Oak Cliff-based healthcare provider Prism Health North Texas makes it easy for transgender people to receive care.

That’s radical at a time when transgender rights are under attack from the Trump Administration.

The U.S. Department of Health and Human Services rolled back protections for trans people in June, removing nondiscrimination language from rules involving health care and health insurance.

At nearly the same time, the United States Supreme Court made a ruling in favor of trans rights, which likely will nullify that change eventually.

But there is a long way to go before transgender people have equal access to healthcare.

“There’s a potential for trans people to be openly discriminated against by doctors and hospitals and health insurance companies,” says Dr. Rachel Rivera of Prism.

From Prism:

Many people don’t know that transgender men and women often have difficulty receiving primary healthcare in traditional doctor’s offices or clinics. Because of the stigma surrounding and violence inflicted on transgender people, they often visit private clinics or resort to going without treatment, adding inequalities to a health care system that is already often unforgiving while also increasing future larger health and insurance burdens when an individual’s delayed doctor visits worsen their conditions.

Prism, formerly known as AIDS Arms Inc., started offering transgender services over 30 years ago, and they run a clinic in Oak Lawn specifically for transgender patients that offers primary care, plus specialized services such as hormone therapy.

Rivera works at the Prism clinic off of Dolphin Road. That clinic mostly treats patients with HIV or those who are taking the HIV prophylactic because they’re at risk for the virus. But she says she does have a number of transgender patients as well.

“Their needs are really quite varied,” Rivera says.

One thing they all receive is gender-affirming care, where everyone in the clinic uses the appropriate pronouns, providing a safe space.

“It’s a challenge because a lot of my patients have had bad healthcare experiences,” Rivera says “They’re often reluctant to tell me what’s going on with their lives. I have to establish rapport.”

She says that some transgender patients she sees have been going without care for a long time and buying hormones on the black market.

“And I have to educate them about doing that transition process safely,” Rivera says. “What are the right hormones? Weighing the risks and benefits of each one and monitoring them so that we can make sure they‘re getting the right amount of medications and that they’re seeing the results they want to see.”

Rivera says she often writes letters in support of her patients’ legal name changes. She notes that transgender people are still prohibited from serving in the military.

“Hopefully we’ll be able to get those protections back in the healthcare industry, but it’s not looking good,” she says.