Stephanie Estey and Daphne Chen, co-founders and co-CEOs of TBD Health, pose for a photo at their newest sexual health clinic located in the Las Vegas Arts District, Tuesday Jan. 4, 2022.
Monday, Jan. 17, 2022 | 2 a.m.
When Daphne Chen was younger, she paid a visit to a gynecologist to get an intrauterine device to prevent pregnancy. The gynecologist refused, she said, and told Chen to return when she was in a relationship.
Her providers did not like that her reasoning for wanting an IUD was to be protected against pregnancy while she was actively dating, Chen said. The cool response from a provider meant to assist her was the impetus for co-creating TBD Health with Stephanie Estey, her longtime friend and now business partner at the sexually transmitted infection testing company.
Last week, TBD Health opened its first in-person clinic in the Las Vegas Arts District, where it will test residents for STIs and COVID-19 with a focus on empowerment and comfort rather than adhering to the judgmental clinic experience that Chen had, she said.
“It really made us question why it had to be that way, and could we create a platform that celebrated sex and was sex positive, gender affirming, creating an experience that actually made you feel good about taking care of your sexual health through the course of your life?” Chen said.
TBD Health’s green, red and pink walls, adorned with sex-positive imagery, welcome patients seeking STI testing in a way that reinvents typical sexual health care, Chen and Estey said. Choosing Las Vegas as a location for the company’s first in-person clinic was based on high demand for at-home test kits from Nevada clients, Chen said.
STI cases across the United States have been steadily rising, according to an April 2021 study from the Centers for Disease Control and Prevention, with 2019 being the highest at 2.6 million annual cases. There were approximately 1.9 million cases in 2014, with each consecutive year hitting an all-time high.
In Nevada, there was a reported increase in chlamydia, gonorrhea and syphilis in 2018, according to one study. There were 17,508 chlamydia cases, an increase of 6.1% from 2017, and gonorrhea cases increased by 11% among men and 23% among women.
The clinic, or care hub, opened to all patients this month after initially operating as invite-only. Before any in-person work, TBD Health sold at-home STI kits testing for chlamydia, gonorrhea, trichomoniasis, HIV and syphilis, all of which can be tested for at the Las Vegas clinic. Singular tests start at $40 while comprehensive panels start at $150 without insurance.
Patient who test positive are connected with one of TBD Health’s five clinicians. Each clinician, before starting work with TBD, completes a “TBD Retraining Program” that coaches them on the sex-positive and gender-affirming care that TBD expects online and, now, in person, Estey said.
“I think that unique approach is something that, we’ve at least seen, really separates TBD because people actually feel as though … it’s a human approaching them and talking about the best plan of action and how to think about sexual health in that framework,” Estey said.
Head clinician Lori Grant said it is important to build personal relationships with her clients. Grant has also worked with clients virtually, allowing her access to a larger pool of patients, but the in-person work allows for longevity in the patient-provider connection, she said.
“I think the personalized, nonjudgmental approach is going to be very new, as well as having a very sex-positive outlook on our care practice model, where you don’t feel guilty because you enjoy or want to have sex,” Grant said. “You actually want to have your questions answered in a compassionate way where you’re not getting judged.”
Nevada also ranked first in the U.S. for its rates of primary and secondary syphilis, and second in its congenital syphilis rate. In 2018, primary and secondary syphilis rates rose overall 14.2% from the previous year, with an 8.5% increase among men and 58% among women.
“Something that we’ve really learned is that it’s so, so important to provide easy access to STI screening, which is something that both at-home as well as these in-person care hubs can really do,” Estey said. “Thinking about how we can provide sort of more proactive solutions to combat this, the rise of STIs is something that we’re really, really interested in doing.”
With the additional rise in demand for COVID-19 testing in the Las Vegas Valley, Chen said she hopes the care hub’s COVID-19 testing will provide a necessary service to the community while providing the same welcoming atmosphere.
Chen said TBD also aims to provide health care options to a city where reproductive care could be overwhelmed, should Roe v. Wade be overturned in the future. Las Vegas has two Planned Parenthood locations, which also provide STI testing — on Flamingo and Pecos roads, and on Charleston Boulevard near Valley View Boulevard.
“We had talked to a few ... locals, and talking about how in their county there’s one gynecologist, and so they’re driving seven hours away to find sexual health care,” Chen said. “I’m glad to see that there’s such a progressive stance toward wanting to be a safe haven for other states, but I think there might be a little bit of a lack of resources within the state itself.”
