Transitioning 2.0

Community support has always helped trans people become themselves. Now, Big Tech thinks it can too.

- By Lil Kalish

By August, Felicity Giles knew it was time. Her happiness was long overdue. The 36-year-old trucker changed her name, adopted the middle name Saoirse—“freedom” in Gaelic—and started looking into medically transitioning. “It was mainly an attempt to break from who I was and who I grew up as,” she told me. At the start of 2021, she spent weeks calling Planned Parenthoods in Fort Worth, Texas, where she and her spouse live, seeking a consultation for hormone replacement therapy. But the pandemic, and high demand, meant waiting more than a month to get a consultation, let alone begin HRT. Even when appointments opened up, she said, “I called them every day and never got through.”

Scrolling through Twitter one night, Felicity read about Plume, a new subscription telehealth service that makes it easier for trans people to access hormones and lab work or procure doctors’ letters needed for surgeries and name changes. A day after forking over a $99-per-month fee, Felicity was talking to a Plume clinician. After a few questions, they chatted about HRT. Within hours, Plume connected her with a local physician who prescribed her estrogen and dutasteride, a testosterone blocker. Felicity picked up her first dose that night.

Plume is one of about a dozen telehealth services catering to trans clients that have cropped up in the last two years. It’s a niche market aimed at eliminating barriers that keep trans people from accessing health care. According to a 2015 study, a third of trans people report that health care providers have harassed them or denied treatment on the basis of gender identity.