Jul 262013

This is a post by one of my Summer 2013 interns, Kelsey. Find more posts from her and other current and former interns under the Intern Corner section.Shanna

According to recent research, 41% to 72% of queer (Iincluding LGBTAIAA) people never come out to their health care provider (McManus, Hunter & Renn). However, the majority of individuals who chose to come out experienced increased satisfaction with their care afterwards. What a relief! But, coming out to a provider is easier said than done. Queer individuals encounter compounding oppressions, and often challenge the norms for gender expression and sexual preferences. Coming out to a provider can be especially complicated, stressful, and your identity may just be hard to explain. Not to mention it’s exhausting having to constantly be teaching, when few are willing to seek the information on their own. However, with the right provider, healthcare can be completely individualized.

So, how can you come out to your health care provider? The first thing to remember is the provider is there to help YOU. Listening is crucial. There is no space for assumptions in the doctor’s office, especially on their behalf. The provider must refrain from determining your needs before you open your mouth. In order to do this, providers must deconstruct their assumptions about gender and gender expression. But still, sometimes as the patient you have to explain things more than once. For example, many health care providers assume that their patients are heterosexual so, continuing to advocating against this assumption is an uphill climb but very necessary! You can be honest and explain your needs.

For example, a transgender individual who has just decided to start hormone therapy may have a well-established relationship with their provider. But, this trusted provider does not understand the needs of a transgender person. To overcome this barrier, the patient can start the conversation by asking questions like, “do you know what my needs are and do you understand them?” If the answer is no, the patient can say “are you willing and able to become educated on my needs?” If the answer is still no, than the patient can ask their provider to refer them to someone who can help. Wouldn’t it be great if more doctors had experience with transgender individuals?

You may also need to explain that a certain identity, just like a certain appearance, does not equate to a certain set of needs. Honest conversations can turn a dreaded trip to the doctor into an empowering experience that ensures continued self-care. For example, providers may not understand that you may be considering birth control this year, even though at your last appointment your partner was female, and you have ovaries and a uterus. Another example is that you need to be able to trust that your provider will believe you if you say you are in an abusive relationship, even though your partner does not fit the stereotypical abuser profile.

Gender and sexuality are fluid and no identity is simple. Unfortunately in our society, doctors are less versed in the needs of queer individuals. But this does not mean you deserve to have your needs met and your concerns validated any less.

Tips for Patients:
• Take your time finding an accepting and supportive health care provider

• Tell your provider your preferred pronouns

• Bring a trusted friend with you to your appointment

• Ask questions

• Explain your health concerns

• Be a self-advocate

• Report discriminatory or dismissive behavior