Having worked for years in transgender health care and advocacy, reproductive health care and opioid awareness, Jen Hastings has built up an impressive, decades-spanning résumé. While that important work continues, Hastings is considering a shift back to clinical care as access to reproductive care faces attacks across the country.
Teacher, artist, hospice worker, and restaurant cook are all jobs Jen Hastings held before attending medical school. The work as an art teacher, though, and the ability to see art and expression as a form of healing allowed Hastings to develop a unique view of health care.
“Looking at us humans in a really holistic perspective has been a thread through my life,” said Hastings. “It’s not the disease we have, but the health we hold, and I came to medical school with the belief that our current medical system didn’t have that kind of perspective on healing.”
Over the years, Hastings has been at the forefront of transgender health care and advocacy, and has accumulated an expansive résumé. Locally, Hastings spent 20 years at Westside Planned Parenthood Mar Monte as a lead physician, acting as director of the organization’s transgender health care program for 16 of those years.
Hastings also co-founded the Santa Cruz Trans Therapist Group in 2007, to train therapists on how to support trans people appropriately. Further, since 2014, Hastings has worked as the physician lead for Safe Rx Santa Cruz County, teaching the public about issues of opioid safety and treatment as the opioid crisis persists.
Hastings, now 67, didn’t finish medical school at UC San Francisco until age 34 and completed a family practice residency three years later. Hastings came to Santa Cruz in the late 1990s, and began practicing full primary care at Planned Parenthood when the physician had a life-changing experience.
One of the organization’s medical assistants came out as a transgender woman. She was the first openly trans person close to Hastings. Soon after, Hastings set off on a path to learn everything about gender that they didn’t know — the start of a personal and professional journey.
Hastings began to recognize feelings that had always been there, but that they did not have the language to describe. Hastings realized that they are nonbinary, and now simply uses the name “Jen” or gender-neutral pronouns.
“It really put into perspective the experiences that I had as a kid and didn’t know what to do with,” said Hastings. “I sort of squished them down, because there was nowhere to put them.”
Hastings set out on a course to learn about transgender care. In 2006, Planned Parenthood Federation of America asked Hastings to write protocols for the organization so that any Planned Parenthood — in the United States and internationally — could provide transgender services.
Having co-founded the Santa Cruz Trans Therapist Group, Hastings explained that at the time, therapists did not have adequate training to approach trans care in the way they needed to. The standard then was to receive a letter from a therapist or mental health specialist in order to begin hormone therapy. Hastings said that requiring a letter from a therapist with no training in the concept was “ironic.”
“I think, to this day, people don’t tell their true story or authentic narrative because they think they have to meet certain requirements in order to receive hormones,” said Hastings. “So needing a letter from a therapist who doesn’t know anything about what to do is pretty crazy.”
Cabrillo College trustee Adam Spickler — who in 2018 became the first openly transgender man to win elected office in California — notes the importance of Hastings’ efforts to dispel the association between being transgender and mental health disorders.
“Jen’s been able to make sure people understand how disastrous it is if you’re a primary care doc, specialist, surgeon or oncologist who deals with hormone treatment to start off with a patient with the premise that there is any kind of disorder around their gender identity,” he said. “Jen really helped shift the field here locally, so that folks who otherwise don’t have experience with the LGBTQ+ community were getting what they needed to support their patients.”
Spickler said that when he told his primary care doctor that he wanted to start hormone therapy, the doctor tried to talk Spickler out of it and added that insurance wouldn’t cover the procedure. He ended up proceeding with Hastings at Planned Parenthood shortly after.
Several years later, when Spickler was able to get chest reconstruction surgery covered by insurance, he got in touch with a doctor who had previously received training from Hastings. He said that made a world of difference.
“One of the very first things he said was that he would likely make mistakes in his language and accidentally say something offensive, and asked me to call him on it so he could learn,” he said. “That’s the good work that Jen does in our community.”
Spickler added that his insurance company initially rejected his request for surgery. While he was successful in appealing that rejection, Hastings and other Planned Parenthood physicians provided templates for trans patients to appeal their own rejections — and gave them to medical providers, too.
“With those, doctors can give templates to their patients and tell them that it may be helpful in the appealing process,” Spickler said. “It’s not just the medical care capacity, but insurance companies are more than half the battle.”
Hastings remains heavily focused on gender education and training both within medical settings and in the community at large.
Joel Baum is a former senior director of professional development for Gender Spectrum, a national organization with Bay Area roots that works to foster greater understanding of gender as it relates to young people. He first encountered Hastings early on in his time with Gender Spectrum, when the organization met with Planned Parenthood Mar Monte personnel to discuss their approach with trans children. Baum said he was immediately impressed with Hastings’ dedication and humility.
“There was no ego at all, with Jen it’s all about caring for patients and young people that need it,” he said. “And, of course, we needed to figure out how to do that well.”
Baum said that Hastings’ work is farther reaching than just medical care, something that was already clear more than a decade ago. When it came to advocating for the needs of trans and nonbinary children, Baum said, Hastings “dove in with both feet.”
“There was starting to be an awareness of simply needing to understand that kids have a sense of gender that may not be exactly what everyone else thinks it is,” he said. “That level of gender literacy was going to be really important for them.
“It was this whole notion of giving kids agency and the ability to say, ‘This is my story and I probably know it better than anyone.’ It’s so much about creating space for young people to tell you what was happening for them, rather than telling them what was happening.”
During Baum’s tenure with Gender Spectrum, Hastings played a big role in programming the organization’s annual family conference on gender in youth. Hastings worked to ensure that those presenting would emphasize the importance of listening to young people and urging parents to do the same as they both tackle complex issues.
That same approach has guided local families through their own gender journeys as well.
Andrea Damon, associate director for TransFamilies of Santa Cruz County, first began attending the group’s meetings five years ago when her daughter came out as trans. Damon said that Hastings’ insight has had a profound impact on how she viewed her daughter’s experience.
“As a cisgender person, I have never spent much time contemplating my own gender. One of the things I’ve learned from Jen is to think more about how we understand ourselves, and to imagine what it’s like to feel that incongruence,” she said. “Jen helped me deepen my understanding of what gender actually is because the whole idea of gender dysphoria was so foreign to me.”
Damon said understanding this breadth of new concepts about gender was a challenge, but Hastings ultimately helped her learn the role she had to take on for her child.
“I had to let it go and start from scratch. Not that the new knowledge was necessarily contradictory to what I had before, but I had to start building from the bottom again,” she said. “I began to understand that my role was simply to love and support my child, but not drive this ship.”
Over time, as Damon got more involved with TransFamilies, she has worked with Hastings on a number of presentations and panels. Damon said Hastings provides an “open heart” in an area that desperately needs it.
“Jen can recognize the complexity of the situation and doesn’t come from a position of shutting anyone down who has questions or worries that may be counter to Jen’s own belief system,” she said. “Jen is definitely an advocate and an ally, but also has the communication skills and compassion to work with families in a way that supports their young person and the family as a whole, too.”
Though Hastings has contributed greatly to strides in trans health care, and the acceptance and understanding of trans experiences locally, nationally the rhetoric remains unsettling.
“What we’re seeing nationally is a heartbreaking backlash on trans rights, supporting trans youth, and parents who have children exploring their gender,” said Hastings, referring to a crisis of misinformation around issues of gender identity. “People are saying that 5-year-olds are getting surgery, but they’re not. Whether they’re exploring what pronouns they use, what clothes they wear, or what their haircut is, to reject that exploration has a profound negative impact on kids.”
Now at age 67, Hastings is considering a return to clinical practice, and is toying with the idea of working out of state a few times a month to provide medication abortion in areas that are battlegrounds for abortion access.
Hastings is also working to bolster legislative protections both in California and across the country. The goal is to make clear funding pathways for clinics so they are able to provide abortions on site.
“Basically, working on legislation to support access to abortion care for all persons, regardless of income,” said Hastings.
But even as Hastings fights for positive change nationwide, those who have worked with the versatile doctor over the years say Hastings’ decades of effort continue to have a profound effect on the Santa Cruz County community.
“It’s because of Jen, in some part, that I’m walking through the world as I am today,” said Spickler. “All of the things that would distract me from living my productive life have been long dealt with because of people like Jen Hastings.
“Now, I just get to be me, doing good work in the world, and not me, hampered by my identity, trying to do good work in the world.”