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Meet Jerrica Kirkley

Today we’d like to introduce you to Jerrica Kirkley.

Jerrica, can you briefly walk us through your story – how you started and how you got to where you are today.
My name is Jerrica and my pronouns are she/her/hers. My story starts from birth, really, since my company, Mariposa Health, is so intertwined with who I am. I grew up in North Carolina constantly surrounded by bigotry, discrimination and hatred of all marginalized people. As a child, I never had any role models to tell me these things I was witnessing were bad, but they always felt wrong to me on a deep level and I never really knew why especially since I was part of a community that was condoning these behaviors. The hatred towards the LGBTQ+ community I was seeing at the time, was almost purely centered on gay cisgender men (cisgender means the sex assigned at birth is the same as one’s gender identity), and I didn’t know the word ‘transgender’ until I was in college. While I didn’t have the insight until recently, I lived the first 34 years of my life constantly repressing my true identity in an effort to live up to the expectations of living as a boy and then a man that was impressed upon me since I was born.

I also lived a life full of anger, frustration, and self-hatred that was always inexplicable until now. I was constantly searching for something that was never fully apparent to me, so it translated over as always looking for the next career move, or the next best place to live, or the next hobby I needed to pick up. It was like trying to quench a thirst that could never be quenched. I never consciously thought I was a girl when I was younger or told my parents that I was. I didn’t preferentially or routinely express or participate in activities that were thought to be more feminine. But, I always had a feeling that something was different about me, at times much stronger than others, but I could never put my finger on it. So I floated along, doing what I thought I was supposed to do. After completing medical school and residency, my brain finally had some time and space to start some emotional processing that had been put on hold for a long time.

Within a few years, I realized this difference I had been feeling all along had to do with my gender. It became obvious that I was not a cisgender man and I also had a strong desire to express more femininely but I wasn’t sure where I was going to fall on the gender diverse spectrum at the time. As I started to lift the repression, my feminine identity came flooding in and I even started to remember events from my childhood that I had previously blacked out, which were clear signs of me desperately grasping for my femininity. So at the age of 35, I came out as a transgender woman, shortly after launching my company, Mariposa Health. While coming out has had its challenges, I can honestly say I am the happiest I have ever been and all the anger, self-hatred and searching, instantly melted away.

I am a family physician by training and have been providing gender affirming care (commonly known as “HRT” = hormones replacement therapy) or prescribing hormones and other medications to help affirm somebody’s gender which is different than their sex assigned at birth, by physically transitioning their body, since 2013. During medical residency, I helped create a hormone prescribing protocol and an LGBTQ+ curriculum for residents, faculty and staff. I have built out the gender affirming care program at a large community health center in Colorado and also helped start two clinics, one of them a free clinic, dedicated to the care of trans folx (the use of ‘trans’ throughout the interview includes all transgender/non-binary/gender non-conforming individuals). I have given training on how to provide gender affirming care to academic institutions, community health centers and private practices in Colorado and beyond. Even before my own gender identity had risen to my consciousness in a meaningful way, I have always felt intense joy when delivering gender affirming care and helping others through their transitions that I have been unable to find in any other facet of medicine. But through all of these efforts, I wasn’t able to overcome a lot of the barriers that exist for trans people accessing care. People often live in areas where there are not any competent or even welcoming medical providers. Even when they do live in areas with competent providers, they often face exorbitantly high prices if their insurance doesn’t align or there are long waiting lists just to be seen. And it happens so often, that even if there is a competent provider, patients still face discrimination, misgendering and misnaming by other staff in the clinic and have to walk into a space that is not only unaccommodating but can also be dangerous.

One afternoon in February of 2019, my now business partner and best friend from medical school, Matthew Wetschler, was telling me about his experience working for virtual healthcare delivery companies that could facilitate patient visits by texting and video conferencing, exclusively, with no physical location. Suddenly a light bulb went off in our heads with how this could impact gender-affirming care delivery and effectively eliminate most if not all of the barriers that remain for trans people, but nobody was doing this on a fully virtual easily scalable platform. It was from that conversation that the idea for Mariposa Health was born – to create direct-to-consumer delivery of HRT for trans folx on a mobile-first app-based platform, through primarily asynchronous communication (texting), on a flat fee subscription basis regardless of insurance or lack thereof, that can be scaled across the country. We officially launched in July of 2019 in Colorado using Spruce Health’s platform, and are currently in the process of securing funding to build our proprietary app and working on expanding to other states.

Overall, has it been relatively smooth? If not, what were some of the struggles along the way?
One of the hardest things about creating something that many people want and need is offering it at a price that is affordable, but also reflects the value of what is offered and sustains the service to exist on as wide a scale as possible to impact as many people as possible. We have set the pricing at a level that we feel is reasonable and often more affordable than industry standards for what we are offering (instant access directly to your doctor, expertise, safety, lab monitoring) but are constantly looking for partnerships and revenue streams to be able to offer services at a discount as we know not everybody will be able to afford it. We have recently partnered with the Transformative Freedom Fund, also based in Colorado, to help fund a full year of care completely free for up to 10 patients, which we will be starting soon.

Another obstacle that we are confronting is language. As a trans person myself, and somebody who has cared for many other trans people over the years, I know first-hand that how I describe myself and the identities I hold for myself, do not mean the same thing for all trans people. The language used to describe gender identities is constantly evolving and choosing the language that is inclusive and not offensive in some way can be very challenging at times. One way we try to stay on top of this is by having an organization that is primarily composed of a diverse group of trans people at each level of the company. We are always open to and seek feedback from not only our patients but the trans community at large.

Tell us about your company. What do you do, what do you specialize in, what are you known for, etc. What are you most proud of as a company? What sets you apart from others?
Mariposa Health is a direct to consumer health care company which delivers “HRT” (hormones and other medications to help affirm gender) for trans folx on a mobile-first app-based platform, through primarily asynchronous communication (texting), on a flat-fee subscription basis regardless of insurance or lack thereof, that has the ability to be scaled across the country to thousands of people. So, basically, instead of walking into your clinic to see your doctor, you just open up an app on your phone and start texting directly to your doctor. No wait lists, no phone trees, no being put on hold and being disconnected, no waiting rooms – just instant direct connection to your doctor for lifesaving gender affirming medications. We make sure we are addressing all patients with correct pronouns, names and gender identities and create individual treatment plans that are best for each patient. Currently, our services include medical evaluation, prescriptions, lab monitoring, letter writing for surgery support and name/gender marker change, and resource provision and linkage to behavioral health support as needed all for a flat monthly fee. We provide care on an informed-consent basis, meaning we explain all the known risks and benefits of therapy and the patient decides if it is right for them, assuming there are no major medical contraindications to therapy. Nobody needs a letter from a behavioral health provider to start care with us. Once we can scale this model, we hope to be able to expand into different service lines like more comprehensive primary care.

One of the things I am most proud of about Mariposa Health and that makes us unique is that we not only provide care for trans people, but we make it a point to comprise our company of primarily trans individuals at every level of the organization. When I say every level, I mean it, from front end to back end – this includes medical providers, care managers/nurses, user experience, branding, marketing, engineers and board of advisers.

If you had to go back in time and start over, would you have done anything differently?
We have made a lot of tweaks along the way, but it’s still fairly early and I cannot think of anything in particular I would have done differently on a large scale, although I’m sure those will come up as we go. Part of building a business involves making a lot of assumptions, especially around how people will find out about and interact with your service or product and who those people will be. Some of our assumptions rang true around filling the gaps of access to care when it comes to lack of competent providers and geographic isolation, but we also realized we were filling a gap we didn’t realize existed. Our initial approach was to start in towns outside of metropolitan areas knowing that there are often few or no medical providers offering this type of care, but still many people seeking it. As people started to find out about us, we realized that many of our registrations were coming from the Denver metro area where there are multiple clinics with gender affirming care providers, even dedicated transgender centers within clinic systems. Despite this high density of providers, patients were still having difficulty accessing care due to insurance restrictions and high co-pays, so it ended up making more sense for them to come to see us.

Also, the learning curve of running a start-up is indescribably steep. Matthew and I have had to learn about the medical and corporate legal organization, managing finances, marketing and branding, obtaining funding, digital platform development and hiring a team all while running Mariposa Health and working part time in other capacities to support ourselves and the business until further funding and revenue are generated. One of the biggest lessons that comes from all of this, is learning to lean on others. Fortunately, we have had some great advisers and co-workers with extensive experience that we have been able to learn from.

Pricing:

  • $99/month
  • $549/6 months
  • $999/12 months

Contact Info:


Image Credit:
Sorry, we don’t have any professional photos yet! These photos were taken by my business partner (Matthew Wetschler) and friend (Hana Low).

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