For People, Not For Profit

With Fenway’s growth into a larger organization came more deliberate ventures into new fields of research and care—all with their associated education and policy programs. As early as 1983, when much of the Center was engaged with the AIDS epidemic, Fenway Health became one of the country’s first providers of alternative insemination, a field in which Fenway still leads. The hiring of Dr. Judith Bradford in 2000, and the establishment of The Fenway Institute in 2001, allowed for the expansion of research studies to include LGBT health issues in the U.S. Department of Health and Human Service plan, “Healthy People 2010” (and now 2020), addressing health disparities among diverse populations across the nation. Today, Fenway’s influence on LGBT health is international, with formal research studies in two locations in India, and collaboration with health professionals in least seven other countries to establish research programs, health centers, and education programs. Programs to address domestic violence, anti-smoking education aimed at gay men and women (bolstered by research findings that lesbians are nearly four times as likely to smoke as heterosexual women), one of Boston’s earliest alternative insemination programs, AIDS prevention programs aimed at men of color, and a significant behavioral health program are all part of Fenway’s four decades of commitment and care. The center’s behavioral health programs have changed and grown over time as well, providing psychological care and counseling to address crystal methamphetamine abuse, depression, and other concerns that dispropor- tionately affect Fenway’s target populations. The expansion of these services led the organization to outgrow two health center “homes” and several additional rented locations until March of 2009, when it moved into 1340 Boylston Street, with its ten floors of medical, research, education, and conference space. …This progress may not have always been in a straight line. In its earliest days, the Health Center weathered a number of external threats, including opposition from the Christian Science Church, which, as owner of its first location at 236A Huntington Avenue, was unpleasantly surprised to find a health center as one if its tenants. Throughout the 1970s and 1980s, a number of Boston’s leading hospi- tals and state health officials challenged Fenway’s provision of care—first because it was not formally licensed, and later because it was providing outpatient care and nontraditional treatments to AIDS patients. The organization twice fell upon difficult financial times—once in 1980, and again in 1985. The dominance of the AIDS epidemic on Fenway’s program development in the 1980’s and 1990’s at times caused strains with other key constituencies. It took a surprisingly long time for the organization to embrace transgender people, despite an early commitment to their care by a few individual staff members in the 1980’s. The remarkable combination of medical planning, organizational focus, fundraising success, and creative real estate financing that led to the opening of 1340 Boylston Street in 2009 may have created an unintended unwillingness among closeted gay men, or perhaps closeted gay men of color, to use such a visibly “gay” health care facility for their HIV and other sexually-transmitted disease screening and treatment. As a result, Fenway Health and its Fenway Institute have founded Fenway: Sixteen, a re-established walk-in facility offering services tailored for these individuals at Fenway’s historic 16 Haviland Street headquarters, with its more discreet, community-based location. The health center’s efforts to expand access to its services has also led it to operate South End Associates, located at 142 Berkeley Street, in 1992; and to acquire the Sidney Borum, Jr. Health Center, which serves gay and lesbian youth, in 2010. But even without a straight line from its roots in the Nixon Administration to international leadership today, Fenway Health’s progress is remarkable—from a first-floor office furnished with medical equipment from a retired general practitioner and waiting-room chairs from a defunct movie theater across the street to a ten-story, $57 million building; from an all-volunteer staff of fewer than 20 people to a current staff of over 300; from three evening clinics a week to five and one-half days of medical, behavioral health, dental, and eye care tailored to the LGBT community but welcoming to all; and from 9,000 patient visits per year in 1979 to 80,000 such visits in 2010. The details of this progress make for a great story, one that is a joy to share with anyone interested in community health, organizational development, and the rich diversity of the city of Boston. The three Mayors of Boston since 1971 have been staunch supporters of Fenway Health. “I could never have gotten to first base without the real friends we had in the city of Boston,” remembers Sally Deane. She also remembers the people on Mayor White’s staff who have gone on to make important contributions in their own right: Elaine Noble, Barney Frank, Brian McNaught, and Harry Collings, to name a few. Finally, there is the personal relationship so many of us have with Fenway Health, a love story which comes across in so many of the tales included here. Mine has its most memorable moment in 1979, when, as Chair of the Fenway Health Center’s board of directors, I participated in a debate about continuing to offer free care by volunteers vs. requiring all of Fenway’s providers to be licensed, so we would be eligible for third-party payments and other government support. At the time, our board struggled with serious financial problems that threatened the organization’s survival. Many of the staff and board members who were part of this debate did not survive the AIDS epidemic. This book is dedicated to one of them in particular, and it is also a tribute to them all.