Giselle Media, Fresnoland
This story was originally published by Fresnoland, a nonprofit news organization.
The temporary site is set to open on March 17, offering gynecology services, gender-affirming electrolysis, and transition-related care
What's at stake:
Amid efforts by the Trump administration to restrict LGBTQ+ rights, including bans on gender-affirming care for trans youth, an LGBTQ+ medical center will offer services in Fresno and the Central Valley.
At 19, Alejandro Sanchez moved from Mendota to Fresno to begin his medical transition, seeking healthcare resources his hometown lacked.
In Fresno, he said he cycled through multiple doctors in pursuit of gender-affirming care but instead faced neglect. He said providers refused to use his name and pronouns, overlooked his medical chart when addressing his testosterone treatment, and even misattributed his identity to a mental health disorder.
It wasn’t until Sanchez visited a local women’s health center for reproductive issues that he found support. The center referred him to Dr. Julie Nicole, an LGBTQ+ friendly provider specializing in transition-related care—marking the first time he felt truly seen and accepted.
“Dr. Julie Nicole was my prescribing doctor for testosterone for seven years, and that saved my life,” said Sanchez. “While resources are still limited in Fresno and the Central Valley, it’s so much more than it was seven years ago. It’s transformative to see her and other medical providers creating a dedicated space for care. Access to gender-affirming care is life-saving—it removes barriers and allows us to experience joy and happiness.”
Dr. Nicole and other local providers are preparing to open Fresno Collective for Inclusive Medicine, Fresno’s first LGBTQ+ health clinic and all-inclusive medical center, designed to provide affirming care. In February, Fresno Inclusive began to take telehealth appointments and their temporary location is set to open March 17.
The medical center opens amid concerns that President Donald Trump’s administration is making it more difficult for trans Americans to live openly and safely, free from harassment and discrimination.
Similar to Trump’s first term, when he advocated for anti-LGBTQ+ policies and rolled back protections, Trump signed an executive order on his first day in office recognizing only “two genders, male and female.”
The executive order aimed to restrict access to accurate federal identity documents and threatened to withhold funding from hospitals over gender-affirming care. Other orders included attempts to ban gender-affirming care for trans youth under 19 and a bill to prevent trans girls from playing sports with other girls in school.
LGBTQ+ rights also remain a major target, with the ACLU tracking 511 bills nationwide that aim to restrict them in this year’s legislative session, as of March 11. The current number is just 22 bills shy of last year’s total of 533.
Fresno’s first LGBTQ+ health clinic is an act of defiance
Faye Black, a medical coding and billing specialist at Fresno Inclusive, was surprised to discover that Fresno, the 5th largest city in California, didn’t have a dedicated LGBTQ+ clinic when she moved from Texas.
“This just shows how much a space like this is needed,” Black said. “There needs to be resources that bring intersectionality to erased communities.”
Since January, Black said Fresno Inclusive has received about a dozen calls daily for appointments, with over 20 telehealth appointments held in February.
However, many callers expressed concern that Fresno Inclusive might not have the opportunity to provide gender-affirming care, such as hormone replacement therapy, before facing potential shutdown. Their concerns stemmed from Trump’s efforts to ban gender-affirming care for trans youth under 19 and cut federal funding for providers offering such care.
PFLAG, along with other advocacy groups, sued to block Trump’s ban. As a result, a federal judge has granted temporary blocks of the executive order twice, most recently through a preliminary injunction.
“It’s an act of defiance for people to see us open now during the Trump administration, actively building a space where not only the LGBTQ+ community can find affirming healthcare, but all people,” said Black.
Fresno Inclusive will provide a range of gender-affirming care services, including hormone therapy and surgical procedures such as hysterectomy, oophorectomy, and labiaplasty.
Beyond gender-affirming care, Fresno Inclusive will offer sexual health services, including STI testing and treatment, contraceptive options like IUDs, birth control pills, and Nexplanon, as well as gynecological care for menstrual issues, menopause, and pelvic pain. Electrolysis will also be available for gender affirmation, PCOS management, and cosmetic purposes.
Carlos Lopez, an electrologist at Fresno Inclusive, said that trans people in the Central Valley are accustomed to traveling to Northern or Southern California for medical transition and other transition-related care.
“San Francisco and Los Angeles have all the best resources and clinics—it’s finally our time,” Lopez said. “So many people in the Central Valley need this, and now we can provide these services so they don’t have to completely outsource.”
He plans to serve as a “patient navigator,” assisting individuals in connecting with gender-affirming surgeons for services that Fresno Inclusive currently cannot provide.
The clinic will also offer letters of recommendation for other gender-affirming surgeries and coordinate out-of-town post-op follow-ups, such as drain removal and wound checks, with doctors in both Northern and Southern California.
Lopez said Fresno Inclusive will continue expanding its services and training medical providers to offer more types of care. This includes Dr. Sam Schmitz, a family medicine physician, who will begin accepting new primary care patients in spring 2026 after completing their residency at UCSF Fresno.
Fresno Inclusive will also reinvest in its current providers by supporting Lopez in furthering his education and pursuing a nursing degree.
Fresno Inclusive differs from other medical centers
Fresno Inclusive’s temporary site will operate as a medical center until their main medical site next door opens in June, around Pride Month. Afterward, the temporary site will transition into a community center, providing a space for local LGBTQ+ and all-inclusive groups, such as Gender Alchemy for support groups and BLACK Wellness & Prosperity Center for maternal wellness classes.
The community center will also feature a Dr. Alan Hart library branch as part of PFLAG Fresno and the Fresno EOC LGBTQ+ Resource Center’s Little Queer Library project. This initiative will provide books written by, for, and about LGBTQ+ people for community members to read and check out. The branch is named after Dr. Alan Hart, an American radiologist and the first transgender man in the U.S. to undergo sex reassignment surgery, who is also credited with discovering that X-rays could detect early tuberculosis infections in patients before they became contagious.
Dr. Nicole said the community center is designed to bring people together in a safe space while supporting local nonprofits initiatives. Some proceeds from Fresno Inclusive will be reinvested into the community center to support its efforts.
It’s part of Fresno Inclusive’s effort to ensure support for people, regardless of federal developments. While Dr. Nicole noted that local and state officials, including California Attorney General Rob Bonata, have backed gender-affirming care; the future of such laws remains uncertain due to the Trump administration’s actions.
“At Fresno Inclusive, inclusivity goes beyond just LGBTQ+ people,” said Dr. Nicole. “It extends to supporting trans individuals and their families, as well as families who may not feel comfortable anywhere else.”
Dr. Nicole hopes to foster a deeper understanding of gender-affirming care and what she calls “joyful medicine” at Fresno Inclusive. The clinic will “prioritize patient comfort,” offering soft cotton or fleece examination garments based on preference and season, along with socks, robes, and handmade heated weighted wraps for the shoulders, neck, and abdomen. Medical instruments are also warmed for added comfort.
The staff will also engage in open discussions about available techniques and medications, especially for procedures like endometrial biopsies and IUD placements, ensuring patients feel informed and comfortable.
For safety, the sites will be equipped with buzzer systems and intercoms, and they will accept a limited number of walk-ins.
Black is working to ensure Fresno’s first LGBTQ+ health clinic continues to accept a variety of insurance types, including Anthem/Blue Cross, Aetna, and Cigna, while also striving to secure Medi-Cal coverage, despite the risk of federal funding cuts to the program. Fresno Inclusive also plans to offer a direct payment option that would be more affordable than going through insurance.
“Most trans people are under Medi-Cal or uninsured, and the insurance that they have, if they do, is likely state insurance, so Fresno Inclusive is actually doing the work of making sure they can serve our community,” said Sanchez. “They’re not here trying to price gouge, but instead offer life saving health care.”