Tia’s SoHo Clinic wraps you in a blanket of warm pink and oranges the minute you walk off the 2nd-floor elevator. The integrative women's healthcare practice has clinics in New York, California, and Arizona. As I step into the waiting room of their newest clinic in Soho, my eye catches the shelves of books with titles like, “Come As You Are” by Emily Nagoski and “How To Do The Work” by Nicole LePera. I immediately feel my shoulders relax; this won’t be like other OB/GYN visits.
Less than a year ago I was in a small, beige-filled room talking to a male physician about my fertility. I’m a 29-year-old Latinx woman. I’d been on the birth control pill for about 9 years and like riding a bike, as soon as I’d come off the pill, my body reverted back to painful periods, heavy flows, and mid-cycle cramping. I had questions about why my ovulation was so noticeable and painful and then snuck in the question, “I’d actually like to talk about my fertility — I’m not looking to get pregnant right now, but I would love to get a baseline on my fertility health.”
He immediately shut me down. “You don’t have to test your fertility, you’re young and the test won’t give you any real information.” It’s the same response he’d offered when I previously mentioned my painful period and ovulation.
I felt gaslit and small as I walked out of the appointment. Over the last few months, since getting COVID for the first time ever last spring, my already painful periods had gotten a little bit worse. The blood clots became bigger and more frequent. I developed low iron levels. I knew that if given the opportunity again, I would advocate for myself differently with another doctor.
When Rescripted came to me to write this piece, I knew this was a moment to redeem myself and truly take care of my body and get peace of mind.
I had a chance to speak with Devon Klauck, WHNP, Director, Clinical Product at Tia, about their approach. “During our fertility assessment appointment, we can do a full ‘workup,’ which typically includes a blood test, ultrasound, and personalized counseling to support your reproductive planning,” she explained. “The tests ordered during your fertility assessment will be decided by you and your provider based on your history, current health, and fertility goals. Your provider will then review the results with you, counsel you on all of the different options available, and help you plan the next steps on your journey.” This felt like a comprehensive approach to getting ahead of my future plans — whether that means trying to have kids someday or not.
Before heading to the clinic, I had to work through a thorough online check-in process. Similar to an online survey, you’d click through to the next page as soon as you answered a few questions. (Nothing to print out here!) The onboarding process included questions about everything from the heaviness of my flow to my parent’s medical history. Having lost my mom when I was only 10 years old, it felt heartening that the questions about her health were being asked of me through a computer in the comfort of my own home, instead of with a stranger staring at me as I stumbled through the grief and semantics of her life and loss. The onboarding process made me feel like when I walked into a room with a Tia provider we would already be on the same page, and hopefully, on the same team.
As I sat on the plush pink couch in the waiting room for my name to be called, I jotted down the list of questions I wanted to walk through with my provider. The questions were ones I wanted to be able to answer for this piece and also for my own health. Tia’s team encourages any patient coming in for a consultation to do the same.
“Logistically, it can be helpful to write down the questions you have ahead of time, so you don’t forget to ask them,” encourages Klauck. “It’s also helpful to share any plans or goals you have around starting a family, like if or when you think you might want to conceive, and how many children you would like to have (if any). If you aren’t sure of your plans, that’s fine too! Basically, the more information you can share about yourself and your goals, the better.”
Everyone’s fertility journey is different and intertwined with their own convictions around mothering, caregiving, and pregnancy. I’ve used therapy to work through my perceptions around motherhood, so for me, this Tia consultation was aimed at giving me a deeper understanding of what my options are and how my current period hardships may impact them, if at all. There is never a wrong or right time to get a fertility check. You don’t have to be ready to have a child immediately or struggling through years of infertility. Your only requirement is being curious about your own health. “If you have any questions at all about your fertility, it’s a great time to have an assessment,” adds Klauck. “[This] does not mean you need to do any testing or physical exams, it can simply be a conversation. Your care will always be centered on you and your goals.”
The Tia patient exam rooms feel like a natural extension of their inviting, stylish waiting room rather than a sterile, staunch, traditional space. There’s a soft robe (instead of a paper robe) to switch into if you’re having a full gynecological exam. And the easily 50’ inch TV that’s mounted on the wall cycles through Tia’s offering, mission, and your own medical information that the doctor will be guiding you through.
While the space definitely feels modern, it more importantly makes you feel seen.
When my provider walks in, she starts by simply saying hello and getting to know me as a person. I feel her honesty emanating from her. She then walks me through what a fertility test entails — we’ll be testing and interpreting my hormone levels. She asked me follow-up questions when I mentioned my desire to have kids one day. She also contextualized my fertility health through the lens of culture (being Latinx) — no one had ever done that before. She mentioned that because most fertility studies were done with white female participants, as a woman of color, my fertility journey may look a bit different.
She also asked me more questions about my low iron levels and my heavier periods. I didn’t have to fight to be heard, instead, it felt like a two-way dialogue where she was truly listening and treating me as a partner in my health journey.
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“Some fertility issues can be easily uncovered through a fertility assessment, lab work, or imaging,” explains Klauck. “For example, polycystic ovarian syndrome (PCOS) is a common hormonal disorder that can often be diagnosed through careful history taking and lab work or ultrasound. Diagnosing PCOS is the first step in addressing any fertility issues it may cause. Other fertility issues are not as easily uncovered but may be suspected based on your history, results, and your provider’s expertise. Understanding that you may be at risk for infertility can help guide decisions if and when you decide to try to conceive.”
It made sense why my provider asked about both my current menstrual health and family history because it was all connected. I wasn’t treated as a collection of body parts like in previous OB/GYN visits; this was holistic and looked at me as a whole person. It gave me confidence.
My visit to Tia became the new standard for what future healthcare visits should look like. I like going to an office where a doctor cares enough to sit with me for 30-minutes instead of rushing through a 15-minute (or less) checklist of a visit. I appreciate the warmth of the space they’ve designed because when you’re talking about menstrual health, fertility, or any other sensitive or vulnerable topics, it should feel safe.
Learn more about Tia, and get comprehensive in-person and virtual care to support your physical, mental, and reproductive health.
Vivian Nunez is a writer, content creator, and host of Happy To Be Here podcast. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.