When Dr. Chris Awwad became the medical director of Bergen New Bridge Medical Center’s Center for LGBTQ+ Health and Wellness this year, he not only took the helm of a thriving medical practice at New Jersey’s largest hospital, but he realized he may have to fill the role of a public advocate if needed.
New Jersey is a fairly progressive state when it comes to public policy affecting the health care of lesbian, gay, bisexual, transgender, queer, and other communities. But with a bill introduced in Trenton last year that would criminalize hormone therapy and other treatments for transgender teens, Awwad said his practice can’t escape political reality.
“It’s nice to be able to build a center like this, but there’s a certain risk involved,” he said.
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“There are a lot of people trying to lobby and legislate what I can do in the exam room with my patient,” Awwad said. “It’s always something that comes to mind.”
Despite the bill and similar moves in state legislatures across the United States, many New Jersey hospitals have opened LGBTQ+ health care centers in recent years, where hormone therapy is a popular service. But the centers also offer a full range of primary care, along with specialist care such as sexual health, HIV treatment and community-tailored mental health counselling.
“A more holistic experience”
Patients could come for treatment of sore throats, rashes, fevers and other common ailments as much as specialist care, Awwad said.
“You used to go to a place to get hormone therapy if you’re trans,” she said. “If you need to, you go one place to get your primary care, one place to get HIV care. We actually wanted to try and bring everything into one program so patients could have a more holistic that could include all of those.”
The expansion of LGBTQ services in the suburbs is a change from the past, when most of the clinics that popped up in the early days of the AIDS crisis were only in city neighborhoods with large gay populations, such as New York’s Greenwich Village or the Castro District in San Francisco.
“It’s important to have access in suburban areas rather than just big cities,” said Sean Patrick Riley, director of the PROUD Center at Robert Wood Johnson University Hospital Somerset. “You don’t have to go to Philadelphia or New York. You can stay here and get the same quality care.”
The RWJ Center opened six years ago when hospice clinics for LGBTQ patients were not common in New Jersey. It ran just one night a week and saw 200 patients in its first year. But through word of mouth, the demand has grown beyond the county of Somerset. The center is now open five days a week and sees more than 1,500 patients a year.
Renamed in honor of Babs Siperstein, the New Jersey native who became an advocate for transgender rights, the center has six full-time staff members led by Riley, an advanced practice nurse, who previously practiced in Missouri. She said her move to New Jersey with her husband was an eye-opener in a good way.
“I was lucky to move to a state that doesn’t politicize health care,” she said of efforts to curb transgender treatments in other states. “It’s a big difference, especially when you’re providing care to a community where you belong.”
Hormone treatment firestorm for adolescents
Some of the centers offer services only to those over 18 so they can avoid political storms like those that have erupted in more conservative states over providing hormone treatment to teenagers. Bergen New Bridge provides primary care services to adults and adolescents and offers referrals for adolescents to pediatric endocrinologists for hormone treatment.
In September, Senator Edward Durr, R-Gloucester introduced the Child Protection and Anti-Mutilation Act, “which would charge doctors with a third-degree felony if they were found to have treated anyone under 18 with hormone therapy or surgery The bill carries a three- to five-year prison sentence and a fine of up to $15,000.The bill has languished in the legislature, which is controlled by a Democratic majority.
“We can protect children from unnecessary and permanent harm by delaying these important decisions until they are adults,” Durr said in a statement upon the bill’s introduction.
Eight months later, Governor Phil Murphy signed an order in April that established New Jersey as a “safe haven for gender-affirming health care.” All government departments have been ordered to protect healthcare professionals and patients from potential repercussions for travel to New Jersey to obtain gender-affirming healthcare services.
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Open to doctors
At least 40 percent of patients at AtlantiCare’s LGBTQ+ Health Center in Atlantic City are in the “process of their transgender journey,” many with hormone treatments, said Dr. Edward Hamaty, the center’s interim medical director. Since the center opened in 2022, popular services have included primary care and treatment for depression, stress and other psychological issues, he said.
Having a place for this community helps patients open up to doctors in ways they may not have before, she said.
“I recently had a patient who started talking to me about her husband, and he stopped and said, I don’t normally talk about him,” Hamaty said. “She was so happy to be able to talk about her family with me. That’s our goal.”
As Pride month draws to a close, Awwad said he wants to make sure his center isn’t just a good public relations move.
“There are a lot of people waving Pride flags and people saying, ‘We’re here for the community,’ but that can be very superficial,” she said. “We want to make sure that we have a good core of services that we’re delivering and that we’re doing all of these things well all year round. We’ll still be here when the Pride flags come down.”
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