One Colorado: Invisible: The State of LGBT Health

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 sexual
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 sexual 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 sexual
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 sexual 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 HIV. 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 counter parts.

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