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One of the big challenges we have in healthcare for the LGBT community is an incredible lack
of data. Because the federal government doesn't study LGBT folks well, because we don't ask
the right questions in medical settings, we don't know a lot about our community. One
Colorado prioritized actually a survey of... Coloradans a couple years ago prioritized
health as one of the issues that the LGBT community was concerned about.
I think any woman could relate to the anxiety that comes with getting your annual pap smear.
I was twenty-three years old I was going to my doctor to have my annual. That was right
about the time when the HPV vaccination was coming out. What you hear on TV isn't you
know commercials it's not a clear on what it is it just says ask your doctor about it.
I asked the doctor and I was like, well, um... what is HPV vaccination and should I get it? She
basically said "but you're lesbian right" and I said "yes" and she's like, "oh, well then you don't even
have to worry about it." To think that I was restricted from a super important and almost
lifesaving vaccination because of my identity, where the doctor didn't even go into further
detail or further questioning of my *** history and just made a judgment call on whether
or not needed the vaccinations, was pretty scary.
I felt that people felt uncomfortable coming out. They felt they were going to be discriminated
against because of their orientation. Because of that barrier, feeling uncomfortable identifying
who they are, they often wouldn't seek services. So what you end up having as a consequence
is that you have people suffering from chronic disease, higher rates of smoking, high rates
of alcoholism and substance use, high rates of domestic violence in LGBT populations.
So I think it creates an issue where people should be seeking care and they're not, and
so we have that disparity because of that. I think one of the first things I would do
is, I would really demand that we can start collecting better data because as we know
more information, One Colorado did working with CDPHE in local public health is to try
to come with the best available data and I think that's a good start. I think that there's
disparities may be worse than that.
I remember going to my family physician you know for a regular checkup I don't know if
I had a cold or something and I went in and just the treatment that I received was different
the conversation was different. You know this is a guy who I had went to since I was very
young, someone who had been my family physician for a really long time. I just remember the
climate was different. It wasn't necessarily anything he said or did but the knowledge
that he had heard this thing. I found this book that was on my parents table one day
and it was a book about reparative therapy. I had found out that he, my family physician,
had actually given that to my parents as perhaps a way to fix me or cure me. I think that in
any community, doctors are really respected within our society. I think that's especially
true in smaller communities. You know, if I'm supposed to be sharing, talking with my
doctor about my *** health, or any other aspects of my health, but I don't feel comfortable
because I know that he doesn't think that being gay is okay, I'm likely not going to
go to that physician or be open and honest with them.
The timing by which you disclose whether or not you're gay or not really sometimes has
to do with the providers' timing. So, I've had some difficulties in the past with just
that timing. Do I lead this conversation or does the provider do that for me and then
I'm in a position of having to respond to that conversation? Some of that is again learning
on the part of the provider, learning on the part of the patient, about who leads this
conversation that's very important about *** orientation in health. I'm a breast cancer
survivor. I was diagnosed with breast cancer by a male physician, who talked to me at great
length about my negligence in breast care. The insensitivity around that conversation
actually made me pretty opposed to having pretty straight conversations about my own
health. Some of this insensitivity really had to do with my *** orientation, had
to do with statistically how often as lesbians and bisexual women we sometimes disregard
preventive care. Those conversations didn't happen in this provider relationship. I didn't
know how to relate it to the community that I was in as a black person. I didn't know
how to relate it to the community I was in as an LGBTQ person, no context what so ever.
And the reason I didn't have context is that I had a provider that didn't have context
to describe to me, what I was going through. That was a painful process and it's a process
that I talk to people about a great deal now, and that is having context for your health.
So one of the things that we asked in this survey last year, was whether or not people
perceived their medical provider to be LGBT friendly. We noted that, very importantly,
that people who perceive their provider to be friendly to our community, to be friendly
to our families, those patients actually got better care, or at least they reported better
care. They went to see their primary medical provider more often. They were more likely
to get a wellness check or an annual physical. They were more likely to get tested for ***.
They were even more likely to get a flu shot, which is huge. And so that friendliness, being
perceived as a provider to be friendly to the LGBT community, we think actually plays
itself out with regard to patient outcomes.
So, when I was starting to transition, it started early on with just going to the health
clinic on campus. It's amazing how much changes in just a couple years. The first person I
talked to was completely uninformed about hormone replacement therapy, HRT. So, I didn't
go back to that clinic for like two years or something because I was like well they
obviously don't know what they're doing, they're uninformed. When I finally did go back, I
had heard from a friend that there was someone new there who had worked with trans people
before, knew what to do, was working with a doctor that has a really good reputation
in Denver. I went to her and she was awesome. She knew what she was doing. She knew how
to get me started on hormones, was very respectful. It was like night and day from my first experience
in the campus clinic to the second experience. If we're going to try and make change, it's
about going to even the little independent clinics and saying "hey can you make it such
that you don't have to select Mr. or Mrs. in your system?" That can be a huge change
for people. It is frustrating and I think that there are a lot of people who get stuck
and can't find a way out, or the way they find out just puts them in a horrible position,
and an uphill battle for the rest of their lives.
We have been an invisible community for a long time. It's time to come out of that.
It's time to come out of that in doctors' offices across this country, in clinics, in
healthcare systems. It's time for us to have courage.
You know I think doctors get into this work because they care about people, and I think
that at the end of the day that's what's going to happen. We just need to do a bit of work
to get there.
Being members of the LGBT community, yes, we do have to be more informed. But how amazing
is that, to be more informed? More information is power, knowledge is power.
It's incredible important for medical providers to ask the right questions, for us to come
out. Only after we do that, only after we have those conversations that are open, will
we begin to see those disparities decrease between LGBT Coloradans and their straight