Presenters highlighted identity stigmatization and low income as barriers to health care for LGBT people at the 2012 LGBT Student Health Symposium, organized by Howard Brown Health Center, the Center on Halsted and the University of Chicago School of Medicine.
“There’s oppression everywhere; it will impact us. We have to recognize it impacts mental health and the ability to access health care when people need it,” said Dr. Harvey J. Makadon, a clinical professor of medicine at Harvard Medical School and director of the National LGBT Health Education Center at the Fenway Institute in Boston.
His report for the Institute of Medicine indicates LGBT youth have an elevated risk for attempted suicide and depression, and sexual minority youth may have higher rates of substance use than heterosexual youth. The report also found LGBT people fear discrimination in health are settings, which prevents them from seeking routine care.
Makadon spoke in depth on transgender health care, explaining the importance of transition-related care. He also suggested adding sexual orientation, biological sex, gender identity and preferred gender pronoun fields to intake questionnaires.
“Transgender people often have to teach doctors because it’s hard to find a physician in the area who knows anything about transgender people,” said Makadon.
Representatives from Chicago Black Gay Men’s Caucus discussed the HIV epidemic in the black men who have sex with men community, which account for 52 percent of new infections nationally, approximately twice their white and Latino counterparts.
“When 2 percent of the population makes up 52 percent of infections, hello, we’ve got some issues,” said Craig Johnson of the Chicago Black Gay Men’s Caucus.
Magda Houlberg, chief medical officer of Howard Brown Health Center, explained the unique need for LGBT clinics, especially ones that offer patient-centered care, focusing on informed consent and harm reduction when advising patients. Many patients utilize the clinic’s sliding scale payment plan because they live in poverty and/or lack health insurance. While Howard Brown Health Center does offer primary care, the clinic is known for HIV related services and the transgender hormone replacement therapy program.
“[Howard Brown Health Center] actually serves patients from 30 states and one Canadian province. People travel very far for our services,” said Houlberg. “This illustrates the great need for LGBT health centers … We have a high percentage of folks who don’t have access to care outside our center or county services.”
Stigma around all identities, especially sexual orientation, gender identity, race and social class, can intersect and effect access to medical care, according to Piper Coutinho-Sledge, a sociology doctoral candidate at the University of Chicago. People with a stigmatized identity are also more likely to be in poverty and lack insurance, so that also keeps people out of the doctor’s office.
“Medical professionals have to be a fierce advocate for people who may not want to walk through your door,” said Coutinho-Sledge.Follow @QueerKnowledge