Nestled conveniently off the 41 and across the street from Fresno’s best Mediterranean Grill and Cafe (don’t @ me) there is a new hidden gem. The Fresno Collective for Inclusive Medicine Inc., or Fresno Inclusive for short, is a curated space, where healthcare intersects with community, envisioned by Dr. Julie Nicole (she/her) and Dr. Sam Schmitz (they/she). Officially incorporated October 24, 2024 with telehealth services in February, they officially opened their doors on March 17, 2025.
When you walk into Fresno Inclusive’s temporary location on Tulare St., your eye will catch a colorful bookcase followed by a waiting area straight out of a hip household in Old Fresno, all cast in generous natural lighting. From the waiting room to the cotton robes and (hand sewn) examination pants, the emphasis on comfortability evident in the attention to detail is an indicator that the founders care about their patients. Warm colors and post modern style furniture welcome you to make yourself at home.
When making decisions about their clinic, Drs. Nicole and Schmitz consider patient comfortability and sustainability. Photos by Mars Santos.
Why Does Fresno Need Fresno Inclusive?
When Dr. Schmitz first moved to Fresno, they shared that despite being a physician who understands the healthcare system, they "could not find one [doctor] in Fresno that was affirming" that wasn’t their supervisor.
“I think that the biggest problem is that there's a lot of queer people here, and I think there's a lot of people that would want to stay here, but the job opportunities in the community don't support it… When I moved here, that was part of the problem. I'm like, I'm a physician. I should be able to navigate the system to be able to find a doctor that is (affirming),” Schmitz told uSpark.
They added that they could not imagine how challenging that must be for a person who is not a physician and already has the barrier of navigating the complicated healthcare system.
Dr. Nicole emphasizes that while there is a need for gender-affirming care (which they do provide) they want to be seen as a comprehensive clinic where patients can receive all their healthcare needs in an affirming environment where providers treat them respectfully.
"Trans people have diabetes too. They have hypertension, they need primary care, they need pap smear. They need STI screening… So to boil it down to only gender affirming care is just care that is affirming. It's good primary care, it's good gynecological care for everyone because you can come not even being trans, but being queer and come to a space that is affirming,” she explained.
In addition to comprehensive, affirming care The Dr.s will use funds from the for-profit clinic to help support their new community center, a space intended to "provide a home to support the nonprofits that already exist."
We wanted to hear directly from LGBTQ+ community members about their experience receiving medical care in Fresno, so we interviewed Jayda (they/them), Daney (he/him), and Allie (she/her).
Jayda has been satisfied with the care they have received at Planned Parenthood. Daney feels similarly with a few caveats and is excited to hear there is a new option. Lastly, Allison, (a former and now current patient of Dr. Nicole), who has faced countless barriers before, during, and after her transition, is thrilled about the opening of Fresno Inclusive.
Jayda (they/them)
There are limited options in Fresno for affirming care. For many members of the queer community, Planned Parenthood is a popular choice.
Jayda (they/them) has been going to Planned Parenthood since they were 14. When asked about their experience receiving services there, they responded that they have always felt comfortable, the nurses kind and the providers knowledgeable. They trust that they are “in good hands”.
“It's unfortunate… some of my friends have talked to me about it before and they'll be like, oh, I just can't stand dealing with such and such. I’m like, oh, I'm sorry, I just haven't had the same experience,” Jayda told uSpark in a phone interview.
Appointment wait times are usually around two weeks which they are accustomed to so they plan accordingly. A downside they shared was that doctor’s often did not stay at the clinic long. Despite that, the doctor’s they have encountered have always met their needs.
“You might not have the same doctor for a while depending on how often they move on from the areas and stuff they live in…but I’ve always had some pretty good luck with Planned Parenthood,” they said.
Daney Riojas (he/him)
Daney Riojas (he/him), has also had mostly positive experiences with Planned Parenthood since starting HRT in November 2024 with the caveat that the quality depends significantly on the location and level of understanding of LGBTQ+ care and specifically the trans experience. He reports having had better experience with doctors who are queer or LGBTQ+ specialists.
“With my experience of being very open about being trans, I think you're better off going somewhere where they have specialists or even other queer people to help you. Just because a lot of times cis people or non-queer people may not understand specific struggles,” Riojas stated in an interview with uSpark.
He also reports that when starting HRT, he would have appreciated more information on changes he could experience in his body, and not just the very basics because everybody is different.
“I shouldn't have to go on Reddit to get the actual nitty gritty of smaller things that happen to my body. My doctor should be able to tell me, ‘oh, and here are some other experiences that trans people have had,’”
At the time of our interview, Daney had not heard of the new clinic but was excited to know that there are more options in Fresno now.
Allison (she/her)
For Allison, access to gender-affirming healthcare has long been defined by wait lists, misinformation, and emotional exhaustion.
“Back in 2018, there was only Planned Parenthood and Dr. Nicole,” she explained. “Dr. Nicole was doing private HRT, but she was super booked out—it was four months just to get into her clinic, then another two or three months for my HRT appointment. I was 15 minutes late, and it was another two months. I was sobbing in the hospital elevator. The lady there thought I’d been diagnosed with cancer”.
Beyond the logistical barriers, Allison has repeatedly faced medical bias—what she describes as “trans broken arm syndrome,” where unrelated health concerns are dismissed as a side effect of her identity.
“I went to a doctor about a lump on my back, and she said, ‘Oh honey, those are love handles. What’s going to happen when you start estrogen?’ I’d been on estrogen for five years at that point.”
She also described being given subtherapeutic doses of estrogen—what the trans community refers to as “Han dosing”—that left her with persistently low hormone levels.
“Doctors are still using guidelines from the 1970s and ’80s. People are stuck on one milligram for years, wondering why they aren’t seeing changes. It’s miserable.”
While she was grateful to have found Dr. Nicole, Allison says the experience of getting care at an OB-GYN clinic often came with discomfort.
“It was always in an OB-GYN clinic. I’d be sitting there surrounded by pregnant women and their scary-ass boyfriends scowling at me,” she recalled. “Even though Dr. Nicole is a sweetheart, the staff constantly messed up my name and gender.”
After Allison received her gender- affirming surgeries, she stopped seeing Dr. Nicole because she knew the demand for LGBTQ+ providers was high. Sacrificing her spot with Dr. Nicole meant someone else could get the affirming care they needed. To Allison, a place like Inclusive represents a profound shift in care.
“Now (Dr. Nicole) is just down the block, and it doesn’t feel like a burden anymore,” Allison said. “It’s a space built for us. I’m not fighting the entire trans population of Fresno just to get an appointment.”
The impact of affirming care goes far beyond prescriptions. “I had never gotten a job before my facial feminization surgery. I was agoraphobic. I just felt so fucking disgusting and I couldn’t be seen,” she said. “Now, I have a salary, a fiancé, a house. I forget that I’m trans sometimes. It’s just a part of who I am now—not this insurmountable thing.”
The Medical Clinic
The medical clinic offers these medical services:
- Gynecology services
- Family medicine (coming soon)
- Pediatrics
- Electrolysis
- Gender-affirming care
- Primary care
- STI screening
- Mental health medication management
- & more… call to inquire about your needs (559) 889-3246.
Key Aspects:
- They're designed to be an affirming space where providers ask for pronouns and use lived names.
- Many employees and physicians have shared life experiences with the LGBTQ+ community.
- They aim to provide complete healthcare in one location, not just gender-affirming services.
- Care for entire families, including children
- Short wait times (patients can typically be seen within a day or two if their insurance is accepted).
- THEY ACCEPT MEDI-CAL.
They're planning to expand to include more mental health services and therapy options in the future.
The Community Center
When the permanent location for the clinic is complete, they will transition the temporary space into a non-profit community center. The primary goal of the center is to be a space for nonprofits that cannot afford their own facility.
"Our goal was more to just house a home where people can work out of and host events out of, in a kind of communal center, like a co-op."
The center will have various seating areas, reception desks with resources, group work spaces in the back for nonprofits, and office spaces that organizations can sign up to use.
While some events may be grant-funded, the core operations are supported by clinic revenue. Because the community center is financially sustained by the profits, this creates stability for the center addressing a significant problem in Fresno, which has seen three LGBTQ+ centers open and close over the past decade due to unstable funding.
The space will be free for nonprofits to use.
"We are an affirming space. We are built by the community for the community.”
They say, sometimes you don’t know what you have until it’s gone. Other times you don’t know what is possible until you have it. Fresno Inclusive is unlike any medical space that exists in Fresno.
Fresno Inclusive Contact Info:
Website: https://www.fresnoinclusive.com/
Phone#: 559-889-3246
Instagram: @fresno_inclusive