Ivan Hsiao’s Journey to Transforming Trans Health

What does pride mean to you?

Confidence in self-legibility. Having thought deeply about who I am, I have the self-knowledge and courage to choose myself. I also know that I will succeed because I am queer and trans, and not despite these wonderful identities.

We talk about imposter syndrome and pathologize gender minorities for experiencing self-doubt, when we should be focused on addressing and dismantling systemic barriers we face that leads to such doubts. It took me many years to realize that I can only find true success if I lean into who I am, even if it makes me different, and recognize that it’s a gift to identify opportunities and solutions where others cannot.

What inspired you to start Trans Health HQ? 

The transgender community deserves high-quality, dignified, and affirming healthcare. Trans Health HQ is a one-stop shop for healthcare teams that centralizes resources around gender-affirming care and rewards every clinician for effectively treating and advocating for their trans patients. Looking back, three core experiences collectively inspired me to build Trans Health HQ.

While volunteering at the San Francisco LGBT Center, I saw the power of affirming healthcare to bring delight and relief. However, structural barriers to receiving such healthcare – from combatting immediate threats of gender-based violence to lack of provider knowledge around specific interventions – have made it difficult for transgender individuals to access both routine preventive care and other medical treatments. Transgender individuals often have to educate clinicians about their care, all while being misgendered or eventually denied care due to provider discomfort. Hearing these stories, it was evident why there are health disparities in the trans community.

As a trans person, I understand the stakes of obtaining medically necessary, life-saving care. Affirming my gender allowed me to embody who I am, so that I can experience life as myself. However, each step required a significant amount of self-advocacy, bureaucracy, and education. My privileged background as a healthcare and life sciences management consultant provided me with clinical knowledge, confidence in doctor interactions, paid time off for trans health conferences, the income cover uninsured care, and employer-based insurance. My healthcare experiences frequently involved explaining the difference between sex and gender, flagging contraindicated treatments, or ending a session early when a clinician suggested that being trans was a mental illness. I also vividly remember the number of well-intentioned doctors who wished they could help but did not feel comfortable treating me without additional clinical support or education. Even with major privileges not afforded to most trans people due to structural discrimination, I had a tough experience getting care. My own experiences affirmed the importance of all clinicians knowing how to provide quality routine healthcare for bodies of all genders.

Even with major privileges not afforded to most trans people due to structural discrimination, I had a tough experience getting care. My own experiences affirmed the importance of all clinicians knowing how to provide quality routine healthcare for bodies of all genders.

Lastly, I saw hundreds of clinicians motivated to improve care for transgender patients at the 2023 National Trans Health Summit, and in subsequent LGBTQ health conferences I’ve attended. In conversations with doctors and nurses, I learned about the general lack of training on trans health and the limited opportunities to collaborate with other clinicians who treat trans patients. These conversations also highlighted the potential to increase clinician self-efficacy and confidence in treating transgender patients.

These experiences made me realize that there was a real opportunity to solve problems that patients and clinicians face around gender-affirming care.

Could you describe your experience at the i-lab?

Gaining access to the entrepreneurial ecosystem through the Harvard Innovation Labs was one of the major reasons I picked Harvard over other schools. I knew there were few other universities where I could get a world-class education in health equity in my academic program, and programming about how to make sustainable change in the real world at a place like the i-lab.  

I’m happy to say that I made the right decision: I deepened my understanding of the healthcare system and characterized the issue of trans health at the Harvard T.H. Chan School of Public Health, while leveraging the community, advisors, experts, and programming at i-lab to design a viable solution. Together, this helped me feel confident that I can put the privilege of a Harvard education to good use in the real world for the trans community.

Gaining access to the entrepreneurial ecosystem through the Harvard Innovation Labs was one of the major reasons I picked Harvard over other schools. I knew there were few other universities where I could get a world-class education in health equity in my academic program, and programming about how to make sustainable change in the real world at a place like the i-lab.

What was it like being in the President’s Innovation Challenge?

Being named one of the 2024 President’s Innovation Challenge Finalists was surreal. I had watched previous awards ceremonies online and was in awe of the community of founders that i-lab attracted, as well as the support system that i-lab could offer entrepreneurs. It’s been an honor to meet many respected, successful founders at the i-lab, many of whom have raised the bar for me on the type of founder I want to become. I was also grateful to have the Harvard platform and funding to advance Trans Health HQ, having received a Spark Grant in Spring 2024, and been named a finalist for the Social Impact Fellowship Fund for Fall 2024.

Who is an LGBTQIA+ visionary who has inspired you and why?

There are too many to name! I’ll pick two transgender individuals who influenced the way that I thought about gender, health, and entrepreneurship.

Schuyler Bailar (College ‘19) helped me vision a new world for myself, and then for others. Schuyler is an accomplished athlete (a NCAA D1 swimmer), scholar, and activist whose work focuses on gender and human rights, and Schuyler himself is a transgender man. I was always fascinated by his accessible, scrupulously cited educational content on gender and health. Schuyler’s posts around gender exploration and affirmation were personally informative and helped me introspect what gender meant for me.

Dr. Jerrica Kirkley, one of the doctors who founded Plume, is an endless source of inspiration. To see a successful trans entrepreneur providing the trans community with another route to have their critical healthcare needs addressed gives me hope that we can utilize digital health to rectify minority health disparities. Dr. Kirkley speaks eloquently about social justice and medicine, has deep subject matter expertise in the healthcare field as a doctor, and works in a way that is informed by her own experiences navigating the healthcare system as a transgender woman.

Both Schuyler and Dr. Kirkley taught me that being a transgender person addressing transgender issues is not enough. We need to listen to the transgender community broadly since our experiences and needs are not homogenous. Seeing them reshape our world through research, education, and entrepreneurship gives me hope for a brighter future.

What opportunities exist for LGBTQ+ entrepreneurs? 

The experience of being LGBTQ+ in today’s world lends us an opportunity to innovate in a way that dismantles — rather than perpetuates — systems of harm by being in community and learning from each other. Personally, I really look forward to building an all-trans founding team for Trans Health HQ.

Many of us can vision new worlds and see unique opportunities where others cannot: the creativity, adaptability, and empathy within this community is unparalleled, and just looking at what queer people have been able to create together historically makes me excited for our future. LGBTQ+ founders have already created 36% more jobs, 114% more patents and 44% more exits than the average founder. When we come together with other queer people and allies who are passionate about advancing gender health equity, we can continue solving issues facing our community, and cultivate greater investments – beyond the record high of $258.1 million of foundation resources recently – to enable our thriving.

For some of us, there are also increasing opportunities to be out. I have such deep respect and admiration for those before me, who paved the way for me to live a life that is truly mine, and for the younger generation who fiercely embrace the full breadth of humanity in all its beautiful identities and expressions and loudly demand a more inclusive, just world for all. For me, having the privilege to be out also means I have a responsibility to move our world forward however I can, towards a place where we will not have to come out anymore.

Having the privilege to be out also means I have a responsibility to move our world forward however I can, towards a place where we won’t have to come out anymore.

What challenges do LGBTQ+ entrepreneurs face today? 

We must remain critical, but hopeful, in this tumultuous time. There are 500+ anti-LGBT bills in the US, all of which harm our community by fueling discrimination, or actively taking away our rights.

Given this environment, we must balance visibility with safety and opportunities. While identities are not choices, the extent to which we display them have real consequences for our health and our companies. There is ample research to show that discrimination has an adverse impact on mental health, and entrepreneurs already have an elevated risk of mental health conditions. Discrimination can also hinder our ability to raise funds: for example, LGBTQ founders raise <1% of VC funding, and cis men founders raise 10x more than trans founders.

I mention my transness, and stress the importance of trans health equity, because my proximity to the issue is core to how I lead Trans Health HQ. It is because of the platform that Harvard has given me to talk about the startup – at HSPH’s graduation, at HBS’s New Venture Competition, at HKS’s Cheng Fellow Showcase, and of course the PIC – that I’ve been able to make incredible connections that have enabled me to fund, develop, and pilot our intervention. It is also the reason that I receive death threats.

While entrepreneurs’ identities are often interwoven with their startups, being confronted with such extreme forms of discrimination working in trans health has been a challenge for me and my family.

How can the entrepreneurial community better support, recognize, and make space for LGBTQ+ innovators?

1. It is critical to understand that LGBTQ+ issues are not issues at the margins — questions of gender health equity and bodily autonomy affects us all. Supporting the right to make our own decisions about our bodies without threats of violence or coercion is protecting human rights for ourselves and those we care about.
2. Visibility and promotion of LGBTQ innovators need to be coupled with protection and investment in their ideas, and in systemic change in the entrepreneurial ecosystem. Intentionally connect LGBTQ+ founders to the right investors, mentors, and supporters, so that we have the same chance at success as the average founder. Normalize sharing pronouns, tracking sexual orientation and gender identity data to characterize founder journeys, enforcing a zero-tolerance policy for hate speech or queerphobic/transphobic behaviors in-person and online. When we can show up as ourselves, our energy can go toward solving the problems we need to solve.
3. We can all learn to be better allies. The LGBTQ community is also not a monolith, and the opportunities and challenges that different groups within the community are different. There are many resources which provide this foundational education, such as the HRC, GLSEN and ACLU.

What’s next for Trans Health HQ?

We are building out our resource and community hub to centralize the most-requested clinical and legal resources from our clinicians, hiring for our founding team, and fundraising to launch to our first 10,000 clinicians. Please contact us if you are interested in a collaboration and stay connected with us on LinkedIn.