In 2016, Dr. Katie Bast and her partner, Mixhi Marquis, opened Mosaic Health and Healing Arts in Goshen, Indiana, to care for transgender patients in a state that has frequently proved hostile to LGBTQ rights.

(You can read more about that environment—and Mosaic’s patients—in Rewire‘s companion investigation.)

Part of what drew Bast to transgender health care was that she could relate to what her trans patients said about wanting to live a more authentic life.

After attending Mount Holyoke College in Massachusetts, Bast returned home to Indiana, married a childhood friend, and had three children. She worked as a midwife in Elkhart, Indiana, performing mainly Amish homebirths while her husband worked as a Mennonite pastor. Then Bast decided to go to medical school, and her world opened up.

“I fell in love, mostly with myself, with my ability to think, my ability to study, the bigness of the world,” Bast told Rewire. “And I also, by the way, happened to fall in love with [the woman] who I was driving back and forth with.”

Her husband supported Bast’s need to explore her sexuality.

Around the time Bast started medical school in 2009, Marquis, a former automotive engineer, was fighting to pass a human rights ordinance to protect LGBTQ residents in her hometown of Goshen from housing and employment discrimination. The measure narrowly failed. Marquis has advocated for gay rights since the 1990s, when she co-founded a group for fellow LGBTQ workers at Chrysler in Detroit; they met about 30 miles from the plant so people would feel safe attending.

After a mutual friend suggested Bast and Marquis should meet—they had similar energetic presences, the friend said—Bast scoped Marquis out on Facebook, then approached her at a Pride Week event Marquis had helped organize in a South End bar. The two became friends and then partners. Both remain married to men, who have been among Mosaic’s biggest supporters; they have been known to drop by Mosaic with coffee and baked goods, or to help with technical and mechanical support.

This year, Bast and Marquis hosted a Thanksgiving dinner that included their parents, Marquis’ husband, Bast’s mother-in-law and oldest son, and Mosaic’s nurse practitioner, Erin Flynn, and her husband.

“It’s fun to see how they have blended their families and fallen into it,” Flynn told Rewire. “It’s amazing.”

To see how Mosaic fits into the wider picture of transgender health care in Indiana, read our companion investigation.