A Transitioning Nonprofit

By Mark Schulte, December 2018 Issue.

News stories about “illegal immigrants” have most likely taken over your Facebook newsfeed lately. They’re the stories of people in one country trying to establish a life in another one. At times, feeling like they don’t belong in either one.

What if you were one of these immigrants? But you were not only trying to find the right country but the right gender, too? How does someone who is in the United States without access to medical care get the attention they need to exist in the world as the gender with which they identify?

That’s the very question that Josef Burwell asked himself. He created his own answer: Peacework Medical. Because of him, Phoenix finally has an organization that can provide medical care to community members who are both undocumented and transgender.

Peacework Medical was first introduced to Echo readers last year, as part of Burwell’s Hall of Fame induction. Through that interaction, he shared details of Peacework’s contribution to aid in other countries, including Haiti, Cambodia, Honduras, Guyana, Ghana, and Belize. What each of these countries had in common was being hard-hit by natural disasters and/or poverty. Emergency aid had already arrived and made some progress in the recovery, but there was still a long road ahead.

Burwell, a North Carolina native who has lived in Phoenix since 1996, made sure that those who needed help the most had timely access to it. Much of the initial relief would have been concentrated in the easily accessible areas of those countries.

Seeing an underserved audience who needed help, Peacework Medical went to the remote areas where the people weren’t receiving the assistance they needed.

To sum it up, Burwell quoted Mother Teresa, “We went to the poorest of the poor.”

In doing so, he realized that people much closer to home were struggling as well. Immigration and Customs Enforcement (ICE) was picking up undocumented immigrants in Arizona and holding them in cells based on the wrong gender.

“They were being held as men,” Burwell explained, “and being assaulted and raped by guards and by inmates.”

Even those no longer being detained still were unable to live their truth. They were not only without medical options, but they were also struggling with gender identity issues. They knew who they were on the inside but didn’t have the resources to change their outside.

“Some of them aren’t the poorest of the poor,” Burwell explained, again referencing Mother Teresa. “They’re rich in spirit. But they are the most disadvantaged of the disadvantaged.”

Burwell understood the struggle. He had joined the Army as a closeted lesbian at a time when “Don’t Ask. Don’t Tell” hadn’t even been implemented, so he suffered constantly in silence, afraid that he would someday be outed against his will. His fears came true a short time later and he was held for months, tortured endlessly in an attempt to get him to name other gay and closeted soldiers. Finally released after refusing to be a snitch, Burwell went to college and became a Physician Assistant.

He eventually joined the CIA and – realizing that he wasn’t a lesbian, but instead a man born in the body of a woman – became the first active member of the traditionally conservative and stoic agency to transition.

As a medic in the CIA, he had provided care in a variety of countries around the globe. Then, as a founder of Peacework Medical, he did the same, but this time as a civilian volunteer. When he was approached in 2015 by people from Phoenix, including members of Trans Queer Pueblo, he was told that there were at least four to five trans individuals who needed immediate help, but the group said they could easily find more.

“It took about six to eight months to wrap up the Haiti relief,” Burwell said. “I managed to find a space here in Phoenix and immediately had nine patients who needed assistance.”

Today, Peacework Medical has nearly 200 patients. They’ve helped a number of women gain asylum in the United States because of their status as refugees who will be harmed if they were sent back to their home countries. Now, instead of fearing for their lives and their identity, these women have a local primary care facility that they can trust.

Some arrive at the clinic fully transitioned, happy to find a place where they can continue their care. Others had stopped their change because of either not being able to afford the necessary medications or having them taken away while they were in detention. They are now provided a place where they can restart their progress.

While a majority are women transitioning to men, there are also clients who are men transitioning to women, as well as gay men and lesbians. What they have in common is their undocumented status and that they would otherwise not have access to any medical care.

“That’s what Peacework Medical has always been about,” Burwell emphasized. “They would most likely not be getting medical care – any medical care – if we weren’t providing it.”

Burwell credits the organization’s longevity to its partnership with Trans Queer Pueblo. While not a part of Peacework, the group does find the patients, make the appointments, provide interpretation, assist with follow-ups and keep the complicated process flowing to those who need it most.

Burwell admitted that trans rights and immigration rights have both hit a wall thanks to the current administration.

“We’re seeing the people Donald Trump wants out of our country and he doesn’t care if they live or die,” he said, pausing before finishing his thoughts about the sad state of our country today, “and, some of our own citizens agree with that.”

So, while Peacework’s location has changed, its mission really hasn’t. Whether it’s for disaster victims in a remote part of Haiti, or transgender immigrants right here in Phoenix, Burwell and his team of volunteers continue to care for those who others have unfortunately neglected.

If this story has moved you to help make a difference – and we certainly hope it has – you can make a tax-deductible donation at peaceworkmedical.com to help Peacework pay for labs.
Even more importantly, there’s a need for clinical help.
“If you’re an MD, DO, PA, ND or NP, we welcome you. You don’t have to speak Spanish; we have translators. You don’t have to know the first thing about transition hormones. We’ll teach you,” Burwell explained. “And a lot of our work is follow-up and primary care. That’s something any clinician can help with.”
If you – or someone you know – is undocumented and in need of gender transition care, the fact that a place like Peacework Medical exists may be a revelation to you. The clinic is located in west Phoenix and serves marginalized and vulnerable communities who don’t have access to health insurance. Appointments are taken for the first Sunday of every month, with follow-up care provided as needed during the other times.
The most common way people find Peacework is through Trans Queer Pueblo; they can be contacted at facebook.com/transqueerpueblo.


Peacework Medical has touched the lives of almost 200 patients. While they may not be U.S. citizens, they are human beings in need of care. One of the group’s original – and current – patients, Paloma Dominguez, agreed to share her story with Echo to show the real effect the organization is having.

Echo: When and how did you come to the United States?

Dominguez: I migrated from my country (more than 20) years ago as an undocumented person, leaving homophobia and transphobia behind. I walked across the desert to get here.

Echo: Had you began your transition?

Dominguez: At that time, I was trying to get a hold of hormones regularly, but I (often) didn’t have enough money to buy hormones.

Echo: How did you first learn about Peacework Medical?

Dominguez: I came because I was invited by Trans Queer Pueblo…to go to the clinic to begin hormone replacement therapy.

Echo: What have they done for you?

Dominguez: (They’ve) helped me on a personal level, to make sure my physical health was good, and to have hope for my journey transitioning.

Echo: If Peacework didn’t exist, where would you be now?

Dominguez: I don’t know where I’d be. It’s really hard to find hormone therapy in the United States, especially for someone like me. The only way to get a hold of hormones is through the black market, which is dangerous. I don’t know where I’d be, but I wouldn’t be here.

Echo: What would you say to someone considering getting help from Peacework?

Dominguez: To have trust in the clinic. They give a helping hand and treat us well – the LGBTQ undocumented community of color.