Jack Fonder is the community health worker for The Transformation Project in Sioux Falls. He was hired in September 2022. (Courtesy of Jack Fonder)
Jack Fonder trusted his doctor. He’d spent years under her care, and she understood his medical history.
But that changed when he transitioned.
“It was one of the worst experiences I’ve ever had,” he recalled.
Fonder is a transgender man – a person whose gender identity is as a man, but was assigned female sex at birth.
While his doctor hadn’t done it intentionally, she repeatedly used his deadname, or birth name, in conversation. The doctor also misgendered him by referring to him as a woman instead of a man during the visit, he said. The missteps grinded against Fonder.
He realized quickly that he had to find a different care provider – one who wouldn’t make him feel insignificant and ignored. Someone he could trust again.
That experience isn’t unique in the LGBTQ community. It’s difficult for people in the community to find mental and physical health care providers who support them.
“If you don’t have the words to express that or if your mental health is already at a point where you’re barely hanging on by a thread, those kinds of things can send you over the edge,” Fonder said. “It can make people not want to go back to the doctor at all.”
That’s why Fonder is the community health worker for The Transformation Project, a Sioux Falls-based transgender advocacy group. He helps members in the LGBTQ community connect with health care professionals and social services so it’s easier for them to get the care they need and avoid harmful health experiences.
But earlier this month, Gov. Kristi Noem abruptly terminated a contract from the state Department of Health that secured funding for Fonder’s position. The Transformation Project plans to sue the state for alleged civil rights violations related to the cancellation.
No referrals, just resources
The nonprofit was awarded about $136,000 in federal funds to hire and train a community health worker to help connect members of the LGBTQ community to physical and mental health care. The funds, dispensed by the state, were earmarked by the U.S. Centers for Disease Control for the hiring of community health workers to serve rural areas and marginalized communities.
The Transformation Project’s executive director, Susan Williams, said in an open letter that the group was in compliance with contract terms, though a letter from the state Department of Health announcing the terminated contract listed several alleged breaches of contract.
Noem’s spokesman Ian Fury told a conservative news outlet the reason the contract was canceled was because “South Dakota does not support this organization’s efforts and state government should not be participating in them.”
News of the terminated state contract ambushed Fonder. While it was upsetting for the LGBTQ community and for The Transformation Project, the unexpected announcement also threatened his livelihood and the livelihood of his spouse and children who rely on his employment.
“I’m just here trying to live life, raise my family and be a contributing member of society,” Fonder said. “To have these constant attacks, it does feel very personal when you’re part of the community they want to attack.”
The role of the community health worker at The Transformation Project is not political. Fonder acts as a liaison to help connect LGBTQ people with resources and re-establish trust with health care providers so they can maintain their mental and physical health. He does not formally refer people for services, he emphasized.
“I’m not a doctor. I’m not a professional in the health care system whatsoever. I am a person who can connect you to resources – I can’t refer someone for surgery or hormones,” he said. “I can give you a list of doctors you can talk to for whatever you need, but not specifically for those things because we’re not trained to do that. We just want to get people healthy, happy and provide them resources they need.”
Program reached 10 people before starting
The Transformation Project has been an outspoken advocacy group for transgender youth in South Dakota, as the demographic faces discrimination and hostility, leading to depression, isolation and suicidal thoughts, experts say.
For example, 80% of LGBTQ youth report they’ve experienced discrimination for their sexual orientation or gender identity, according to The Transformation Project. 53% of LGBTQ youth in South Dakota have seriously considered suicide in the past year, and 19% report attempting suicide in the same timeframe, which is higher than South Dakota youth overall. About 75% of LGBTQ youth also report experiencing anxiety and 58% report symptoms of depression.
While the three-year-old organization has tried to help provide resources to LGBTQ people, The Transformation Project didn’t have a dedicated position to handle the demand, said Susan Williams, executive director. Having a dedicated community health worker helps reach a larger number of people.
Even before receiving his certification as a community health worker in mid-December, word had spread about Fonder’s role, and he was able to connect about 10 people to physical and mental health resources.
“I know a lot of people who went through transition and didn’t have services to help. It makes it harder and can be life-threatening,” Fonder said, adding that the people he’s helping are “just barely getting through each day.”
Several of the people Fonder has connected with are college students, Williams said.
“They had some really challenging interactions with classmates because they are transgender, and are dealing with some mental health challenges as a result of that,” Williams said in an email. “He connected them to mental health resources, arranged transportation for them since they don’t have a car here, and he will continue to work with them to make sure they’re getting the support they need.”
Fonder added that he’s known people who have died because they didn’t have the right health care support and their situation was “too much” for them to handle on their own. He doesn’t want that to happen again.
“I think a lot of this is, yes, we are serving the LGBTQ+ community, but if you take this away, we’re just serving people,” Fonder said. “I’m doing the same work as a community health worker at a hospital or with helping immigrants. We’re focused on different communities, but we’re still helping people.”
Strengthening all community services
Fonder also connects community members with social services, such as food banks, homeless shelters and employment centers.
He not only educates people in the LGBTQ community about services, but acts as a liaison and educator for organizations by offering information about the LGBTQ community. His role helps to identify gaps in public services as well.
“There are places in the Sioux Falls community that aren’t aware of what it means to be transgender or part of the LGBTQ+ community, and because of that people don’t feel safe utilizing those services,” Fonder said. “Not everybody who needs to go to a homeless shelter is straight. Everybody needs access to the same kinds of services.”
The Transformation Project has announced its intention to retain Fonder in his role despite the loss of funding. It has set up an online fundraiser that asks the public to “raise $105,000 to cover the funding shortfall that was created.”
“We’re still going to push forward, continue to do the work and push harder,” Fonder said. “We’re not going to give up or back down, because our community needs us to be here and fighting for them.”
The organization is planning to open a community center in 2023, which will offer a space for the LGBTQ community to gather and host public health events. There is $75,000 already raised for the project, and a fundraising campaign will begin in early 2023.
“I think the community health worker program is going to lead to better things in the community,” Fonder said, “not just for programs in the LGBTQ+ community, but for everybody that lives here.”
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