Dr. Jerrica Kirkley is the co-founder and CMO of Plume, a Denver-based, direct-to-consumer telehealth company that provides medical consultation and gender-affirming hormone therapy for transgender patients. As a trans woman, family practice physician, and educator, Dr. Kirkley and her co-founder, Dr. Matthew Wetschler, started Plume in 2019 to radically increase access to gender-affirmation services. For a monthly fee of $99, Plume clinicians will create a custom treatment plan for patients, which can include prescriptions of testosterone, estrogen, and testosterone blockers to help individuals align their physical body with their identified gender. Nearly 80 percent of Plume’s clinical team identifies as trans, and more than half of the company’s business side is comprised of transgender individuals. In February 2021, the company successfully raised $14 million in Series A funding from Craft Ventures, General Catalyst, Slow Ventures, and Town Hall Ventures. To date, Plume is operating in 33 states and has been regarded as one of the fastest growing trans tech companies in the nation.
Highlights of our conversation include:
Creating Plume
While in medical school, Dr. Kirkley’s mission was to provide high-quality healthcare to marginalized communities. In particular, transgender and gender-diverse individuals face tremendous disparities in their health and healthcare. Compared with cis-gender individuals, transgender and gender-diverse individuals have higher rates of mood disorders as well as tobacco and substance use, with rates of suicide 26 times higher than that of the general population. Many medical issues have been amplified by pervasive maltreatment from medical providers. In order to educate medical students and trainees on the medical and psychosocial management of transgender and non-binary patients, Dr. Kirkley collaborated with a mentor to build a formalized curriculum during her family medicine residency. In addition to these experiences, Dr. Kirkley’s personal experiences and journey also continued to shed light on the core issues that transgender and non-binary patients face in accessing and receiving healthcare. Dr. Kirkley ultimately leveraged her dual perspective — as a provider and a patient — in building what now is known as Plume.
“There just really isn’t a lot of support depending on where you are in the country and in the world. As somebody who has provided gender care and has received it myself, recognizing those pain points, and really seeing the edges of the medical system as we know it, I wanted to create something that could provide high quality care in a way that is accessible and is breaking down the barriers that existed… want[ed] to build something by and for trans people that really reflected our experience.”
COVID-19’s impact on gender-affirming care
Because of the lack of resources provided to many clinics, a substantial number were shut down during the COVID-19 pandemic. Those that remained open were swamped as a result. This unfortunately left a plethora of people and patients unable to receive timely and necessary care. In a more positive light, however, this process opened the eyes of stakeholders and investors to the value of leveling up technology and resources. Additionally, although surgeons and insurance companies are progressively acknowledging the necessity of gender affirming surgery, the pandemic established this triaging of “medical necessity,” in which gender affirming surgery sometimes went to the wayside.
“Gender affirming surgeries are medically necessary. Period.”
How Plume Works
Plume is operated on a subscription-based model. A monthly fee includes an initial consultation and all follow-up care, including lab monitoring and prescriptions, refills. Currently, the company is providing gender-affirming hormone therapy along with letters of support for surgery, gender marker change, and legal name change.
The process of subscribing includes downloading the app and undergoing an on-boarding process. 20–30 minutes after this, you can schedule your visit and text whenever something comes up or if you would like to schedule a follow-up visit. The company has a full team of clinicians, nurses, physician assistants, care coordinators, and clinical managers, 80% of whom are trans.
Next steps for gender-affirming care
A 2011 study found that the mean time spent on lesbian, gay, bisexual, transgender, and queer (LGBTQ) education in medical school curriculum was about five hours, and in some cases, zero hours were spent on trans health-related topics. In order to promote greater representation of such topics in training, Dr. Kirkley advocates for more clinical experiences involving transgender and non-binary patients as well as didactics that discuss important concepts within gender-affirming care. Dr. Kirkley encourages listeners who want to get involved in LGBTQ health to seek engagement in policy efforts (both at the local and national stage), to leverage technology to increase access to healthcare services, and to promote research and clinical trials involving transgender and non-binary patients.
For the entrepreneurs and innovators looking to engage in this sector, Dr. Kirkley conveys that this involvement needs to come from the heart.
“It really needs to come from the heart…The companies that thrive are the ones that have a passion, that recognize a key unmet need, and that are dead-set on solving that need. It needs to come from a heart-forward place — especially when working with vulnerable populations that have historically faced disparities in healthcare.”
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Story written by Katie Donahey, Luiza Perez, Priya Kumar
