Although Pride Month celebrates the progress and impact of LGBTQ people locally, nationally and internationally, it also highlights the differences and challenges they face.
According to a 2016 Missouri Foundation for Health data sheet, LGBTQ people are twice as likely to receive medical care as the general population. In addition, they are more likely to have poorer access to care and poorer health outcomes than heterosexual people.
In his 30 years in medicine, Dr. Stephen Adams, medical director of the Ozarks AIDS Project, said he has not seen much change in attitudes toward LGBTQ people in Springfield. But “there is an improvement.”
“We have a couple of documents that will take care of transgender people and prescribe PrEP. We don’t have a lot of people in the village who are comfortable with not only doctors (infectious diseases) but also care,” Adams said.
PrEP, which indicates pre-exposure prophylaxis, is a medication that people can take to reduce their risk of developing HIV through sex or drug use. It comes as a pill or a shot.
All the stigma, discrimination and bureaucracy come together to keep people from getting the attention they need, and local advocates say that education is the only way Springfield can change that.
Dani Lacio, coordinator of the GLO Center’s Ozarks Inclusion Project, hopes to expand the list of providers in the area who can treat LGBTQ people. Currently, GLMA: Health Professionals Advancing LGBTQ Equality has only 15 providers listed in Springfield, many of whom are consultants.
When people ask for primary care, they may come across a provider with “Broken Arm Syndrome”; when a health care provider, consciously or not, believes that all medical problems are the result of someone being trans.
More: ‘Being transgender is not a medical condition’: the meaning of trans-broken arm syndrome
Lazio has experienced “Broken Arm Syndrome” live.
At age 28, they were diagnosed with estrogen-positive breast cancer, and had to undergo a hysterectomy. But since they are not binary, they had to go to five different doctors before performing the procedure.
“I made it very clear that I was non-binary, that I didn’t identify as a woman, that I needed to move away and be denied once I heard that (insurance) trans definition,” Lacio said. “They were trying to deny me a hysterectomy (hysterectomy) and saying I was trying to do gender confirmation surgery.”
Lazio studied history during his undergraduate degree, and said he still sees much of the idea of gender in the 1950s in health care as well.
“We have this boy / girl mentality, yes / no, inside the box / outside the box,” Lacio said. “There’s no spectrum (when people understand) and that’s what we have to go through and understand: there’s a spectrum. Just because I’m not binary doesn’t mean that the next person you know will be identified in the same way or be. The same experience.”
A traumatic visit to Springfield 2017 for urgent care was part of what prompted Cecil Cornish to move to Joplin.
He was a college student at Cornish until a sexual couple told him not to talk about it with other partners.
“I was sexually active, like most college students, and I was scared of HIV, I would say,” Cornish said. Therefore, he sought post-exposure HIV testing and prophylaxis or PrEP.
While in urgent care, Cornish described him being treated “like a leper”: When he entered, he “flipped” and had to wait in another room to receive attention.
When they saw Cornwall, she said the nurse asked her why she needed an HIV test and explained the details of her sexual relationship. He then apologized from the examination room.
More: The short-lived SOGI ordinance in Springfield protected gay and trans residents. Is it time to try again?
“I heard nurses on the floor tell me how I had sex, when I was just having sex, what active sex I had,” Cornish said. “I could hear them laughing, and I could hear them just receiving a kick that scared me because I had HIV. This is disgusting. How they treat me is disgusting.”
When students take turns through APOs, Adams makes sure they discuss how to normalize attention and remove judgment from the exam.
Adams gave the example of asking a patient about his or her sexual activity: “Are you having sex with more than one person? PrEPaz “.
“(You don’t say) ‘Oh, don’t do that.’ I can’t tell you to stop doing that, and even if I did, you won’t stop doing it. So it’s my job to normalize, “Adams said. “‘Okay, this is normal. I’m here to help you stay safe.'”
For the Cornish, it was a terribly painful experience.
“I remember seeing the nurse doctor after that because I felt embarrassed crying in my car,” she said. “I said, ‘I’d rather have HIV than have to talk to that woman, talk to her like I’m evil all the time.’
Cornwall had a negative test for HIV, but said he backed down when it came to getting PEP.
“The lady I was talking to literally had no idea what I was talking about. She asked me and treated me like I was guessing,” Cornish said.
Cornish said she was defending herself by telling the nurse what medication she wanted and which pharmacy to send it to. Although he doesn’t think the woman was acting cunningly, Cornish worries about what might happen if someone who is weaker enters.
“It’s a lot of ignorance. That woman, I don’t think, wanted to hurt my feelings personally or make me feel bad about myself, but the fact is that she was so indifferent and dangerous,” Cornish said.
More: Springfield Achieves Below-National LGBT Equality, Showing Improvement Since 2017
A 2015 study found that medical students receive about 5 hours on LGBTQ health issues. Adams believes more doctors need to know about the options and outcomes of HIV treatment.
“Life expectancy is no different for someone with HIV. Most people will take a pill once a day with almost no side effects. And once you are undetected, you run the risk of passing HIV to someone else. It’s zero, information most doctors don’t know it is also “.
Adams sees education as a key to removing stigma and improving health care for LGBTQ populations.
“I think if we really want to change attitudes, we need doctors who are trained in places like San Francisco, New York, Miami and Atlanta, because that’s where they’ll see a more diverse patient population,” Adams said. he said. “Springfield is not the most diverse place on the planet.”
Although there is still a long way to go to improve care, Lazio is seeing some encouraging signs, such as the sex assigned at birth and the 13-year-old son’s physical sports form that required sex now identified.
“It’s so small, but that’s still a big first step,” Lacio said.
In addition to these small signs, Lazio is also working with CoxHealth and Burrell to help doctors better educate LGBTQ people on how best to provide care. Mercy said its health care system provides employee inclusion and annual education.
“Education is the way we change things.”
Susan Szuch is a Springfield News-Leader public health and policy reporter. Follow him on Twitter @szuchsm. Story idea? Email email@example.com.
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