While the coronavirus pandemic has highlighted the many ways in which the United States' healthcare system is rife with inequity, A.G. Breitenstein saw the inequity facing the LGBTQIA+ community first-hand years ago.
The former attorney-turned-venture capitalist began her career working with queer and transgender children working in the sex trade in Boston. She found working with street clinics and other aspects of the healthcare industry were often one of the most frustrating elements of her work.
"I got a front-row seat to how poorly the healthcare system worked for our community, and that set up the arc of my career," Breitenstein told Business Insider. "For so many reasons, our experience of healthcare is uniquely bad."
That led to Folx, a telemedicine startup that specifically serves LGBTQIA+ patients and has raised $4.4 million from top healthcare investors such as Define Ventures, Bessemer Venture Partners, and Polaris Partners.
Folx is the latest in a new crop of primary care companies focusing on particular groups of Americans. Some are focused on caring for the elderly or those served by Medicaid, while others like Tia and Maven have zoomed in on women's health.
The hope with Folx is to build a primary care practice that's specifically for the LGBTQIA+ community.
"I'm not a big believer in the primary care provider model, because it's a general store on the prairie model," Breitenstein said. "What we are building is tailored for our community that covers most but not nearly all what we need."
Folx's approach eschews the model on which traditional healthcare is built.
Normally, a patient goes to a doctor for a problem. After an examination, the doctor will diagnose that problem, and then write a prescription or treatment plan for the patient to fulfill.
Folx patients, on the other hand, start with a goal. That could be starting a family, maintaining their sexual health, or gender confirmation surgery. The healthcare providers, which currently all operate remotely, then work backward with the patients to develop a treatment plan that works best for the patients' lifestyle.
Breitenstein refers to this process as "demedicalizing." Its goal is to provide transparency and build trust between patients and doctors.
Rebuilding the LGBTQIA+ healthcare model from 'top to bottom'
The healthcare system in the United States is "unnecessarily messy and ugly" for LGBTQIA+ patients, Breitenstein said.
Even after going back to school for public health, working in big companies, and investing with UnitedHealth's VC arm Optum Ventures, Breitenstein knew the foundational trust of healthcare within the community had eroded.
Folx, she said, is trying to rebuild it.
"I just thought, how can we make this sucky system not suck so much," Breitenstein said.
Starting Thursday, Folx members in six states — California, Florida, Massachusetts, Texas, Virginia, and Washington — can receive virtual care and medication delivery for hormone therapy, erectile dysfunction, and at-home STI testing in addition to one-on-one evaluations with one of the startups' eight care providers.
Folx does not currently work with insurance companies and operates on a full cash-pay system, but Breitenstein maintains that the services cost well below what a traditional deductible would be on most plans.
Investors bought into the long-term vision for Folx, Breitenstein said, which is built on becoming a pillar for the community through healthcare. Though all services are currently cash pay, later iterations could include a membership fee or other payment systems as it expands the types of services it can offer.
"We would like to be the health and lifestyle brand for the queer and trans community for all things healthcare," Breitenstein said. "That's not delivering the traditional model of healthcare but rebuilding it top to bottom."
