Startups

How gender-affirming healthcare startups are navigating legal miasma

Comment

Paperboard heart with the transgender flag on a pink background
Image Credits: David Espejo / Getty Images

Kate Anthony started in the Lone Star State.

It was there, in 2019, that she launched her app Euphoria, seeking to provide information and resources on gender-affirming care. She knew the stakes were going to be high, and as the state passed anti-trans legislation, she and her company were forced to flee.

Settling in Denver, Anthony made a plan on what to do next. She decided to maintain business as usual while the fight for trans rights continues. She’s not alone in that decision. Many apps, if not all, that service the trans community are hyperexposed, under fire and seemingly undeterred.

TechCrunch conducted a vibe check to see how trans entrepreneurs servicing their communities are navigating this moment. The Human Rights Campaign told TechCrunch that legislators in state houses have introduced 344 anti-LGBTQ+ bills this session, with more than 140 specifically targeting the trans community.

These proposed restrictions range from an Alabama bill that seeks to deny medical care for transitions to Iowa and Alaska bans on trans students participating in sports. Louisiana introduced a bill to bar medical professionals from offering minors translation-related care, and Florida now prohibits gender-affirming care under Medicaid.

Anthony said it’s inevitable that her company will one day be sued by someone or some state. Other founders said they are watching the court systems closely, with some rethinking strategies regarding consumer privacy and employee benefits. And for the startup and venture community, support is better late than never — it’s a critical time to defend trans founders.

Backstage Capital found less than 1% of all venture funds went to openly LGBTQ+ founders. This dearth of capital contributes to a lack of innovation, operation and protection for one of the nation’s more persecuted communities, compounding how difficult it is to be a trans founder and run a startup aimed at the trans community.

“I try to be an eternal optimist, but I also need to be pragmatic,” Anthony said regarding what the next few months will look like for her. “I’m scared as hell.”

“We’re making sure we’re on top of what is happening”

Euphoria stems from personal experience, Anthony said. She launched the app after finding her own transitioning experience to be long and difficult. One of the biggest problems was that information on the process was hard to find, she recalled.

“It was hidden in underground support groups and internet forums, [stocked] with anecdotal information,” she said. “I just thought to myself, ‘There has to be a better way.’”

The result was Euphoria, which is made up of four different apps and provides services such as transition coaching, daily motivations and a banking service to help people save for their transitions. The company, which Anthony said has 100,000 users, also provides a state-by-state breakdown of how rulings and legislation will impact transition journeys.

After the Florida ruling this month, Euphoria alerted its customers that their hormonal medications and surgical procedures are no longer covered under Medicare, resulting in the app sharing resources nearby. Anthony calls this a “real-time” dynamic that the app adopted.

“It adapts and helps our users sift through [information], showing them the end practical results of these legislations or these rulings so they can make an actionable decision as it pertains to their health care,” Anthony said. “And to just how they exist as a member of society.”

The app is legally exposed in a few states, however. Texas Gov. Gret Abbot, for example, says providing gender-affirming medical care to trans youth is considered child abuse under state law. Aydian Dowling, the founder of the app Trace, which helps trans individuals document their transitioning journey, is also pondering his company’s legal liability.

Trace is headquartered in Wisconsin, a state also attempting to bar transgender children from receiving gender-affirming care. A concern raised after Roe v. Wade was overturned is that the states that banned abortion could utilize the data from tracking and documenting apps, like Trace, to punish those seen as breaking newly implemented laws. As a result, Dowling said his company has started reassessing its approach to consumer privacy.

“We try not to collect a lot of data; we don’t sell any of our data; the only way somebody could potentially get data would be through a subpoena,” Dowling said. “We will not allow these anti-trans people to bully us into giving information.”

Regarding servers, Dowling said the company has started pondering the legal safety of having its information stored in databases hosted in states such as Wisconsin or even Texas.

“If that means we should move servers to a place that we know is more protective, if that means we have to call on lawyers and get people who are well versed in this, then that’s what we will do,” Dowling continued. “We’re making sure we’re on top of what is happening.”

As previously reported by TechCrunch, Roe’s reversal impacted more than just reproductive rights. Landmark court cases decided the right to exist for minorities and other marginalized groups, and the United States Court of Appeals for the Fifth Circuit, which led to Roe’s downfall, showed these rights could be toppled on a whim.

For this reason, Anthony is paying close attention to what that particular court decides to take on next. She and Dowling say they already have legal groups on standby.

“If there’s going to be a court that takes a shot at Bostock, Obergefell or Griswold, that’s who it’s going to be,” she said, referencing the cases that protect trans and gay individuals from workplace discrimination, ensure same-sex couples’ right to marry and protect married couples’ ability to purchase and use contraceptives without government interference.

Meanwhile, telemedicine company Folx Health is used to dealing with legislative restrictions, and Rocco Kayiatos, one of the first executives at the company, said all trans-related care will become an even more tenuous political issue come election time.

Folx Health offers virtual doctor visits and works with companies to offer LGBTQ+ employee benefits. It also mails medications such as hormone therapy; a service that’s poised to be a contentious issue.

Telemedicine remains a debated topic, and states like Texas have sought to toughen their ban on the mailing of abortion pills by attaching a jail sentence to the action. Kayiatos said that Folx Health has run into problems mailing, for example, testosterone to transgender men because it’s a hormone also used as a steroid by athletes.

“Rolling back trans people’s rights and access is going to continue to be a focal point of the conservative [political] platform,” Kayiatos told TechCrunch. “It’s all the more important for trans-led companies and businesses to continue to build and exist to service this community.”

Anthony seconded that, saying despite what happens this next few years, the trans community has always had a long, storied history of learning how to survive in the face of hostility and is “uniquely positioned” to respond to patchwork systems and unfairness. She added that if anyone in the venture space is interested in helping, now is the time to cut trans founders a check.

“We’ve always existed and even if things get worse, we’re not going to cease to exist,” Anthony said. “It’d be harder to justify crafting legislation that outlawed specific services and industries as that could create economic fallout.”

This article was updated to clarify the Gov. Greg Abbott’s statements regarding providing gender-affirming medical care to trans youth. 

 

 

More TechCrunch

Ever wonder why conversational AI like ChatGPT says “Sorry, I can’t do that” or some other polite refusal? OpenAI is offering a limited look at the reasoning behind its own…

OpenAI offers a peek behind the curtain of its AI’s secret instructions

The federal government agency responsible for granting patents and trademarks is alerting thousands of filers whose private addresses were exposed following a second data spill in as many years. The…

US Patent and Trademark Office confirms another leak of filers’ address data

As part of an investigation into people involved in the pro-independence movement in Catalonia, the Spanish police obtained information from the encrypted services Wire and Proton, which helped the authorities…

Encrypted services Apple, Proton and Wire helped Spanish police identify activist

Match Group, the company that owns several dating apps, including Tinder and Hinge, released its first-quarter earnings report on Tuesday, which shows that Tinder’s paying user base has decreased for…

Match looks to Hinge as Tinder fails

Private social networking is making a comeback. Gratitude Plus, a startup that aims to shift social media in a more positive direction, is expanding its wellness-focused, personal reflections journal to…

Gratitude Plus makes social networking positive, private and personal

With venture totals slipping year-over-year in key markets like the United States, and concern that venture firms themselves are struggling to raise more capital, founders might be worried. After all,…

Can AI help founders fundraise more quickly and easily?

Google has found a way to bring a variation of its clever “Circle to Search” gesture to iPhone users. The new interaction, launched in January, allows Android users to search…

Google brings a variation on ‘Circle to Search’ to iPhone users

A new sculpture going live on Wednesday in the Flatiron South Public Plaza in New York is not your typical artwork. It combines technology, sociology, anthropology and art to let…

Always-on video portal lets people in NYC and Dublin interact in real time

Apple’s iPad event had a lot to like. New iPads with new chips and new sizes, a new Apple Pencil, and even some software updates. If you are a big…

TechCrunch Minute: When did iPads get as expensive as MacBooks?

Autonomous, AI-based players are coming to a gaming experience near you, and a new startup, Altera, is joining the fray to build this new guard of AI agents. The company announced…

Bye-bye bots: Altera’s game-playing AI agents get backing from Eric Schmidt

Google DeepMind has taken the wraps off a new version AlphaFold, their transformative machine learning model that predicts the shape and behavior of proteins. AlphaFold 3 is not only more…

Google DeepMind debuts huge AlphaFold update and free proteomics-as-a-service web app

Uber plans to deliver more perks to Uber One members, like member-exclusive events, in a bid to gain more revenue through subscriptions.  “You will see more member-exclusives coming up where…

Uber promises member exclusives as Uber One passes $1B run-rate

We’ve all seen them. The inspector with a clipboard, walking around a building, ticking off the last time the fire extinguishers were checked, or if all the lights are working.…

Checkfirst raises $1.5M pre-seed to apply AI to remote inspections and audits

Close to a decade ago, brothers Aviv and Matteo Shapira co-founded a company, Replay, that created a video format for 360-degree replays — the sorts of replays that have become…

Controversial drone company Xtend leans into defense with new $40 million round

Usually, when something starts to rot, it gets pitched in the trash. But Joanne Rodriguez wants to turn the concept of rot on its head by growing fungus on trash…

Mycocycle uses mushrooms to upcycle old tires and construction waste

Monzo has raised another £150 million ($190 million), as the challenger bank looks to expand its presence internationally — particularly in the U.S. The new round comes just two months…

UK challenger bank Monzo nabs another $190M as US expansion beckons

iRobot has announced the successor to longtime CEO, Colin Angle. Gary Cohen, who previous held chief executive role at Timex and Qualitor Automotive, will be heading up the company, marking a major…

iRobot names former Timex head Gary Cohen as CEO

Reddit — now a publicly-traded company with more scrutiny on revenue growth — is putting a big focus on boosting its international audience, starting with francophones. In their first-ever earnings…

Reddit tests automatic, whole-site translation into French using LLM-based AI

Mushrooms continue to be a big area for alternative proteins. Canada-based Maia Farms recently raised $1.7 million to develop a blend of mushroom and plant-based protein using biomass fermentation. There’s…

Meati Foods bites into another $100M amid growth to 7,000 retail locations

Cleaning the outside of buildings is a dirty job, and it’s also dangerous. Lucid Bots came on the scene in 2018 with its Sherpa line of drones to clean windows…

Lucid Bots secures $9M for drones to clean more than your windows

High interest rates and financial pressures make it more important than ever for finance teams to have a better handle on their cash flow, and several startups are hoping to…

Israeli startup Panax raises a $10M Series A for its AI-driven cash flow management platform

The European Union has deepened the investigation of Elon Musk-owned social network, X, that it opened back in December under the bloc’s online governance and content moderation rulebook, the Digital Services Act…

EU grills Elon Musk’s X about content moderation and deepfake risks

For the founders of Atlan, a data governance startup, data has always been at the heart of what they do, even before they launched the company. In fact, co-founders Prukalpa…

Atlan scores $105M for its data control plane, as LLMs boost importance of data

It is estimated that about 2 billion people, especially those in lower and middle-income countries, lack access to quality and affordable essential medicines. The situation is exacerbated by low-quality or even killer…

Axmed raises $2M from Founderful to streamline drug supply chains in underserved markets

For decades, the Global Positioning System (GPS) has maintained a de facto monopoly on positioning, navigation and timing, because it’s cheap and already integrated into billions of devices around the…

Xona Space Systems closes $19M Series A to build out ultra-accurate GPS alternative

Bankruptcy lawyers representing customers impacted by the dramatic crash of cryptocurrency exchange FTX 17 months ago say that the vast majority of victims will receive their money back — plus interest. The…

FTX crypto fraud victims to get their money back — plus interest

Google on Wednesday launched its digital wallet in India with local integrations, nearly two years after the app was relaunched as a digital wallet platform in the U.S. As TechCrunch exclusively reported last month,…

Google Wallet is now available in India

Bluesky has launched a new product roadmap for the coming months. The decentralized social network said on Tuesday that it is planning to introduce direct messages, support for videos, improved…

Bluesky to add DMs, video support and in-app custom feed curation

Samsung Medison, a medical device unit of Samsung Electronics that specializes in developing diagnostic imaging devices, said on Wednesday it plans to acquire Sonio, a Paris-based startup that makes AI-powered software…

Samsung Medison to acquire French AI ultrasound startup Sonio for $92.7M

Kyle Kuzma is a lot of things. He’s a forward for the Washington Wizards NBA team and a 2020 NBA champion. He’s also a style icon — depending on who…

NBA champion Kyle Kuzma looks to bring his team mentality to Scrum Ventures