Pride Month: Healthcare Self-Advocacy for LGBTQ Patients
As a听lesbian, gay, transgender, non-binary, queer, intersex or asexual (LGBTQIA+)听patient, you have, at some point, probably听had trouble听accessing health care.听Experiences of stigma or听discrimination may have prevented you from seeking medical treatment. The prospect of finding a provider who specializes in LGBTQIA+听health may be overwhelming.听Or,听you may听苍辞迟听be out to your family and听unable to听afford treatment without their听help.听听
Such barriers to care and treatment can take a serious toll on your physical and mental well-being. That鈥檚听why it is important to听understand your health needs and risks, and to learn how to advocate for your own听best听care.听
Being Your Own Patient Advocate
Start by听establishing听a trusting relationship with a gender affirming primary care provider听with whom听you can听comfortably听discuss听all aspects of your health,听advises Gregory McWilliams, MD, an attending internal medicine physician specializing in听LGBTQIA+ health.听鈥淚t鈥檚 important to establish a good relationship with a primary care doctor听who听you can be frank听with, and听who you trust听will听keep your conversations confidential,鈥 Dr. McWilliams says.听
Next, make sure that you are benefiting from comprehensive screening听for听typical听chronic conditions, such as,听hypertension, diabetes, and obesity,听as well as听specific听health听issues and听needs that听may be听difficult to discuss.听鈥淐omprehensive care requires us to make sure we鈥檙e screening the听LGBTQIA+听the same as we would the non-LGBTQIA+听肠辞尘尘耻苍颈迟测,鈥听Dr. McWilliams says.听
Among gay men, for example,听HIV treatment and preventative medicine听require particular attention.听鈥淭he vast majority of our practice is preventive,鈥 Dr. McWilliams says, referring to the听pre-exposure prophylaxis听known as听PrEP听that听reduces the risk of HIV infection.听听
Preventative Care is Important for LGBTQ Patients
Preventative health, such as听screening for cervical cancer, is also听critical--and听often overlooked--in听lesbian听health. 鈥淟esbians often听feel听that听they are听not听at risk for cervical cancer听or find听pap smear screening听triggering,鈥 Dr. McWilliams says. 鈥淭hat鈥檚 how these core听preventative听health measures听get听put on听the听back burner听or disregarded,鈥澨he听says.听听
Trans patients听will want a provider who can speak about surgical as well as non-surgical options,听like hormonal replacement therapy (HRT),听Dr. McWilliams says.听鈥Surgery for trans patients is often听the听final step听but many听patients don鈥檛 want to go through听surgery and need a provider who can manage HRT.鈥澨听
Screening and preventative health also applies to听comprehensive mental health care,听which is especially important for LGBTQIA+ people,听who may have听significant trauma in the form of negative reactions,听stigma and discrimination,听depression, and anxiety after听coming out to family,听friends, or听employers,鈥澨听
Such听trauma--which may even include听negative听interactions听with physicians--commonly translates into higher rates of depression, anxiety,听substance use, or听suicidality,听according to听Jess听Zonana, M.D. Assistant Professor of Clinical Psychiatry. 鈥淎 lot of听LGBTQIA+听people have had negative experiences听interacting with healthcare providers,听which is an access barrier in itself,鈥 Dr.听Zonana听says. 鈥淔or听those听who have had negative experiences seeking health care as a result of their identity, either听by听being misgendered if they鈥檙e trans or outright denied care, there鈥檚 overt stigma, and stigma has a huge impact on the risk for mental health conditions.鈥听
Make sure, therefore, that your provider takes the time to ask you about how you are feeling emotionally, screens听for听and monitors听substance use disorders.听
Health Services Available to LGBTQ Patients
If you are an听LGBTQIA+听person of color from an under-resourced community,听under- or unemployed, or听lack health insurance,听the care you need may seem out of reach. But you can find听supportive and sensitive healthcare听resources听at听Weill Cornell听惭别诲颈肠颈苍别鈥檚听the first student-run clinic focused on addressing mental health disparities among New York City鈥檚 lesbian, gay, bisexual,听transgender听and queer (LGBTQ+) communities. The听Qlinic听provides free mental health care to members of听these听populations, including those with substance use disorders. Another resource is听, which provides a range of comprehensive mental health services for transgender and gender-diverse children and adolescents.听
Finally,听WCM provides听LGBTQ+听friendly听healthcare听services, including:听听
- Prostate Health听
- Women鈥檚 Wellness Exams听
- Primary Care鈥 & Family Medicine听
- Psychiatric Care, Depression & Suicide Prevention听
- Alcohol鈥 and 鈥Substance Abuse听鈥疭别谤惫颈肠别蝉听
- Breast Screenings and Mammograms听
- Integrative Health听
Specific programs,听treatments听and specialty services:听
- Voice Therapy听
- Hormone Therapy听
- 听
- Youth Anxiety Program听
- Plastic Surgery and Injectable Silicone听
- Hepatitis and Liver Disease听
- Breast Cancer Treatments听
- Gynecological Cancer Treatments听
- Prostate, Testicular and Colon Cancer Treatments听
- Heart Disease & Cardiovascular Health听
- Infectious Diseases Including HIV/AIDS鈥听