8 GROUNDCOVER NEWS INSP MARCH 20, 2026 Left: Living unsheltered means that even a minor wound can become life-threatening. But Wrexha never thought that she was vulnerable to such a “crazy thing.” “It scared me,” she said. Right: Wrexha sleeps where she can. She sees herself as a protector of women on the streets and still has a seething hatred of bullies. Photos by Giles Classen. The everyday medical risks of street homelessness GILES CLASSEN Denver VOICE When Teaya Wrexha woke up near Paco Sanchez Park, her thumb was already swollen to about the size of a squash. She dug into her thumb and began pulling out a bug that had burrowed deep into her flesh. “I think it was a millipede, maybe a centipede,” she said. “I was sleeping outside, and I woke up with my thumb burning. It was like the thing had gone inside. I squeezed it, and it hurt so bad. I thought I was gonna lose it.” Living unsheltered means that even a minor wound can become life-threatening. But Wrexha never thought that she was vulnerable to such a “crazy thing.” “It scared me,” she said. Wrexha tried to clean the wound with what she could find, but she did not have much to work with or any money. She had some antibiotics for dogs, so she took those, hoping that they would help. But her thumb continued to get bigger and bigger until she lay on the grass in agony, sometimes screaming in pain. Wrexha is transgender but does not take hormones currently. “I found my own gender. I took it back,” she said. She added that it is difficult to access gender-affirming care while living on the streets, and she is not sure how her body would react to the treatment, so she is waiting until she is more stable before she explores her options. “Why they tried to convince me I was a guy is the real mystery,” she said. “Because I wasn’t a normal guy, and I was bullied. Now I stand up to bullies.” Wrexha has been homeless since she was a teenager. She exhibited behavioral issues in school and struggled with ADHD and bullying. Ultimately, her father forced her to leave the family home. Wrexha sleeps where she can. She sees herself as a protector of women on the streets and still has a seething hatred of bullies. But one insect bite had immobilized her in pain, barely able to stand. The injury lingered, but Wrexha refused to go to Denver Health and refused transportation to other clinics. She said that she has learned to be independent and find a way in impossible circumstances. “I’m not going to Denver Health,” she said. “They treat us like shit. I’ve had too many bad experiences there.” Wrexha did get access to bandages and treatment and said that she hoped that her hand would heal without needing to go to a hospital or clinic. Most people understand that in the event of extreme weather, people living unsheltered on the streets are at risk. But, like Wrexha, many also experience dangers and traumas that are hard to imagine. Dr. Sarah Axelrath, a primary care and addiction medicine physician with the Colorado Coalition for the Homeless, said that the reality is far more complex and dangerous. Working through Stout Street Health Center’s clinics and street medicine teams, Axelrath treats people living outdoors across Denver. She describes a web of overlapping risks — medical, environmental and social — that most people living in housing never have to think about. “People who are unsheltered have higher rates of both acute and chronic illnesses and injuries,” she said. “We see a lot of acute injuries like accidental traumas, a lot of acute illnesses, like skin and soft tissue infections, and bad flus and pneumonias. And then we also see higher rates of pretty much every chronic medical condition you can name, including hypertension, diabetes, heart disease and cancers.” Environmental risks and more traditional medical conditions often coexist, she said, compounding suffering and making treatment uniquely challenging. Even when someone living on the streets wants treatment, accessing care can be difficult. “When you are homeless and unsheltered on the streets, you can’t just pick up and go to a doctor’s appointment,” Axelrath said. “They would have to potentially leave their tent unguarded with everything that they own inside. It’s like walking out of your front door with the door unlocked and wide open, inviting somebody in to steal everything you own.” Barriers compound from there. Transportation and tracking appointment dates and times can be difficult when someone has few resources. And it is common for people experiencing homelessness to have deep trauma from past medical experiences, leading to distrust of medical institutions. That fear and distrust, Axelrath said, is rooted in real harm. Many patients see STREET MEDICINE page 12
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