Editor's note: This story is part of Southwest Michigan's Second Wave's On the Ground Kalamazoo series.

KALAMAZOO, MI —In October 2024, Cares Sexual Wellness Services opened Iridescent Health, a clinic that provides HIV case management, gender-affirming care, and primary care services. 

Located in Suite 200 at 629 Pioneer Street, Iridescent Health has an important mission: for patients “to feel accepted, supported, and welcome,” according to the website. The clinic is open to all community members; however, Iridescent Health is promoted as an LGBTQIA+ facility.

Cares is a Southwest Michigan community-based organization with offices in Benton Harbor and Kalamazoo. Founded in 1985 by a group of friends who were tired of seeing their loved ones pass away from untreated HIV, Cares has grown into the second-largest HIV/AIDS service provider in the state. Executive Director Kelly Doyle says the organization started “on its back foot” in the living room of one of its founders, and with no knowledge of HIV other than word of mouth. 

Casey GrootenLove Chambers (left), and Vanessa Stadel, NP gave Seconwave a tour of the Iridescent Health space. While uncertainty for marginalized communities continues to grow due to recent federal actions, doctors and nurses, like those at Iridescent Health and Cares, are working to provide safe, affirming, and comprehensive care. Their efforts not only address their patients' medical needs but also act as resistance against discrimination and misinformation.

Lack of HIV knowledge perpetuates stigma 

Each individual interviewed for this article mentioned the stigma surrounding HIV as a burden. Doyle says that in the mid-1990s, because of the creation of new HIV treatments, there was a shift in the work Cares did from helping people as they were dying, to helping people live their fullest lives. 

Stigma continues to be a barrier to effective HIV/AIDS treatment and care. "We know of a few things in how that [stigma] shows up," Doyle says. One major issue is the existence of HIV criminalization laws, which penalize individuals who do not disclose their HIV status before engaging in sexual activity.

Courtesy, Bill DineenCares Executive Director Kelly Doyle with former Executive Director David Feaster "These are laws that if someone doesn’t reveal status before they have sex, they can go to prison… but how do you prove that?" Doyle asks. She says this highlights the legal and ethical complexities of such policies. These laws rely on accusations rather than facts, which makes them difficult to overturn in multiple states.

The stigma surrounding HIV also has a profound impact on misinformation and education. "When someone is undetectable, when they are taking their medications correctly, they cannot transmit the disease," Doyle says. Despite medical advancements in treatment, many folks still operate under an antiquated understanding of HIV, leading to fears and social ostracization. 

How to educate about HIV and transgender care?

Doyle underscores the necessity of education at all levels. "Education, on a governmental level," Doyle says, advocating for comprehensive sexual health education and routine HIV testing during medical visits. "One of the reasons we put this clinic together is because you go to the doctor, and they don’t talk to you about your sex life," says Doyle, stressing the importance of trusting medical professionals but also advocating for one’s sexual health and asking questions in the doctor’s office. 

Kalamazoo STD rates are high

Kalamazoo has the second-highest rates of gonorrhea and chlamydia in the state, demonstrating the urgent need for improved sexual health education and accessible healthcare services.

Casey GrootenA view of one of the exam rooms at Iridescent Health.When it comes to transgender healthcare, Doyle shines a spotlight on the challenges posed by political rhetoric. "The trans community has been used for politics. In that use, there is a cruelty that is happening to the community" says Doyle. The spread of anti-transgender propaganda has created obstacles to educating the public about transgender issues. However, organizations like Kalamazoo’s own OutFront, and Equality Michigan continue to advocate for the queer community and push for greater education and acceptance.

Concerns about potential funding cuts

The current administration’s stance on social programs and healthcare funding is concerning for the future of HIV treatment and transgender healthcare, say all who are involved. When asked if she feared for the well-being of trans folks, particularly for trans youth, Doyle responds, "Two million percent!” 

Doyle recalls reports from therapist colleagues who witnessed increased suicidal ideation among their trans clients following the 2024 election. They are "trying to make it in a world that has not embraced them fully," Doyle says, recognizing the compounding challenges of growing up in an unaccepting society.

Casey GrootenLove Chambers and Clinical Care Coordinator Christine Babcock in the reception area of Iridescent Health.The discrimination faced by trans individuals contributes to higher rates of suicide, depression, and anxiety, says Doyle. This claim is supported by a study published last year by The Trevor Project, in Nature. Among other things, the study reports an increase in suicide attempts by transgender and gender-nonconforming teenagers by as much as 72% in states that passed anti-trans laws aimed at minors.

The current administration’s policies also threaten safety net programs, including those that support HIV care. "The current admin had a federal freeze on dollars. The goal is to get rid of the safety nets, not just with HIV," Doyle explains. This move is part of a broader effort to dismantle programs designed to protect low-income Americans, with potentially devastating effects on marginalized communities, says Doyle.

ICasey GrootenKelly Doyle and Tracy Hall at HRI's Walk for Homelessridescent Health works to lessen the negative effects on some of these marginalized communities by providing truly personalized care. The clinic primarily serves adults but refers younger patients to specialists when necessary. "If a youth comes to us with HIV testing, we are able to test them for the disease without a parent’s consent at 13 years of age or older. They can test and treat." Doyle.

The primary care services provided at Iridescent Health extend beyond HIV treatment. "Folks want a one-stop shop," Doyle says, highlighting the clinic’s comprehensive approach to healthcare. However, potential federal funding cuts pose a serious threat to its sustainability. 

Federal funding essential

"For Cares HIV services, if the federal funding is gone, they would close," Doyle warns, emphasizing the reliance on local foundations to keep operations running.
The three healthcare providers at Iridescent Health say the work is deeply fulfilling.

Fabulous, amazing, wonderful," Vanessa Stadel, NP, describes her experience since October of last year. "Being here is very unique because there is no pressure. We have as much time as we need [with patients]." Unlike traditional healthcare settings, where time constraints dictate patient interactions, Iridescent Health allows patients to drive their own care experiences.

Registered Nurse Love Chambers echoes this sentiment. "Literally, every day that we leave, we are like, oh my gosh that was so busy and so fulfilling." Chambers describes the clinic as her "dream job," where she can ensure trans patients feel safe discussing sexual health and personal concerns without fear of judgment.

Casey GrootenCares Executive Director Kelly Doyle with Yolanda DelFierce at Pride when she became Miss Kalamazoo Pride. The response from both peers and the community has been overwhelmingly positive. "Have gotten really good responses from peers," Stadel notes, though she acknowledges the general lack of awareness about gender-affirming care among other healthcare providers. Christine Babcock, the office care coordinator, adds that before Iridescent Health opened, she had to transport patients to Benton Harbor for gender-affirming services due to the limited availability elsewhere. "Going to see someone who sees them as a whole human being is huge," Babcock says of patients.

Healthcare plus vital support

A clinic like Iridescent Health is not just a healthcare facility, it is a vital support system. "41% of trans folks die by suicide because of discrimination," Chambers says. "Having a place where people know they can come, be supported, have questions answered, be treated with respect and dignity” is invaluable. She continues, “Every clinic should be somewhere where, regardless of gender or orientation, people can be respected and supported."

Casey GrootenLove Chambers and Clinical Care Coordinator Christine Babcock in the reception area of Iridescent Health.Stadel highlights the power dynamics in medical settings and the importance of patient autonomy. "There is always a power dynamic between a doctor and a patient. We genuinely and truly support their choices whether or not they match up with medical recommendations."

Ultimately, the team at Iridescent Health is committed to ensuring that everyone who walks through their doors feels safe, valued, and empowered. 

There's "no place for judgment in healthcare," Chambers says. She also leaves Second Wave with a message for other healthcare providers: “Listen to and trust your patients.”