The reluctance of doctors to believe women’s pain or to trust us when we say something is wrong is well-documented. The idea that cis women and other people with vaginas should be treated differently than cis men and other people with penises by the medical establishment, due to our unique biology and hormones, is only just now starting to gain some traction. Over the past few years, women's wellness apps like Tia, which allows users to track their menstrual cycles and ask the in-app chatbot questions, have sprung up to address this gap. Now, the founders of Tia are bringing the insights they've learned from the app to the Tia clinic, which aims to offer a "cycle-connected" model of care.
“In medicine, we all too often treat women like men,” Tia co-founder Carolyn Witte tells Bustle. “And the outcomes show. Having different needs isn’t inferior; it’s just different. Women need a different care model. And that’s what we aim to do — deliver it.”
The idea for the Tia clinic grew from the ways Tia app users were “hacking” the provided service. While Witte originally envisioned the app as a place were women could come and ask personal health care questions from home — like a ladies-only WebMD — she and co-founder Felicity Yost quickly realized that their users were actually asking questions on the app while they were at the doctor’s office. Tia, it seemed, was filling a need where doctors were falling short.
So they asked their users: How would you feel about an IRL clinic that makes it so Tia and your doctor can stay connected? The response, Witte says, was a resounding yes. After polling the community, Tia decided that New York City was the best place to launch their clinic, with plans to expand to other cities. The first clinic opens on Mar. 6 in the Flatiron neighborhood of Manhattan.
In addition to gynecological services like well-woman visits, IUD insertion, family planning, STI testing, and Pap smears, the Tia Clinic offers general health care services like treatment for strep throat, flu shots, and even acupuncture. They also offer group wellness workshops to their members, with themes based on questions asked in the Tia app. Membership is $15 a month or $150 for the year, and the service accepts some insurance companies. (Members who don't have insurance accepted by Tia can pay cash or submit claims for out-of-network service; acupuncture and the wellness workshops are not covered by insurance, but are billed at separate prices for members and non-members.) Finally, the Tia app allows members to be in continuous touch with their health care providers, and for providers to get a more holistic view of each patient's health.
“We built a second part of our platform that we call ‘Tia MD’ that adjusts all of the [psychological], health, and wellness data from our Tia app as well as other things — like your entire comprehensive health record — and visualizes that on a third tree for you and your provider to use in tandem,” Witte says. “So you walk into the Tia Clinic and it’s a very personalized experience where you can see all of your health records on the screen, you can see all your cycle data, and talk about any correlations and patterns related to your cycle.”
Focusing on those correlations is part of a care philosophy Tia calls “cycle-connected health care.” In a marked contrast to what many people with periods experience at the doctor’s office, Tia’s health care providers integrate the information users input on the cycle tracker on their app to “treat the whole person, not just a series of disparate body parts.”
“What we’re really trying to innovate on, from a care model perspective, is elevating women’s health beyond gynecology, beyond specialty-based medicine,” Witte says. “Our core care philosophy is that women have fundamentally different care needs than men: physiologically, anatomically, hormonally, experientially. We need to build a better a model for them and we’re uniquely situated to do that.”
This model of care could be life-changing for people like Lauren, 32, who two summers ago, woke up in a pool of blood. She has a bleeding disorder and had recently switched to a new insurance company, which led to her changing her birth control pills. Soon after, she started breakthrough bleeding that was as heavy as a full period, lasted a full month, and then would come and go. Something was very wrong. But in visit after visit, her general practitioner told her that she was fine. She tells Bustle her doctor didn't even run any tests, just told her, “It’s probably your body adjusting to the new birth control."
When Lauren went in again after waking up covered in blood, she says her doctor stuck to his “You’re just adjusting” script. Lauren sought a second opinion and while the second doctor found small fibroids, they weren’t enough to explain the continuous bleeding. But it was only then that Lauren was able to convince her GP to switch her back to her old birth control pills. She’d been bleeding for eight months.
While horrifying, Lauren’s story isn’t unique.
“Every single woman has a story,” Witte says. “It’s the norm, not the exception. How do we use these stories to build a better care model? Opening the Tia Clinic is just the next step in our journey.”
Because the clinic focuses specifically on cycle-connected care, Witte says that the medical part of the Tia Clinic will initially only be available for people with uteruses who aren't taking hormone replacement therapy (HRT). People who are on HRT, however, can choose to be Tia members and will be referred to other doctors who handle trans-specific healthcare. Tia's ultimate goal is to build "a radically inclusive and open community” that includes cis women, trans women, and non-binary people assigned female at birth.
If one of the next cities Tia opens a clinic is Lauren’s, maybe she’ll become a member — and finally find out what was wrong with her. Because while the birth control switch worked, the doctor was never able to give her a clear answer about what happened. Until then, like so many women, Lauren will just have to continue on without knowing what, exactly, is going on in her own body.