July 8, 2020
The CCHS Academic Diversity, Equity, and Inclusion Committee hosted two lectures in June to celebrate Pride Month.
The first event, “Working toward Health Equity for LGBTQIA+ Communities,” was a panel discussion held June 9 and moderated by Andrea Wright, MLIS, clinical and technical services librarian at the College of Community Health Sciences.
The second event, “Transparent – A Story of Our Family,” was presented on June 23 by Dr. Kyle Christiason, a family medicine physician who helped open the Unity Point Health Prairie Parkway LGBTQ Clinic in Cedar Falls, Iowa.
Pride Month is celebrated across The University of Alabama and is a UA-supported initiative that seeks to make campus a more diverse and inclusive place for students, faculty and staff.
The panel discussion centered around questions about health disparities experienced by the LGBTQIA+ communities, as well as the provision of health care to members of these communities.
Panelists included: Dr. Jason Flatt, professor in the School of Public Health at the University of Nevada, Las Vegas; Isabel Hope, a UA student and bi-sexual writer majoring in political science and creative media; Jessica Rentz, a UA student majoring in consumer science and president of Spectrum, the University’s undergraduate LGBTQIA+ advocacy organization; and Derrick Steverson, assistant director of community engagement for Five Horizons Health Services and recipient of the 2019 Invisible Warrior Award from Birmingham Black Pride for his work with neglected and high-risk communities.
Stigma, lack of health insurance and too few physicians trained to care for members of LGBTQIA+ communities are among the factors that contribute to the health disparities they experience, the panelists said.
Rentz said many health-care professionals lack the education and training needed to care for the specific health-care needs of these communities. “It’s not a lens that is incorporated into their training.”
Steverson added: “There aren’t enough doctors who know what to look for.”
Hope said LGBTQ teens who are not accepted by their parents are more likely to be homeless and, thus, more likely to be without health insurance.
Steverson said health disparities also stem from stigma. He said the stigma LGBTQ community members experience from the medical profession are in addition to the stigma they feel from their families and religious organizations. “And health disparities of the LGBTQ community are enhanced when it’s people of color.”
Hope said access to mental health care is particularly important for teens, who face significant anxiety about “coming out.” Rentz added that “there are huge gaps in mental health care between the general population and the LGBTQIA+ population.”
When seeking health care, members of LGBTQIA+ communities want to be welcomed and affirmed. “It goes beyond training, to attitudes and beliefs,” Flatt said. “There is a need for health-care providers to understand the unique experiences of these communities. The environment needs to be a welcoming experience.”
Rentz said it is difficult for people in LGBTQIA+ communities to find medical practices where they are affirmed. “Health-care issues are different for the LGBTQ community, but providers don’t think through that lens,” she said.
Flatt said studies show that up to 80% of those in the LGBTQ community report having to teach their doctors about their health needs. “It’s not the patient’s job to teach you about their identity; it’s your job to learn,” he said.
Added Steverson: “Just take care of us as you would any human being.”
Dr. Kyle Christiason said the birth of their daughter was the beginning of a journey for he and his wife to understanding sex and gender.
They didn’t find out the sex of the baby in advance. “There are so few surprises left in life,” said Christiason, a family medicine physician. The baby was born in 1997 and they dressed her in girl clothes. When she was 4 years old, she announced that she was a boy and wanted to be a good big brother to her younger brother.
When their daughter started Kindergarten, Christiason said she complained about her clothes. “We thought it was a tag or an embellishment, but she was most comfortable in and insisted on wearing boy’s clothing. We realized it wasn’t worth a battle and so she wore khakis and sweats.”
When their daughter was starting middle school, she identified as gay – a lesbian, Christiason said. Her family supported her “but our child did not seem happy and, unknown to us, she was actively planning suicide, but also looking online for information,” he said. When she was in 9th grade, “our child finally got through to her parents –that she was a boy. Even though we didn’t know what we were doing, we leaped in to support our son. The day we did, we saw happiness in our son, which we hadn’t seen since our child was five-years-old.”
Ben began taking testosterone, changed his name and gender on legal documents “and chose a path to an authentic life.”
Christiason explained that while sex is a biological classification, determined by chromosomes, genitalia and reproductive anatomy, gender identification is a person’s concept of the self as masculine, feminine, both or neither. Transgender is when a person’s identified gender differs from their sex assigned at birth.
Christiason said members of LGBTQ+ communities face discrimination from family and friends, can be treated unfairly by employers and sometimes are physically attacked. LGBTQ+ youth rejected by their parents and families are more likely to have increased depression and anxiety, use alcohol and drugs, engage in high-risk sex, experience homelessness and attempt suicide, he said, adding that 40% of homeless youth identified as transgender. When seeking health care, transgender individuals report that some providers refuse to touch them and blame them for their health status.
But studies show that when a single adult – parent, doctor, neighbor or teacher – is affirming of a transgender youth, the suicide risk decreases by 65%.
Christiason said because of Ben, he and his wife worked to design a clinic space that was safer and more welcoming for members of LGBTQ communities. Today, the Unity Point Health Prairie Parkway LGBTQ Clinic in Cedar Falls, Iowa, provides: primary care; vaccinations; routine cancer screenings; gender-affirming hormone therapy; pre-exposure prophylaxis for HIV; STI prevention, testing and treatment; contraception management; pre and post gender-affirming surgery care; on-site pharmacy, lab and radiology; and gender-affirming voice therapy.
Christiason said their journey wasn’t easy, and he and his wife experienced grief along the way – “losing a daughter, losing a name we had chosen for our daughter, losing stories we created for our child’s life, like walking her down the aisle at her wedding. But our child was living and thriving. Our other son says Ben is the same, but happier.”