Among the LGBTQ community in the South, Houston is known as one of the safer havens, mostly shielded from the dangers found in smaller zip codes. Yet despite the city’s reputation as both a comparatively queer-friendly oasis and a world-class hub for all things health and medical, it still falls short when it comes to providing compassionate, informed care for pregnant LGBTQ people—not to mention educating them on their rights as patients.

“A lot of concerns that we have are not concerns that heterosexual-passing couples necessarily have,” says local doula Max BurrusWebb. “It’s really hard to talk to doctors about certain things because we don’t have that common language, common experience. So part of what I do is bridge that gap into medical speak.… A lot of things are different when you’re gay.”

BurrusWebb is part of the TLC Doula Group (“TLC” here stands for “Total Labor Care”) located in Old Town Spring, a Houston suburb that hasn’t always been queer-friendly. The co-op offers a wide selection of services to address pregnancy and parenting concerns for LGBTQ partners and individuals, who often find themselves isolated when health care providers fail to understand their lives and experiences.

Lack of informed pregnancy care for LGBTQ people can include—though is not limited to—misgendering, inadequate postpartum depression treatment, ill-informed support regarding hormones, and even outright refusal of service. Challenges in the U.S. health care system at large only exacerbate these issues.

“My generation and the generation behind me were taught to never question authority figures, to always do as you’re told,” says Kathleen Wilson, co-founder of the TLC Doula Group and TLC Birth Alliance. “That has resulted in a community of health care recipients that don’t know what they don’t know. We have to reteach people that you are expected to be an active participant in your health care.”

Wilson cofounded TLC Doula Group in 2010 to empower pregnant people to know their bodies and express their needs. This group now operates beneath a collective called TLC Birth Alliance, which serves as an umbrella for individual pregnancy and birth professionals working on a contract and co-op basis. It isn’t a formal business. Rather, it’s a collaborative partnership between like-minded individuals who work to ensure patient comfort, safety, education, and autonomy.

They exchange resources, attend births together, provide peer reviews, and fill in during appointments when newborns make surprise debuts. As Wilson puts it, TLC Birth Alliance provides almost anything parents could need from conception to infancy, with the exception of midwifery and the actual delivery. From the original group of three doulas, the organization has since grown to include seven, along with a dietitian, a photographer specializing in pre- and post-natal portraits, an acupuncturist, a feeding specialist, and a pelvic floor specialist. Plans are underway to bring a massage therapist into the fold as well.

“I love the medical establishment, but a lot of the things that they do in pregnancy, they do without understanding why they’re doing it or the purpose of what they’re doing,” Wilson says, pointing to vaginal exams after the uterus’s water has broken as an example.

Ashley D’Annunzio, owner and photographer of Best Nest Portraits, first came to TLC Doula Group as an openly queer mother-to-be patient before moving her own business beneath the TLC Birth Alliance umbrella. She started attending the gender-inclusive parenting groups offered through the co-op when her child was three months old, finding solace and community in an environment where her sexuality was never an obstacle.

“There is a lot of judging and mistreatment that can happen, especially in the medical industry. People are not always sensitive,” she says.

Wilson and BurrusWebb can’t give an exact number of LGBTQ parents who seek out TLC Birth Alliance, as not everyone volunteers such information. Regardless, they give all their patients a comprehensive breakdown of what to look for when seeking a delivery doctor or midwife.

No single best OB-GYN or midwife exists, Wilson explains. Pregnant people should choose a provider who ideally suits their unique needs. However, she recommends opting for a professional who emphasizes education by giving complete answers to questions and asking questions in kind, and who displays the nimbleness needed to respond to what patients ask for at any given moment.

TLC Birth Alliance’s members hold education as a core value of their practices. The doulas in the group pay close attention to how medical personnel treat their patients, then pass this knowledge on to anyone in their care. Ultimately, it’s up to the pregnant people to decide whose services they’ll use for monitoring their health throughout the process, with TLC Birth Alliance bulwarking them with everything they need to know to make the most informed choices.

Such an education sets a precedent with patients, one that will serve them long after they’ve given birth. They can carry that power with them in future medical appointments, pass it down to their children, and inform loved ones about how to nurture their own sense of self-advocacy. Effective care sends ripples out into the community. One such epicenter flows outward from a friendly office in Old Town Spring.