Creating such a place that provides free-of-cost gender-affirming care was monumental for Mapu Maia's founders, many of whom grew up with limited access to such care.

Vaina, who was born and raised in a small village in American Samoa, recalled the experiences of growing up in a place where gender-affirming care was not readily available.

"Growing up on a small island, there isn't any accessible healthcare for Transgender people," she said. "The hospital we have there doesn't offer hormone replacement therapy.

"Many in the practice argue that gender-affirming care is not necessary. But we, as Transgender people, Fa'afafine, Mahu, Irawhiti, and all of the above, have lived experiences that cause us to say we beg to differ."

"Gender-affirming care has proven to improve behavioral health for a lot of our community [and] decrease the level of suicide in our community. Gender-affirming care has, overall, saved lives," Vaina added.

Abundance, autonomy, and harmony
UTOPIA Washington's volunteers know how crucial gender-affirming care is. Their vision is to create a world of abundance, autonomy, and harmony, where all forms of supremacy cease to exist for all life.

Providing healthcare was essential to this, so the organization set out in 2017 to open its healthcare center. The goal was 2027, but on Wednesday, it opened four years ahead of schedule.

However, even before the opening of Mapu Maia, UTOPIA Washington had been providing low-cost healthcare, such as STI testing and COVID-19 vaccines. These services were appreciated but not enough. So in 2022, the organization connected with Callie Naholowa'a, a registered nurse with valuable experience building a clinic. Naholowa'a will be working at Mapu Maia as a volunteer nurse.

Of course, the clinic could not open or operate without a doctor. For months, UTOPIA searched for someone willing to donate their time and medical expertise to the clinic. Finally, they found Dr. Malik Fuimaono, who will generously volunteer one day a week, commuting nearly two hours every other week and appearing by telehealth when he does not drive in. His availability will vary, but the clinic is open and scheduling appointments for the next four weeks.

On the days he is unavailable, Mapu Maia will still be open to provide other services, such as bloodwork.

The clinic is still actively looking for more medical personnel, particularly members of either the Pacific Islander or LGBTQ+ community, who are willing to volunteer some of their time.

Once all the plans were set in motion to open the clinic, there was still one last and very important step.

"We [needed] a name for [the] clinic, a name that means something to our community," Vaina said. Board members brainstormed for weeks until they finally found the perfect one.

"Mapu Maia in Samoan is a sentiment given to express to someone who has had a very long or rough journey: we see that, and we are going to provide a space for them to rest, to help them," Vaina said.

"We see the challenge our community has [faced] as a very rough journey," she continued. "Today I want to say to all of you that are here, 'My dear, may we find relief in this house.'"

Care for all
Mapu Maia provides relief in many ways. Not only is the clinic open to anyone, but it will always be free.

"We will not turn anyone away from here, regardless of if you can pay, if you are insured, not insured, if this is just a place you feel more comfortable," Naholowa'a said. "For any reason, you can access care here. We do not collect insurance information at all. We do not collect payment at all. All of our services are provided free of charge."

While the clinic has a focus on gender-affirming care, it will provide a myriad of services. "From a service perspective, we are going to be doing PrEP care, we are going to be doing gender-affirming services, general practice care. We will be doing all STI and STD testing, HIV testing, and anything that falls under a general care procedure," Naholowa'a continued.

"If you're here for diabetes, if your blood pressure is high, we'll be able to help you and provide medication for you as well," Dr. Fuimaono added. "My specialty is very broad. If you want to come in and chit-chat about how you feel about your primary care doctor, I can probably help you out. Especially with the lens of somebody who is Polynesian, there are some social issues that other people are not aware of. If you need a local Polynesian Island doctor, I would be happy to help."

"We're also going through a series of trainings, so we're also going to get our whole staff, including the director, up to speed with how to provide culturally competent care to our community," Vaina said. "There is one thing we're not willing to negotiate on, and that's the values that our community carries, so that is why, as you can see, we need to have our medical director and our nurse be from our community."

While all in-clinic services are free, if patients need to be referred to a specialist somewhere else, they will have to pay for those other services. However, everyone at Mapu Maia is certified in Medicare enrollment, so they can assist uninsured patients in accessing the most affordable healthcare possible.

Mapu Maia is located in Kent, Washington, but it is willing and able to serve people from just about anywhere. For those unable to come into the clinic, staff will set up telehealth appointments with the doctor (for anyone in Washington state), although lab work still needs to be done in person. Care will also be provided to residents of other states, just so long as they come to Washington.

Still growing
Wednesday was only the beginning. Now that Mapu Maia's doors are open, UTOPIA Washington is ready to provide essential services but is still looking to expand.

"Some of the things we are working on are accessing [more] gender-affirming care," Vaina said. "There are some procedures where you cannot get approved by whatever insurance you have unless you have the write-off or sign-off from a therapist." The clinic hopes to eventually find a volunteer therapist who can help with this.

Mapu Maia also includes Hale Kokua, a small food pantry. Behind the clinic, dry and nonperishable goods and fresh, locally grown fruits, vegetables, meat, and dairy are stored. The food is also free to anyone who needs it. Anyone who cannot physically make it into the clinic for food can DoorDash their groceries for free.

The clinic has also partnered with Thrive Cosmetics to provide patients with free cosmetics and skin care items.

In summary, the new clinic will serve an essential role for the Queer and Trans Pacific Islander community by providing culturally competent care for anyone who needs it.