Finding Affirming Healthcare Shouldn't Feel Like a Barrier

One Detroit clinic is working to make comprehensive sexual health care accessible to the queer community

Marketplace Story

The Ruth Ellis Clairmount Clinic team. Courtesy photo

Published: October 29, 2025 | Last Updated: October 29, 2025

Imagine needing to see four different doctors just to manage your basic healthcare needs. One for your annual physical. Another for your gender-affirming hormones. A third for sexual health screenings. Now imagine that at any of those appointments, you might face a provider who doesn't understand your body or makes you feel unwelcome.

This is the reality for many LGBTQ+ people trying to navigate healthcare in America. LGBTQ+ people are more likely to experience barriers in accessing healthcare, including delays in getting needed care. Fear of stigma and institutional distrust remain major barriers. For transgender people, these challenges become even more pronounced. Nineteen percent of trans people have been refused medical care because of their gender identity, while 28 percent have experienced harassment in a doctor's office.

When people don't feel comfortable with their healthcare providers, they're less likely to seek preventive care or disclose important health information. Studies show that LGBTQ+ adults face increased challenges when it comes to mental health outcomes, access to care and physical health.

Take PrEP, for instance. The highly effective medication that prevents HIV transmission is recommended by the CDC for anyone who is sexually active and wants it. Yet only 3 percent of transgender people at high risk for HIV currently use it. Many don't even know they're candidates. The gap between who could benefit and who actually receives PrEP reflects a broader problem: Transgender women face 49 times the odds of having HIV compared to the general population, a disparity driven largely by barriers to accessing prevention and care.

Sexual health testing presents another layer of complexity. Many people receive testing at urgent cares that doesn't adequately address all potential sites of exposure. Providers who aren't comfortable discussing the specifics often miss crucial testing opportunities.

So what does it look like when we get it right? Inside the Ruth Ellis Center's Clairmount building in Detroit, Henry Ford Health operates a clinic that's becoming a model for accessible, affirming healthcare. Run through Henry Ford's infectious disease department, this clinic offers something many queer people have struggled to find: comprehensive care in one welcoming space.

Exam room inside Ruth Ellis Clairmount Clinic. Courtesy photo

"There are significant health outcome disparities for trans people, especially Black and POC trans folks. There's not enough access to affirming care, and people don't have places they're comfortable going to," says Ollie Leatherman, a clinical nurse lead at the clinic. The setup is deliberately intimate. Two nurses, a social worker and a provider make up the entire staff, and they're always the same faces. That familiarity translates directly into better care in a comfortable, open-minded setting. The clinic takes a sex-positive approach, inviting conversation about how and with whom patients have sex without judgment. This kind of frank discussion helps providers identify the most effective and best-suited prevention options, including newer tools like STI-prevention medication doxyPEP.

"Lots of times folks are getting testing at places like urgent cares and other just kind of non-sexual health focused clinics and getting testing that doesn't adequately cover all of their potential sites of exposure," Leatherman explains. Patients who come to the clinic often receive more thorough testing, including throat swabs, rectal swabs and syphilis tests that actually address their sexual practices.

The staff have also noticed a pattern when it comes to PrEP. "We see a lot of hesitancy among family medicine doctors and general practitioners to prescribe PrEP," says provider Erika Pastor, a family nurse practitioner who sees people for primary care alongside sexual health services, gender-affirming care and HIV prevention and treatment. "Sometimes people kind of come in thinking that it's a difficult thing to do or they might not be a good candidate for it when we know that the CDC recommends that anybody who wants PrEP and is sexually active should be eligible for it."

Services include primary care, STI prevention, testing and treatment, HIV prevention and treatment, gender-affirming care including hormone therapy and surgical referrals, as well as medication monitoring for chronic conditions — all under one roof.

There are significant health outcome disparities for trans people, especially Black and POC trans folks. There's not enough access to affirming care, and people don't have places they're comfortable going to.
Ollie Leatherman, Ruth Ellis Clairmount Clinic clinical nurse lead

"Most of the folks that we're seeing for sexual health services, gender-affirming hormones, HIV treatment or prevention we are also seeing for primary care," Pastor says. "That just lowers the barriers, the amount of inconvenience and difficulty that folks have following up with all these myriad of doctors."

Medicaid and other insurance plans that Henry Ford takes are accepted. Thanks to grant money through the state of Michigan, no one should be turned away from STI testing, even without insurance. And you don't need to be receiving other services at Ruth Ellis to be seen here.

Your health matters, and having a usual source of healthcare where you feel comfortable with providers makes all the difference. Whether you're looking for your first PrEP consultation, comprehensive STI testing, primary care with a provider who gets it or gender-affirming care, affirming healthcare options exist in Southeast Michigan.

This article is made possible through our partnership with The Ruth Ellis Clairmount Clinic. To schedule an appointment call (313) 484-5888. The clinic is located at 61 Clairmount Ave. in Detroit’s Piety Hill neighborhood.