Open Forum: LGBTQIA2S+ disparities in healthcare remain an important issue

Celebrators of Gay Day, 2020 (submitted photo)

All Tea, No Shade to many who have made the path to positive LGBT representation in the US Virgin Islands. However, we really need to say a big thank you to the St. Croix for the support and representation of the LGBTQ+ community he has received during the ongoing events of PRIDE 2022. The organizers say they hate that they did not expect the love and acceptance they did We met on June 18, 2022. We felt for a moment that we were all equal and united as one people on Strand Street in the town of Frederiksted. The beloved Ingeborg Nesbitt Clinic is decorated with a rainbow of diversity. FHC provided great inspiration, as host. We are grateful for the amazing attendance of the FHC Nursing Team led by Latonia Nesbitt, Director of Nursing. Nesbet is a direct descendant of the historic buildings of the same name.

Many of our community came out together and celebrated each other’s uniqueness with dance and laughter. There was no split. For a moment everything and everyone was beautiful. We felt safe to be Crocian, Black, Latino, Brown or White, and LGBTQIA2S+ (short for Lesbian, Gay, Bisexual, Transgender, Queer and/or Interrogation, Intersex, Asexual, Two-Spirit, and the myriad positive ways that People choose to define themselves.

We are grateful to the unstoppable spirits of Masserae Sprauve Webster (FHC CEO, Edwin Nieves (FHC-DSCP), Robert “Bobby” Thompson (VI-DOH & 1LUV), STX Pride Inc., the owners of Sand Castles Resort and many more Stakeholders who participated in the health fair.

However, we cannot take our eyes off the oppressive forces lurking in the corridors of injustice. According to the GLAAD, black and brown LGBTQIA2S+ people are more likely to experience economic insecurity than their non-LGBTQIA counterparts, with the majority (56%) of Black LGBTQ people living in low-income families and in the southern United States (51.4%), where most States to protect non-discrimination. These marginalized populations have their own unique living experiences, which differ from their non-black, brown, and non-LGBTQIA2S+ counterparts.

It is important that the media and communication professionals in the public and private sectors in the US Virgin Islands are aware of these statistics and not inadvertently or otherwise perpetuate stereotypes or spread the stigma associated with these factors. Also, consider the ways in which language use, source selection, and framing may exacerbate the already precarious conditions of this community in these Virgin Islands.

Inequality in healthcare for LGBTQIA2S+ remains a significant and growing problem as it is influenced by many external factors. The physical, emotional, and mental health of our peoples (meaning LGBT people), including low income, lack of paid sick leave, and discrimination in access to health care because of class, race, sexual orientation, gender identity, and/or sexual expression. Proximity to environmental hazards can also affect health. In addition, LGBTQIA2S+ people and youth experience health disparities due to a lack of support at home, school, or other unsafe social settings across our islands. In other words, the key to LGBTQIA2S+ health is not the theoretical difference in biology or behavior between LGBTQIA2S+ people and straight people, but in the many challenges and stigmas that make LGBTQIA2S+ susceptible to disease. In fact, LGBTQIA2S+ has been identified as a healthy variation by

National Institute of Minority Health and health disparities need to increase the National Institutes of Health Research. Data about LGBTQIA2S+ health is not available. One of the major barriers to understanding the true validity of LGBTQIA2S+ is the lack of data collection. Many national LGBTQ organizations have made data collection a top priority during the COVID-19 pandemic, when data on the impact on LGBTQ was not collected until months after it began. Existing data does show deep disparities between LGBT people, and significant differences between LGBT patients and providers—including the misconception by providers that most patients would not discuss sexual orientation or gender identity if asked. This lack of data will have continuing and compounding effects on LGBT people, including the study and impact of other diseases and epidemics such as cancer rates.

Frederiksted Health Care Inc. has taken Significant measures to ensure it has allied medical professionals to the LGBTQIA2S+ community. The FHC team receives ongoing training in LGBTQ sensitivity and medical professionals such as Dr. Anita Alexander, Josephine Kozloff, Physician Assistant, and Janet Powers, Nurse Practitioner, P.HD, have clinical care training and certifications that go beyond basic HIV healthcare to help patients live healthy lives. longer.

While blatant discrimination may be illegal, the health care industry continues to be affected by societal homophobia, biphobia, and transphobia, which negatively affects the quality of health care that LGBT people receive. According to the 2021 GLMA Statement: Health Professionals Promote LGBTQ Equality, more than half of medical schools lack any LGBTQ-focused health training other than HIV treatment.

A 2018 Kaiser Permanente report shared that more than half of lesbian, gay, and bisexual people reported having experienced instances of caregivers rejecting care, using harsh language, or blaming a patient’s sexual orientation or gender identity as the cause of illness. Up to 39% of transgender people have experienced some form of harassment or discrimination when seeking routine health care, including denial of care or encountering violence in health care settings. There are currently just over 200 LGBTQ healthcare centers in the United States, but not all of them offer services such as mental health or pharmacies. Thirteen states have no LGBTQ health care centers at all. LGBTQ people who live in rural areas or in those 13 states have little access to LGBTQ care.

Anti-LGBT activists target access to health care. In May 2021, President Joe Biden reversed Trump-era policies and restored federal protections for LGBT people seeking health care. While protections have been restored at the federal level, some states still target and limit gay health care.

In 2021, for example, Arkansas and Ohio passed laws allowing providers to refuse care to LGBT people based on religious objection. And two states, Arkansas and Tennessee, passed laws in 2021 banning or restricting gender sponsorship to ensure care for transgender youth. Other states have proposed bills that penalize parents who provide gender affirmation care to their transgender children, as well as bills that penalize school employees who keep a student’s transgender identity from their parents.

Gay and bisexual men face many more health inequalities than just HIV. Stigma and discrimination can lead to a range of mood and substance use disorders in gay and bisexual men, including depression, anxiety, post-traumatic stress disorder, and alcoholism. Gay and bisexual men also report higher levels of eating disorders, including anorexia and bulimia, than their straight counterparts.

Gay and bisexual men are still subject to a discriminatory deferral period when donating blood or plasma. It’s now a three-month waiting period instead of a one-year ban or lifelong ban, thanks to advocacy efforts from medical organizations as well as LGBTQ organizations, including GLAAD. GLAAD continues to the Federal Department of Agriculture to eliminate the deferment period entirely in favor of risk-based screening, stating that basing any policy on sexual orientation alone is unscientific and discriminatory.

The American Medical Association states that treatment for gender dysphoria is a necessary medical care that can include altering the body to conform to a person’s gender identity (their inner sense of gender). However, until very recently, private insurance companies treated transition-related medical care as if it were cosmetic – regularly including “transgender exclusion clauses” in health insurance plans. This can make access to care difficult, if not impossible, for most transgender people. In 2016, the Department of Health and Human Services issued a rule that states that under the 2010 Affordable Care Act, people are protected from gender discrimination and gender stereotypes in health care settings that have a connection to federal money, which includes big money. The majority of health insurance companies. This was a major step forward in improving access to health care for the transgender community. However, this provision does not cover all actions associated with a medical transition, and any policy that does not receive federal funds may still be discriminatory. Furthermore, even if a transgender person has a health insurance policy that covers medical transition, it is still very difficult to find healthcare providers that are familiar with transgender healthcare, and many off-island gay people are forced to seek medical care.

However, with these intersecting grievances rising to the fore in the public consciousness, many aspects of key long-standing issues of health care disparities have brought the movement back—in some ways, to its protest-driven origins.

Here in the US Virgin Islands, we should celebrate every small victory as if it were a big event. However, keeping the regional agenda for equality for all people consistent, while supporting national platforms for LGBT people.

Rodney Santiago Kid

Editor’s note: Rodney Santiago Kidd is Director of Human Resources and Corporate Compliance for Frederiksted Healthcare in St. Croix.

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