Advancing Health Equity: LGBTQ+ Health

Steven Collens, CEO, MATTER (00:15):

Hello and welcome to episode one of MATTER's Advancing Health Equity podcast. My name is Steven Collens. I'm the CEO of MATTER, and I use he/him pronouns. MATTER is a healthcare technology incubator and innovation hub on a mission to accelerate the pace of change of healthcare. In addition to accelerating the growth of healthcare startups and helping large companies innovate more effectively, we highlight innovative thinkers who have important perspectives to share. Few topics are more important than health equity. There is great healthcare in the United States, but it is very unevenly distributed. Our healthcare system fails a large percentage of the population. In this series, we're going to explore various aspects of this failure. We'll talk to leaders who have deep perspective on how various groups are served or not served by our system. It's June, 2023, which means it's pride month. So we thought what better way to kick off this series than where the conversation about the health needs of the LGBTQ+ community?

(01:16):

Improving health outcomes for the LGBTQ+ community will require increasing access to culturally competent care and resources. We're joined for this conversation by Kate Steinle, Chief Clinical Officer of FOLX Health. That's F-O-L-X, the first digital healthcare provider designed by and for the medical needs of the LGBTQ+ community. The model of care at FOLX is focused on creating joyful, affirming healthcare on one's own terms, and building community and access around those needs. Kate is a nurse practitioner who's been providing in-person sexual and reproductive healthcare in New York City for more than a decade. She's led the implementation of many clinical services and believes healthcare can be a place of radical transformation and empowerment for both those who access care and for the providers of the care. Kate's clinical practice is based on listening with intent and responding with kindness, clarity, and authenticity. Kate uses she her pronouns.

(02:15):

Kate will be interviewed by Brian Richardson. The CEO of StartOut. StartOut is the national nonprofit organization empowering LGBTQ+ entrepreneurs building a world where every LGBTQ+ person has the information network and resources they need to turn their business idea into a reality. Brian's career has spanned the nonprofit tech and public sectors, including services. Deputy Commissioner of the Chicago Department of Public Health. He became CEO of StartOut in March and uses he him pronouns. Kate. Brian, thank you very much for joining us today. We look forward to your conversation.

Brian Richardson, CEO, StartOut (02:51):

Thank you so much, Steven and everyone at MATTER. Happy Pride. So let's just dive right into the conversation. Um, so Kate, could you explain the, the health needs that are unique to the LGBTQ+ community?

Kate Steinle, Chief Clinical Officer, FOLX Health (03:03):

There are a bunch, and you know, I think particularly we're gonna talk a little bit more about health disparities and what our particular health disparities that our, um, that our community faces. But starting off, you know, really thinking about what are the health needs? What are the, the actual things we can do to address, um, healthcare for this community? We need to make sure that there's access to clinicians who are trained in very deeply trained in how to care for the LGBTQ community, which is when I and I stress deeply trained not just about like, use your correct pronouns or, or change that intake form to add in, um, you know, something different about sexual history, but really to understand and to be well aware and researched in evidence-based medicine that is up to date on research again, about the health disparities and, and really how to address those with particular people in our community. We don't have enough of those clinicians now and that therefore creates all of these issues in our community. Like we have so many clinicians out there who are saying, yeah, I'm competent in this care. Um, but what is competence? First of all, that should be like baseline and we should be way far above that.

Brian Richardson, CEO, StartOut (04:24):

Some of my best friends are gay, I can do this.

Kate Steinle, Chief Clinical Officer, FOLX Health (04:26):

Exactly. Or, or even their own identity doesn't necessarily qualify them. And as an expert, right? So even somebody from the LGBTQ community, if you are not aware and UpToDate both in terminology and again in clinical care for this community, then you're not gonna be a good fit, right? You have to do your own work to be able to then care for this community. So I can give you an example when I ask, and I very clearly asked these questions in interviews, um, is, so tell me a little bit about why caring for this community is different for you as a clinician. And if I get an answer that's like, it's actually not that different. Like people are people, uh, I just, I care for all of my patients the same way. I love that. That's a kind thing to say.

(05:12):

Um, it is a, you know, well-intentioned, but it again, if you are, what you're probably doing there as a clinician is making assumptions about what creates that sameness. You're making assumptions about their gender identity. You're making assumptions about what partners they have. You're making assumption about how many partners they have, what types of sex they're having, and just how their family is created and all of those pieces. And therefore you're blinding yourself to their realities if you're not actually specifically addressing and asking questions and just making assumptions. So here's what I want all clinicians to do. I want you to be open and address all people with kindness and respect. That should be the given. But you should also always be kind of one step ahead so that you can also say, I wanna create questions and I want to, uh, you know, pull out information that somebody might not feel comfortable with bringing to me right away.

(06:14):

Because historically they've had really crappy experiences in healthcare and have been silenced or have not been asked questions. And so they haven't brought their whole selves and their whole health and their whole bodies and their whole relationships to this clinical interaction. You know, as a clinician, your job is to get that whole truth, but you don't just get it because you show up in that room. You get it because you show people that you know what you're talking about and that you've done the work and that you actually have that clinical expertise so that they can trust you. So that's the whole, like, that's a need, right? I often think also, you know, we are in telehealth, so we don't have those waiting areas, right? Where the posters might be of certain people or certain representations of families or, um, but in places that do, it's super important to make sure that you walk into that waiting room as somebody who's from the LGBTQ community and you see that this is a place that knows who you are and actually has materials that are addressing your actual sexuality, your gender identity.

(07:17):

What we need to get beyond is you have a pamphlet somewhere in there about  LGBTQ family building, or you have a pamphlet

Brian Richardson, CEO, StartOut (07:26):

That you have to leave through 50 other pamphlets to get to it. Like, if I think if I'm a patient and I'm walking into my clinician's office, right? And I see these posters on the wall that are representative of me and my community and my chosen family, I'm going to be a better patient because just as it's important on the clinician to be able to ask those questions, I want to have the agency to ask questions. But if I walk in and, and I've been in these places where, where, especially when I was younger and before I realized I, I could and had some opportunity through my insurance and things to, to choose a clinician for me, I would walk in these places where I wasn't represented and I was less likely to bring up my issues, whether it was something specifically related to, to sexual health or mental health related to my, my queer identity, or if it was like a sore wrist. You know, like I, well, I'm just, I don't, I'm not gonna build that connection with my clinician and I have to in order to get my best care.

Kate Steinle, Chief Clinical Officer, FOLX Health (08:16):

I think it's a really good point that you make about like being a better patient. Yes. And the onus should not be on you as Yes. Somebody who's from that community, again, the onus should be on the place that is providing the place and the people who are providing that care. There is a lot of different places that have information about different birth control options, right? Oftentimes that is engendered language. And then I think about there is a separate, you know, form that can be used for birth control that for somebody who's on, uh, gender affirming hormones, right? Yeah. But there's the main one which everyone should use, and then there's the one that will pull out only on certain occasions. Yes. My take is like we pull that one out for everyone who's on any type of hormone and use that for everyone because it actually applies, right?

(09:05):

And so if we can center the community and make sure that like they are addressed in the main information sheet and the main source of information, that's the way that we do it, right? Because then it's not like, again, the separate pamphlet or something else. Because when we go with what's the standard one that maybe a, a medical assistant uses, that's when we get into those issues where you're not asking questions that are open enough for people to actually express it. For instance, like someone's coming in for an I U D and they're automatically asked, uh, to get a pregnancy test and they're like, actually, I don't have the kind of sex that could create a pregnancy in my body. Mm-hmm. <affirmative>. Um, there's no need for me to do that pregnancy test. Whereas like, those are the kind of things that we need to go in and not make an assumption. We actually need to go in and, and figure out why we would be doing each type of testing.

Brian Richardson, CEO, StartOut (09:59):

And can, can I just compliment you too? Cause you're modeling this behavior in this conversation even like, like your pronouns using they and someone walks in versus like a woman walks in, a man walks in. No, just a person walks in a clin a a patient walks in because that's who you are when you're coming into that space and you wanna bring your whole self. And I love how you said the clinician needs to center that patient's whole self as well too. Yeah, that's, and that's exactly what we're looking for.

Kate Steinle, Chief Clinical Officer, FOLX Health (10:22):

And that's again, when, uh, when people are engaged with their clinician, when they're fully seen by that clinician, the health outcomes are going to be improved, right? Yeah. People will then say like, okay, because this person knows me now,

Brian Richardson, CEO, StartOut (10:35):

I love all that because I, the original question was, can you explain the health needs for LGBTQ plus people? And it sounds like the biggest health need is just a clinician who you trust and knows is going to treat you as the human that you are. But I guess they did to broaden it out a little bit because, and I, I love the focus on the, the clinical side and the, the individual relationship with that clinician, but if we look more broadly, we know that most of us, if not the vast majority of us, aren't necessarily getting that right now. Right. Um, either with our clinician or in society at large. Yeah. And so surprisingly, there are tremendous health gaps facing your people. Could you talk a bit about what those biggest gaps are?

Steven Collens, CEO, MATTER (11:22):

Hi, it's Steven Collens again. I hope you're enjoying the discussion at MATTER. We help healthcare startups build business capabilities through one-on-one mentorship curriculum to help them navigate the complexities of today's healthcare industry and individualized support from our team. We help them raise capital and gain traction in the market, optimizing their business development strategies, and providing curated introductions to decision makers across all sectors of healthcare. Our not-for-profit, no equity model enables us to build a neutral platform for collaborative innovation. If you're a startup interested in learning more about our community visit matter.health/join.

Kate Steinle, Chief Clinical Officer, FOLX Health (12:05):

Uh, biggest health disparities, there's a higher rate of substance use and substance abuse and tobacco addiction in the LGBTQ community.

Brian Richardson, CEO, StartOut (12:14):

Is that across the whole rainbow?

Kate Steinle, Chief Clinical Officer, FOLX Health (12:16):

It's across the whole rainbow. Yeah. When I was looking, you know, uh, across some things like CDC report, um, is saying that about 20% of the LGBTQ community compared to about 15% of heterosexual adults, um, have both that increased risk for substance abuse and tobacco addiction. Um, that is something that is, we know hugely affecting so many other things down the line in terms of people's health. Um, there's a much higher rate of mental health conditions, um, depression and anxiety. And we know that even during, you know, the pandemic, these have been increasing across the entire spectrum, the entire population. But, um, we've seen continued increase in that in the entire LGBTQ community. And I think, you know, exacerbated in that is similar to the rest of clinical care. Not a lot of mental health clinicians who are adept at caring for the mental health needs in the community at large of LGBTQ people.

(13:20):

Um, there's higher rates of STIs. That's partly because of, um, you know, not having access to the right types of testing or being skipped over certain types of testing. Because when we think about going into an STI clinic and you just get a cup of urine to check for gonorrhea and chlamydia, but it's not checking other sites where you might be having sex. You could walk away with a urine cup and you just checked your urethra for gonorrhea and chlamydia, but you actually had, um, receptive anal sex and therefore you have, you know, that risk there. And nobody has ever tested that. So again, when there's, when there's no testing, there's gonna be higher or there's no app accurate testing, there's gonna be higher rates of STIs. And so how do we make sure that we are addressing that, but also not, um, you know, putting a spotlight on it with judgment, um, higher rates of obesity and eating disorders. Um, and I think that's a really a key one because again, that we know all of that then can influence other types of long-term chronic illnesses like diabetes.

Brian Richardson, CEO, StartOut (14:27):

Well, and what you're talking about, and they all reinforce each other, right? Like it, it's substance use will lead to mental health conditions just as mental health conditions will lead to substance use disorders. And, and Right. The psych continues. And so it exacerbates furthering this, this inequity that queer people is, is most every marginalized community in this country have health equity issues. Um, and so I, my background, I, I've spent six years at the department of here in the city of Chicago as deputy commissioner. Um, currently I run an organization called StartOut. And our job is to help queer entrepreneurs, um, turn their business ideas into a reality. But I know during my public health days around the social determinants of health and how having access to a job or just the challenge of starting your own company and the challenges that marginalized folks face in those areas, or transportation or those sorts of things, could, could you help take us, take it out even one step further and talk about those social determinants of health and how we, and by we, I mean largely the American population and policymakers can start to rethink, um, some of these social determinants and invest in a way that will help improve health outcomes for, for all sorts of marginalized groups.

Kate Steinle, Chief Clinical Officer, FOLX Health (15:36):

Yeah, totally. So we think about what is that neighborhood people live in, right? And so not only, again, we just talked about who has access to, uh, a clinician, but who actually has access to good food and healthy food, and not just fast food or cheap food, which is usually the fast food, um, you know, very processed that's going to have an effect. So what can we do from a community level to make sure that, again, from a clinical standpoint, I'm talking to people, I can have a hours long conversation about eating fresh fruits and vegetables, but if somebody doesn't live near that or doesn't have the financial ability to have that, then that conversation isn't gonna go anywhere. Right? So what can we do with community organizations to be able to bring in green markets or things like that so that we can actually bring that to the people instead of, because that's the location that they live in, that's where they're gonna shop. So we gotta bring it to them.

Brian Richardson, CEO, StartOut (16:32):

And we may have this stereotype in our minds, oftentimes of, of queer folks and LGBTQ folks being the double income, no kids with lots of disposal income. But that's not the case. We know that LGBTQ+ people actually face higher rates of poverty than population at large. They're more likely to live in some of these areas that don't have access to, to good foods or good transportation or, or jobs. And so that just exacerbates us inequality that makes it even harder for them to, or, or access to a good hospital or a doctor's office. You know, you have to totally pull an hour and a half across your city or across your state to find a gender affirming care. Um, yep. Which is a whole nother issue that folks have to face.

Kate Steinle, Chief Clinical Officer, FOLX Health (17:10):

Yeah. And, and I think about the most marginalized and vulnerable within the LGBTQ community, which is trans and non-binary folks, and the economic instability that they often face because of job discrimination. Um, and you know, a lot of people who, like we think about the, the LGBTQ youth on the street and who have been kicked out of their homes because of discrimination and violence that they were experiencing. And when you don't have that education that you got there, you're not going to, you know, from a, from a stable home, from a place that is actually understanding, like, Hey, we love you no matter what. And then now you have no access to that education again, that's going to lead to that inability to, to get and keep a job because people are looking at that resume and, and, um, and you might not have the same, that same experience and that same kind of like direct experience there.

(18:07):

So all of these things, you know, when we, again, thinking about this, and I love that you brought this into the broad picture, like this is not just about, like, again, a form that you're changing somewhere to address somebody by a certain name and understanding legal ID is different than affirming name. These are literally this whole person, and I think this is actually for, for everyone in healthcare, it takes a long time to have these conversations. These are not quick fixes. I cannot give a pill to treat blank, right? I cannot give a, a pill that's gonna let you have access to, um, clean air and a good school and good food on a regular basis. And our American healthcare system is, is like really focused on quick treatments, right? The long-term relationship building and kind of community engagement and community building that needs to actually shift these social determinants of health.

(19:09):

We are not built for that, right? And so we leave it to grassroots organizations in a community to try to solve this really big thing, multiple things. And they don't have that, that economic power that like a huge hospital does, right? So, you know, we've, we've gotten to this place in healthcare where it's like, let's solve this. We're solving the endpoint. We're, we're trying to solve for that endpoint of decades and centuries of all of this stuff, when we actually need to engage with what are these root causes that are causing all of this, you know, health disparities in each of these communities.

Brian Richardson, CEO, StartOut (19:50):

And, and FOLX is starting to do that some as well too. You talked about that, that your telehealth focused. And so I, I don't necessarily have to drive across those two hours or across state lines if my state doesn't let my child get during to affirming care. And it's such a challenge now when we've seen a record number of, of state legislatures pass bills, stopping people from accessing healthcare that they need and want and desire. And then the mental toll that that takes on folks, um, or the financial toll it takes on folks. It just continues to be a bigger challenge. But I think with organizations like ours and community organizations around the country working to address these issues, things are getting done and, and we're making improvements. But I guess the, the big question, especially as we celebrate Pride Month, and there's so much to look back over 54 years since Pride started, we've made tremendous efforts. But as you outlined, there's still so many challenges for us to face in healthcare as well as the root causes of those health disparities. So I guess my, my last question is, is how can innovators be inclusive and take the different needs of, of our community, of the queer community into account when designing new solutions?

Steven Collens, CEO, MATTER (20:58):

Hi, it's Steven Collens again. I hope you're enjoying the discussion. MATTER was founded based on the thesis that collaboration is the best way to fuel innovation in healthcare. In addition to accelerating healthcare startups, we help large organizations innovate more effectively. We help life sciences companies, health systems, insurance companies, and others find value in the entrepreneurial ecosystem, empower their internal innovators and work across healthcare sectors to advance their objectives. If you are interested in learning more about partnering with MATTER, email partnerships@matter.health.

Kate Steinle, Chief Clinical Officer, FOLX Health (21:39):

Listen to that community, that would, that would be the start of it, right? So oftentimes, um, you know, an innovator might come in with a grand idea that they have been playing out in their head in beautiful like fashion, right? And that's wonderful. Um, but you gotta test it out in real life, right? You have to test it out with actually the community that you are hoping to solve this problem for and great that you wanna solve a problem. But, um, a lot of people have been thinking about these problems for a long time, so let's give them a chance to voice what has worked, what hasn't, and what their ideas are to integrate into that. And so, you know, bring them into a product development conversation like, Hey, we're thinking about this. Does this resonate with you? Like, is this something that you would want to engage with? And if it isn't, let's redirect and really kind of like

Brian Richardson, CEO, StartOut (22:32):

And then listen and iterate based on

Kate Steinle, Chief Clinical Officer, FOLX Health (22:33):

Yeah. And, and be humble in that. Yes. And I think that's the thing is like, you know, I, I, I work in a startup world and so like innovators and entrepreneurs are phenomenal in the energy that they bring as long as like they're willing to take a step back and let their baby change a little bit based on what it is that, that the information is coming in. So like, don't hold onto that one star and, and, and bring it into something else. Um,

Brian Richardson, CEO, StartOut (23:01):

Yeah, I think, I think of our, our best high-growth entrepreneurs, the ones who've succeeded are the ones who've made iterations and made changes totally injunction with the folks that they're serving. I mean, it's, it's, it's, it's a, but, but how often we don't do that and we really need to just, how

Kate Steinle, Chief Clinical Officer, FOLX Health (23:14):

Often we don't do that. And I think in especially in this kind of innovation world is like, everyone's moving so fast all the time and we think we have the right stakeholders and then we, you know, we're so far down the path of like doing this one particular thing that we decided on that like a last minute change is, is gonna blow us up or something. I think that, you know, again, if you get the right stakeholders and multiple stakeholders on throughout that whole thing, those iterations are actually, um, smoother and so drastic, right? Don't bring it to the, to the final release or the, the final point without having that along the way. 

Brian Richardson, CEO, StartOut (23:53):

I think also it's the old adage, sorry, it's the old adage of, of what is it? Um, go, go alone and you go fast, go together and you go far.

Kate Steinle, Chief Clinical Officer, FOLX Health (24:01):

Yeah. And I think we gotta remind ourselves of that all the time. The way that FOLX does it is, um, obviously we have clinical care that people are signing up for and they are paying for and eventually very soon, uh, taking insurance for, but we also give a lot back to the community in terms of educational resources so that like, I'm not just drawing information from you, I'm actually writing information for other providers and other patients that are, have nothing to do with folks, just go ahead and share this, right? Like, I have an article about being on prep and also on estrogen gender affirming hormone therapy and what that interaction is. Is anything gonna decrease the efficacy of the other? Can I talk through that? We get so many of those questions all the time that like, I'm happy to have them engage with it and bring us back any other ideas we get some other ideas from, from community members.

(24:52):

And again, how do we share those resources? I think about in, you mentioned this a little bit before, is like the vast number of bills that are going across this entire country, uh, that are focused primarily on trans and non-binary youth, but many on the entire LGBTQ community and on access to care or coverage of care in this country in terms of insurance coverage. I've now become parts of groups, um, of other organizations that are working in this field. And we just get on a call once a month to talk through, like, alright, what are you doing in Florida? Alright, what are you doing over here in Texas? Like, how are we moving through this? Because everyone needs to follow the law, right? Like even if we think it's astronomically clinically irrelevant and wrong and based on no actual medical evidence, we are not gonna break a law regardless of how horrible we feel about it, but we are gonna share resources of what we're doing to a adapt to it and make sure that people are cared for in a particular space. So I can tell you a little bit of like how we're doing that in Florida right now, which is, has a new bill, SB 254 that was signed by Governor DeSantis a couple weeks ago, which disallows NPs and physicians assistants to per, uh, from prescribing gender affirming hormone care and also requires a, an in-person visit to be able to sign an informed consent form that goes over all of the risks of gender affirming hormone care. There's lots of these kind of bills across the country, which

Brian Richardson, CEO, StartOut (26:29):

To be clear is not the case for any other sort of medicine or healthcare related. Yes, yes.

Kate Steinle, Chief Clinical Officer, FOLX Health (26:35):

Right. There's no other, you know, I think that's a really, and and specific to this, and I, again, because I work in this, I know how this is possible because of political environment in this country, right? But we sit around as clinicians and talk about how is this not obvious to the rest of the world or the rest of the country that this is particularly targeted to trans and non-binary people because these are literally the same hormones that people take in menopause or people who, um, have testes take for low testosterone, right? Or kids who are experiencing, you know, precocious puberty take for puberty blockers. These are literally the same exact hormones. And so we're not limiting hormones and care for those groups that I just talked about. We're literally limiting based on an identity and use of that hormone. Yeah. And nothing else like that, you know, exists.

(27:32):

It's fully discrimination that's tr that's couched in this language of protection. And then we think going also back to one of the first things we talked about, which is the increase in mental health, you know, issues that we see when people do not have access to that care, who did have access to that care, and now all of a sudden the state is coming around and saying, you no longer have access to this clinician that you built a trusting relationship with. You no longer have access to this medication. The mental health conditions that we're seeing being exacerbated in these particular instances when people are actually people and communities are, are literally under attack from their state legislatures mm-hmm. Is astronomical. People are wondering, like, do I have to move out of state? Where can I go? What can I do to make sure to protect myself?

(28:22):

Um, and so, you know, again, when I think about as innovators, what do we do? We just shifted really quickly within the span of two weeks and set up in-person locations in Florida so that we can see our, our people, right? So that our patients can get that care and be seen by an MD or a do. Again, don't believe that it's necessary that way, but that is what we'll be doing because this is the way that we can make sure to protect that access and make sure that people don't lose the care that they need. Because it is lifesaving.

Brian Richardson, CEO, StartOut (28:53):

It, it angers me because I, I think innovators are great because identifying a problem and then figuring out the solution. But in this case, it's not that hard to identify the problem because unfortunately the problem is presented on us on a, on a really ugly plate. Um, yeah. But I'm glad that that people at FOLX and other folks on the ground are working together to, to find these solutions. For me, the positiveness is, is this resiliency and this excitement of the fact that so many innovators are coming forward, especially during pride month, which is always a busy time of year for all of us. Yeah. Uh, to figure out ways to, to work together and collaborate and help move this needle forward because we have made incredible progress. Yep. But there's still more to do. Um, but I guess before we close out gate, I'd love to just hear like any, any parting words or words or advice or encouragement for those of us in the community and those of us who wanna support the community in all our many different rainbow colors. Um, yeah, moving forward.

Kate Steinle, Chief Clinical Officer, FOLX Health (29:46):

I really love that you brought it back to that, you know, that point of like, yeah, there's a lot of craziness going on in this country, but there are a lot of helpers, right? There's a lot of good being done here. And I think especially in this, in this time, what I often tell people is like, if you have somebody, either you are in this community, you have a friend, you and you, you do, right? Like everyone knows people and loves people who are part of the LGBTQ community, reach out to them and like tell them how incredibly wonderful and brilliant and like, you know, beautiful they are in the world and how much they matter. Because again, it's like, how do we combat the bad stuff? We just like shower people with like beauty. And I think I've talked to a bunch of parents too, is like, yeah, your kids hearing a lot right now, but guess what you can do?

(30:37):

Like go to that bookstore or that library and pick up all those books about like queer and trans love and like, identity based like beauty. And that's what you can do is like, not just create this own bubble, but like, you can't just keep, you know, yeah. Doom scrolling through this because people's lives are here and that's, that's, we just need them to stay like alive and we need them to stay and feel like they are valued and they are loved. And so I think that's one piece. And you know, I think about like making sure that we have continued access to clinicians is like, if you have a place that is a center of excellence that has clinicians on staff, like welcome some new trainees on there. You don't have, maybe you're not hiring new people, but what can you do to bring your resources to other places?

(31:26):

We actually have, um, somebody coming to train with us from, uh, finishing their NP program and is gonna do a rotation with us. And that's something that like we can offer up so then they can take that elsewhere. And so those are the kind of things again, like share this, share the ways that you are doing, um, amazing things for this community so that, that that light is shining brighter than all of the negative stuff, but keep, well, keep, keep paying attention to the negative stuff and the like hard stuff because we can't let that go.

Brian Richardson, CEO, StartOut (31:55):

So. Yes. Right. Well, and thank you sharing so much today, Kate. Um, and I will, I will follow your advice and say you are incredible and creative and brilliant and beautiful as well too. So thank you for sharing all of that with us today. Um, a great conversation. I also wanna thank everyone at MATTER for giving us the platform to have this conversation. And I wish everyone Happy health, um, and a very happy Pride.

Kate Steinle, Chief Clinical Officer, FOLX Health (32:17):

Thank you so much.

Steven Collens, CEO, MATTER (32:19):

Thank you for tuning into the first episode of our Advancing Health Equity podcast series. We hope you'll join us next time as we turn our attention to older adults. We will feature Amy Eisenstein, senior program officer and director of research and evaluation at RRF Foundation for Aging. And Robert Espinoza, Executive Vice President of Policy at PHI and Chair-elect of the American Society on Aging. They will discuss how our perceptions about aging affect the health and well-being of older adults.