Denver-based telehealth brand expands transgender care into more states

Plume, a Denver-based telehealth brand for the transgender community, is the nation’s biggest provider of transgender health care after a recent expansion into four states.

After extending its services to Connecticut, New Hampshire, New Mexico and Wisconsin, Plume now reaches 37 states. The team hopes to eventually expand to all 50, said Dr. Jerrica Kirkley, chief medical officer and co-founder.

“We want to be in as many places as possible to provide care to as many trans folks as possible,” she said in a phone interview. Kirkley, who’s called Denver home for the past decade, has been on her own journey after coming out as a trans woman more than two years ago.

“I’ve been a patient as a trans person trying to navigate the health care system myself, and now have provided care to thousands of trans individuals through the years,” she said. Kirkley “kept seeing barriers and frustrations,” many of which were specific to the transgender community.

OutRight Action International defines transgender as “any person who has a gender identity that is different from the gender that they were assigned at birth.” Transgender people may opt to affirm their known genders through hormones or surgery, but treatments “can be expensive and are often not covered by insurance,” Planned Parenthood reports.

However, “more and more insurance companies are paying for gender-affirming services,” said Dr. Matthew Wetschler, CEO and co-founder of Plume, in a phone interview. Still, “it’s very difficult to find a clinician that has the clinical expertise and also a clinic system that has the cultural competency to create a positive care experience.”

Kirkley and Wetschler started Plume with their own money. It officially launched in April 2020, but Plume saw its first patients in August 2019. Looking forward, Wetschler said they’d like to boost access by offering more services, such as behavioral health, and eventually have Plume covered by insurance.

Almost 6% of U.S. adults identify as lesbian, gay, bisexual or transgender, or LGBT, according to Gallup data published last year. Around 11% of those LGBT adults identify as transgender. Gallup notes that more Americans are coming out as LGBT over time because “younger generations are far more likely to consider themselves to be something other than heterosexual.”

The shorter, older acronym of LGBT has since expanded to include more identities and sexualities. It’s now common to see other variations, such as LGBTQIA, which adds letters for intersex, queer and/or questioning, and asexual and/or ally, according to OutRight Action International.

Plume membership, which requires a monthly fee of $99 in most states, provides users with digital video appointments with health care providers, prescriptions for gender-affirming medications, lab work, a four-week support group series, guidance for medication injections, medical letters of support for surgery and more. It’s available to anyone between 18 to 65 years old, with the exception of Nebraska, which requires a minimum age of 19.

Because of telehealth regulations, Plume isn’t able to offer testosterone-based therapies in seven states – only estrogen. However, Colorado qualifies for both.

Plume’s team includes more than 30 health care providers, 12 care team members and four emotional support team members, according to its website. It also offers a letter writing service for $150 that allows for one digital video appointment with a health care provider and a medical letter of support for surgery with a one-week turnaround time.

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