyon-martin services as a health-care provider myself. i am the transgender program coordinator at the st. james infirmary and refer clients within a healthy san francisco system.

two days before i got word that the clinic was in danger of closing, i got a call from one of our participants. she had received a hormone prescription from us, but as a condition of healthy san francisco to have for coverage, it needed to be written by her medical provider. she was being told that there would not have an appointment open for her and another two months. the public health system is already stretched thin. if we are thrown back into the system, how can that fragile network picked us up? how can the clinics to pick us up continue to provide competent care with the added burden? for that reason i'm asking for your support, thank you. supervisor mirkarimi: thank you very much. next speaker, please? >> good evening, my name is james award. i am a current patient of lyon- martin, and i am asking your

support and keeping the doors open. before i came to lyon-martin, i had the most horrible experiences in the medical field as a trans person. i stopped saying medical care on my gun and started using the internet. somebody pointed me in the direction of lyon-martin over a year ago and ever since then i have been treated with the most amazing care and respect and dignity i did not know existed for trans people within the health-care system. i don't know where i would go without lyon-martin, so i ask for myself and seven other people who rely on this, not only for economic purposes but just being able to be served as a human being in receiving health care, i ask that you show your support for all of us. we are part of your community. thank you. supervisor mirkarimi: thank you.

next speaker? >> i am an organizer with power. i want to thank supervisor mirkarimi for holding this hearing and supervisor kim for coming out and supporting the community events and all of you for taking the city initiative and your own hands. i think this context right now around health-care is critical because increasingly health care is looked at as a business. yes, this is a question of our health and finances, but fundamentally, there is a moral question. we all know the reality that across the country lesbian, gay, bisexual, and transgendered people don't go to the doctor because of the discrimination we face, and countless studies have shown the correlation between breast cancer and lesbians was because they were not getting medical care until so late in the not aware they were getting cancer and could not the

treatment. the fatality of that illness. -- that connected the treatment to stop the fatality of that on this. i am a past client of lyon- martin, and it was the best experience i have ever had. i never go to the doctor. i have experienced such bad things at the doctor that if you don't have a crisis, you don't go. i think that lyon-martin is an incredible resources, which is why we are willing to fight for it, and i think the city, up $150,000 is insignificant, but it is so small compared with the resources we have and will save the lives of people. if the clinic does not exist, they will not be absorbed by other clinics. they will just not go to the doctor, and we cannot afford that. thank you. supervisor mirkarimi: thank you very much. i will read more names. sandra, estevan, jackson, and

deborah. >> hi, my name is cara, and i have been an employee of lyon- martin the past three years. i court in a public health, which is a collaborative program with the transgendered law center. lyon-martin works to provide improved health care in this state and has achieved unprecedented results for the transgender community. we have worked with over 10 community clinics, helping them create a safe base for transgendered clients and providing staff competency. we just helped launch a clinic in humboldt county. we provide medical training at ucsf, the general, kaiser, stanford and others to name a few. at lyon-martin we have trained

over 35 students who come from as far as the u.k. and as close as ucsf to get hands-on experience and training. we offer the only transgendered rotation and the u.s. students are able to serve trans-identified people. thousands of trans people are receiving, but it health care. the cutting edge work that lyon- martin is doing must continue. please help lyon-martin lyon- martin -- please help lyon- martin and a larger transgender community survive, thank you. supervisor mirkarimi: thank you. >> my name is sandra. i'm a mental-health provider at lyon-martin. i am on to speak to the mental

health piece of the clinic, which has not got a lot of attention, but i think it is crucial. we currently provide individual and group therapies, psychiatric services, and case management for approximately 100 clients every week. it is also a training facility for social service workers to take the knowledge they have learned from the clinic and they go out to other private practices or clinics and provide services to the clients who cannot have the benefit of living close enough to san francisco. we provide a short-term model of 12-20 sessions to clients. to be as accessible to as many people as possible. what happens, often, they go out into the committee and try to find other therapists or providers that can give them the support that they need that and not treat them like they are an anomaly.

what happens is the request to return to lyon-martin for their mental health care, because i think they find that we not only accept them but i appreciate them regardless of their income, ethnicity, sexual orientation, gender identity, a plymouth, sex practices, parenting practices, etc. it isthe trans community ha lifesaver in fund-raising. but there is a huge percentage of our patients not represented in this room. and there are many people of color, many spanish speakers who have yet to join the fight in this, who i think would want you to do everything you can to save this clinic. by granting our financial request today, you can send a critical message of support to all of our patients who have faced abuse and organizations throughout their lives. thank you.

supervisor mirkarimi: thank you. >> my name is as the bonn rodriguez. i worked at the dimensions youth clinic, housed in castro mission health center. thank you for having this meeting today. when you have a population of people who are used to hearing know, as somebody who works in a clinic certain -- serving these people, saying there is nowhere to go is the worst thing you can do. the saddest thing is people are not really surprised to hear it. lyon-martin is one of the places where people not eligible to come to a youth clinic that i can send people. no is not the end. without this clinic, people will fall through the cracks. the wedding at castro-mission right now is 400 people long. folks are not going to be jumping through these hoops to see somebody who they do not trust to begin with.

i just want to urge you to do everything you can to save this clinic and to save the people that use this clinic. supervisor mirkarimi: thank you. next speaker, please. >> my name is deborah benedict. i am also a client of lyon- martin. related to the profile of some of the other speakers who have been here, i can tell you that i have never received health care at the level that i have at lyon-martin. completely non prejudiced, completely compassionate, and willing to listen to complaints that other doctors have dismissed. i had two biopsies for skin cancer on my face that other doctors repeatedly -- i think approximately 10 different times, i have tried to get medical care for the growths a

recognized were not normal on my face. i was repeatedly told it was nothing. it was only lyon-martin that listened to me and heard me say there was something unusual going on. i was able to get treatment. i have never had a situation where the health-care provider has been so proactive and listened to clients about actual issues we have. i believe no person is a better expert on their own health, and knowing what is going on in their body when something is wrong. without community support, there is not going to be a possibility that others who have difficulty expressing issues related to their health are going to have a venue. it is important to note that lyon-martin, which was a nonprofit, never had an open-to- the-public board meeting, as

required in the city charter, which requires that open public meetings be had twice a year by any organization that receives funding from the city of san francisco. if there might have been open meetings, this might not have happened. thank you. >> i am allan jensen, and i am a past patient and current volunteer at lyon-martin. i am here to ask you to help save the clinic. i originally came to lyon-martin a few years ago as a patient. i have had significant health problems. i have a history of depression and mental health issues. i also had been unable to receive transgendered-related care elsewhere, because people would look at me and turned me away. i also have an autoimmune disorder which desperately needed treatment and was

dismissed as psychosomatic. at lyon-martin, i was shown nothing but respect. i had been taken -- taking black-market hormones. dawn got me off that and was sure to follow up with me to make sure how was doing. all of the providers and all the staff are absolutely respectful and wonderful. it was this that made me decide later to come back as a volunteer. i volunteered at other places, but this is probably the first place i have ever heard anybody say, "i am so looking forward to coming to my appointment tomorrow." if you days ago, i got into a bicycle accident and from my arm and got broken up. i have private insurance now. i call the nurse to book me for an appointment, and she almost did not do it. when she pulled up my record, she saw i was transgendered and

had a mental health history. it was marked as psychosomatic and i was asked a lot of personal, in basic questions. it was an awful experience. that contributed to me not getting the health care i needed. i was essentially home with a splint for the weekend, in pain. when i got back in on monday, i was seen by another provider. she saw how nervous i was. she asked me out of curiosity where i was going when i got into an accident. i said i was going to volunteer at lyon-martin. she said that was where she got all her training. it was because of lyon-martin that i continued to receive good health care, you could say. >> before the next speaker comes up, and want to invite laura

collins, and victoria grace, may toolin, sonya lively. >> my name is jackson bowman. i am part of the coalition of community members. i want to speak about -- as a service provider. for the last four years, i have worked with the transitional dutch age use -- with transitional-age youth population. a do not think people familiar with this population would be surprised to know that usually when homelessness, hiv, or mental health needs, or substance used problems are at play in someone's life, that is not the only problem they are faced with. most people who are experiencing one kind of mental illness may be experiencing more

than one. people who are experiencing mental-health problems are also often having problems with substance abuse, having problems with access to education, employment, housing. san francisco does a good job of providing services for young people. however, i think it does less of a good job providing services for adults. because of organizations like mission-castro, i have places to refer young people for services. i do not have a place to refer those transitioning from youth services into adult services. this has been important in being able to offer care to the youth i work with. they can meet the multiple means that they face for young people who are transgendered who need that kind of health care. there are also able to receive services around mental health, substance use common diet, smoking cessation, and other

things that lyon-martin does. there is nowhere else to refer to the young people i work with. i think the $150,000 the clinic is asking for is the minimum the city can do. i would encourage you to do as much as you can. supervisor mirkarimi: thank you. next speaker, please. >> thank you, supervisors. i am laura thomas. i am a former patient of lyon- martin. i access services there about 20 years ago, when i first came to san francisco as a young woman looking for health care. i am also very proud to be a part of the amazing community response that has been the "save lyon-martin" experience. i abort in nonprofits in the city for a long time. -- i have worked in nonprofits in the city for a long time.

i have never seen this kind of response in crisis. i am proud to be a resident of san francisco, which has an amazing investment in ensuring that everyone in san francisco has access to health care and culturally-competent health care. we take cultural competency to the next level in this city, teaching the rest of the world how to provide that care. i am proud of that. i understand this is a difficult time to be keeping a safety net together. i worry that the holes in our safety net are getting larger and larger. i fear that if we lose a clinic like lyon-martin that the holes will be so big we cannot repair are sifted that again. there are going to be a lot of strong health-care organizations facing cuts this year.

we have more to lose if lyon- martin closes. i challenge the board of supervisors to come up with funds to help match with the community has come up with. i think $150,000 from the board of supervisors to match with the community has already raised would be only fair, given the work that so many people have put in to saving this important health resource. thank you. supervisor mirkarimi: thank you. next speaker, please. >> i am with the trend tender law center here in san francisco. -- with the transgendered law center here in san francisco. i want to echo that the staff at lyon-martin our leaders nationally in improving access to care for transgendered people. the clinic provides culturally

competent health care services to san francisco's trans gender community. i work with low income and homeless transgendered people who live in the city. many of my clients first received mental-health services from new lease. they closed their doors. then there were reassigned to lyon-martin. a lot of those folks are facing losing the mental services they then have. the work on things like project health to train other doctors. i clear -- i fear for my clients that will not get reassigned to another clinic in a reasonable time. people are likely to not get health care at all. they face the fear of not being able to find doctors like they have at lyon-martin.

i fear people will not get primary care. they may resort to st. hormones or not get the care they need. i urge you to do all you can to support lyon-martin. >> i am victoria grace, a concerned member of the trans gender community, and a very happy patient of the tamo delaware -- tom modell help center and a client of the trans thrive center. competent health care is of utmost importance. transgendered people have a lot of trouble getting culturally competent health care. i am fortunate to get the good health care i get. tom modell is at capacity and will be utterly swamped.

we have heard about the backlog that pastoral mission -- that castro-mission already has. first new leaf, and then lyon- martin. what else? we must keep lyon-martin open. it is of the utmost importance. social safety net services are being cut across the board. it is not a matter of there is not money. it is like the top 1% have collected everything all to themselves. it is not so much the fault of the former board. i just want to ask you to do everything you can to keep lyon- martin open. supervisor mirkarimi: thank you. next speaker, please.

>> i am a patient at lyon- martin. i am fortunate to have health insurance, but i go to lyon- martin because of negative and neglectful health care i have had starting at 16. my pediatrician walked out of my room when he i told him i was gay. it continued from there. i have not gotten good health care until i moved to the city in july to work in special education in the city. when i went to lyon-martin, i learned there were essential health services that i did not know a woman at the age of 23 should have received. i am healthier now that i moved to san francisco, thanks to lyon-martin. supervisor mirkarimi: i am going to read more names. nikki bass, cheryl c. most, ronnie jacobs.

>> my name is sonya lively. i am 60 years old. most of my life, i have been going in and out of hospitals because every time i tried to get help, they would lock me up and put me on drugs. they did not try to find out why. finally, i decided to instead of killing myself come to san francisco in try one last time. somebody referred me to lyon- martin. i finally found a doctor that would listen and try to help. thank you. supervisor mirkarimi: thank you. >> my name is melissa karen. i am currently the clinic director at lyon-martin. i am a nurse by trade. i came to california three years ago.

we have had a medical historian working with lyon-martin for about a year. she has been capturing the story of the clinic and patients. i want to share a couple of excerpts. i have the printout of all of those stories that i would love to give you, if you want them. the first is a trans patient who said, "i had never received biological care before, because i was so uncomfortable and ashamed of my body. i am afraid my reproductive health will suffer dramatically, as i cannot fathom letting another doctor into my body in such an intimate way." another patient said, a 49 year old who was diagnosed with kidney cancer, "i thought the financial and emotional burden would be too much to handle and no one else would be able to help. there were many times i felt helpless and hopeless.

suicide felt like the easiest option. i am a lesbian, and even though my family feels -- tries to be supportive, i felt more comfortable talking to the staff of lyon-martin. it was reassuring to know i would be treated with the utmost care and respect. i never felt ashamed there." the lead story and wanted to share was a patient who said, " not only do they provide care to those of us who have been turned away by the medical industry, they provide care to those who have been treated badly in the past by some health care professionals. to receive a gentle and non- judgmental care is tremendous. i grew up in maine and most of my friends are from the east coast. my band teacher has given to lyon-martin, my siblings have given, and people i do not even know have given money in mining. the word from the east coast is it would be a travesty to the nation to lose this place.

the provide cutting edge care. i want it to be mainstream. everybody deserves this type of care." supervisor mirkarimi: thank you. >> my name is cheryl semos. i am a former volunteer at lyon- martin, and currently a patient. i can only say that everything that has been said, i want to second. i have experience with other city-funded clinics, as well as private health care at times when i have had private health insurance. it does not matter whether it is other clinics or san francisco general or private health care. it is one of the best hospitals here in san francisco. the service and the care given at lyon-martin is exceptional. it is completely respectful and

proactive. i think someone used that word. i have had the medical staff of lyon-martin treatment concern seriously when i expressed those same concerns to medical staff in other institutions in san francisco and it was a question of, "there are limited resources, and unless it is a critical need right now we are going to have to avoid it." that never made sense to me. if you ignore something, it only becomes critical. i felt like other health care providers were waiting for me to become incapacitated before there would address something. it is the opposite at lyon- martin. they are very proactive. the other thing i would say is a think it is critical that lyon- martin for many reasons. one is that there will not turn you away if you are unable to pay.

and that is an attitude that they are clear about their. -- there. it is not as clear in other city-funded health care situations. the community has done all it can. we raised a lot of money. please give us some money. [laughter] supervisor mirkarimi: next speaker, please. >> my name is nikki bass. i am a patient at lyon-martin and have been treated there since 2009. prior to that, i spent five years going from a clinic to clinic attempting to find treatments that addressed when medical situation. during this time, i was given different forms of medication my body could not tolerate. i would always wind up being told either