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Everyone should be able to have a safe, comfortable medical home for their routine care. This is a simple principle, but sometimes hard to put into practice. Dr. Carolyn Wolf-Gould, the medical director at FoxCare Center's Gender Wellness Center within Susquehanna Family Practice, realized this when she took her first transgender patient in 2007.

"I didn't know much about transgender care, but I told him that I would learn," she explains. "I soon realized how much transgender people's care has been marginalized. Because they needed doctors who understood their identity, they often relied on trans-specific specialists for conditions better treated in primary care, like high blood pressure and diabetes."

The Gender Wellness Center evolved to bring transgender health to the mainstream. This kept it embedded within Susquehanna Family Practice, even as it has expanded to include the work of mental health, legal advocacy, research, education, and surgical teams.

Wanting an inclusive, mainstream practice also drove questions about their space: was it welcoming to all their patients?

The Need

As the Gender Wellness Center grew, the time came to consider the practice's atmosphere and décor.

"Our team looked at the artwork in our space. Much of it was castoffs from my grandparents' house. There were Renoir prints of women in flowing gowns and pioneer pictures of homesteading families. Everybody was white; everybody was young; everybody was able-bodied; everybody was skinny; and, by implication, everybody was cis-gendered," remembers Dr. Wolf-Gould.

To make their space better represent their patients — which included many racial, ethnic, gender, and religious identities — Jacqueline Kelchlin, FNP, a medical provider in the practice, decided to pursue a "medical artistic partnership."

The Program

Founded in 1964, the Cooperstown Graduate Program, a master's degree offered by SUNY Oneonta, is one of the oldest museum studies programs in the country. "And one of the best! Though clearly I'm biased," says Cynthia Falk, the program's professor of material culture. Falk has been with the program since 2000.

The collaboration Susquehanna Family Practice proposed was a natural fit for the Cooperstown Graduate Program. "Serving local communities is one of our core values," says Falk. "We're also committed to diversifying the staff, visitors, and content of our museums."

What's more, these were skills essential to the museum field. "Spaces are important," explains Falk. "The way we design and furnish and display art in our spaces influences who uses them and how they use them. Some museums cast a certain vibe: Be quiet. Look. But don't run, don't make noise, don't socialize. Other museums have a very different feel: they want you to come, gather with your group, and join in conversation."

"If it can happen to a wall in a museum, then it can happen in any space. And in a doctor's office waiting room — where people are waiting during what could be a very tense time — these challenges take on new weight and meaning."

The Lessons

Innovation is often born of limitation. The Gender Wellness Center project included some provocative limitations.

The first affected image selection. "We had a minimal budget," Falk explains. "That forced my students to think differently about art. This wasn't about going to a museum catalogue and finding the old masters. Instead, they were exploring online art platforms to identify up-and-coming artists doing cool stuff now. And they did a great job."

There were also internal limitations to overcome as they explained their pieces to the broad audience of patients in a waiting room. "When I write museum labels, I want feedback from others," says Falk. "You are hampered by your own perspective and you seldom get it right the first time.

"My class was itself diverse, including individuals from a variety of backgrounds and faith traditions. That gave students the opportunity to bounce ideas off of someone with a very different perspective to see how they would respond."

The Connections

Graduate Students Looking at Artwork

The Cooperstown Graduate Program students weren't the only ones learning from this experience. Kelchlin and the Gender Wellness Center team found the students' video presentations pitching their favorite art pieces very moving.

"I was surprised by just how touched I felt by this project. First by Cynthia Falk's care for the community. And then it was beautiful to see the students' work. Because of the pandemic, we didn't get to meet them in person and they only saw pictures of our space. Yet they so thoughtfully picked paintings, presented ideas, and shared what inclusivity means to them," said Kelchlin.

"This has been a tough year for many reasons," says Falk. "In teaching and life in general. For me, I like to be in the space, I like to see volumes. And yet in this course none of us could visit the Center. It was surprising and rewarding to see how well virtual components worked. We can successfully collaborate on projects without setting foot in one another's spaces."

The Results

When the project was completed, the staff of Susquehanna Family Practice voted for their favorite pieces. They purchased three prints and may eventually purchase more.

"Now we have images on our walls that reflect racial and ethnic diversity. If you're a person of color, or if you use a wheelchair, or if you're LGBTQ, you're going to see images that represent your community," says Dr. Wolf-Gould.

The waiting room has become a place where patients sometimes learn from one another. "People connect there.  I've had several cisgender patients express gratitude for the conversations they've had there. Some then take steps to work on inclusivity in their own lives and tell us about that too."

"Inclusive Artwork is one way to express our aspiration to be inclusive. We all have implicit biases that are hard to acknowledge and work on, no matter how much we wish to deny that. When we make mistakes, it reminds us to stop, think, and try to do better."   

"We are open to suggestions on how to continue this work," she concludes. "And more artwork."