Transgender and gender-diverse individuals are not a novel concept, and the idea of existing beyond the binary of female or male is centuries old. However, this population has notoriously faced discrimination, verbal and physical abuse, some of which still continues in the health care community.
A 2015 national survey of almost 28,000 transgender and gender-diverse individuals demonstrated that a third had a negative experience with a health care provider and a quarter of patients have had to educate their own providers about care.
When we look at the complexly layered barriers to care, we have to ask ourselves — would these numbers suffice for any other population seeking care? Encouragingly, there have been great strides within the past decade driving greater advocacy for and research surrounding gender-affirming care.
As Pride Month kicks off in Chicago, many of us look forward to the Pride Parade in Lakeview, the Dyke March in Little Village, and numerous other performances and parties celebrating the achievements of the LGBTQ movement with friends and family.
As is tradition, Rush University Medical Center will have a contingent in the Chicago Pride Parade. And this year, both the LGBTQ Leadership Council of Rush’s Diversity Leadership Council plus faculty, students, and staff in the Medical College have embarked on several LGBTQ and gender-affirming medical education and care initiatives.
‘Say Our Names’
One of these initiatives includes an art exhibit, “Say Our Names,” by artist and film director Lilly Wachowski. “Say Our Names” is on display in the corridor of the Searle Conference Center at Rush through July 8. This is the first time the exhibit has been shown in a large, academic medical center. The goal is to raise awareness across Rush that, despite many important legal, political, and cultural gains over the last 15 years, transgender people continue to struggle for survival and access to basic resources such as health care.
Rush University Medical Center celebrated LGBT Pride Month — and reflected on the recent mass shooting at a gay nightclub in Orlando, Florida — during a reception on June 28. The Rev. Clayton Thomason, JD, MD, chairperson of the Department of Health, Religion and Human Values, began the gathering with this reflection about brokenness and healing.
The Stonewall Riots took place 47 years ago on June 28, giving rise to the modern LGBTQ movement. It’s why June is Pride Month. That movement led one year ago to the Supreme Court’s recognition of marriage equality, and on June 24, President Obama declared the site of the riots, the Stonewall Inn in the West Village of Manhattan, a National Monument.
That movement and its accomplishments, including Rush’s own LGBTQ accomplishments, are what we should be celebrating. But on June 12, pride was interrupted by tragedy, by grief.
There have been many responses in the weeks since the lives of 49 people were taken and 53 more were left injured and bleeding in the Pulse Nightclub. Some responses have been predictable, because — unfortunately — by now in our national life, they are all too familiar.
Stephen Colbert observed on the Late Show, “It’s as if there’s a national script that we have learned. And I think by accepting the script we tacitly accept that the script will end the same way every time. With nothing changing.”
When I applied to be an internal medicine physician at Rush University Medical Center, I updated my CV to add that I had an “interest in LGBT health care.”
I began my career in a fairly conservative suburban practice where I was limited in my ability to serve the LGBT population openly. Throughout that time, my sexual orientation was a topic that was seldom discussed or brought up. It became frustrating to me that as a gay physician, I was not doing everything I could to be the best ally and advocate for the LGBT community.
I was aware, of course, of the health care disparities facing the community — from access to care to lack of education of health care providers. When I made the commitment to better serve the LGBT community, I quickly learned what limited resources existed in the world of medicine. Only very recently have medical schools begun to incorporate LGBT-focused diversity training into their curriculums, and even then, it is only provided at a limited number of schools.
Last week marked the eighth consecutive time that Rush University Medical Center was named a Leader in LGBT Health Equality by the Human Rights Campaign, and Rush Oak Park Hospital‘s third consecutive time receiving the annual designation. While this honor might not seem like breaking news after eight years, it is important to recognize exactly what leader status means for the lesbian, gay, bisexual, transgender and queer/questioning community.
This designation signifies that Rush has made a genuine, longstanding commitment to nondiscrimination policies for both patients and employees regarding sexual orientation and gender identity/expression; training in LGBT patient-centered care; and equal visitation policies for all families. This commitment is not something people should take for granted, even after eight years, given that only 496 hospitals or health systems have earned leader status out of nearly 5,700 hospitals nationwide, and nearly a third of 2016’s leaders earned the status for the first time.
What’s more, there are still four states without any hospitals with this status. These numbers suggest, and stories in the Human Rights Campaign’s Healthcare Equality Index confirm, that the LGBTQ community still experiences discrimination towards and health care inequities.
Progress and setbacks for LGBTQ equality
In fact, the LGBTQ community still faces discrimination in both social and health policy. While the national winds have been moving in the direction of improving the lives of the LGBTQ population — most evident in the Supreme Court of the United States ruling last June that made marriage equality the law of the land — many policies on the regional and state level are challenging the rights of the LGBTQ population.