Bay Windows - August 5, 2004
Laura Kiritsy, lkiritsy@baywindows.com.

With such topics as "Dismantling the Poster Kid Syndrome: Safer Sex for Those Who Work in the Field," "Funding the Movement: Can We Afford the Changes We Want To Make?" and "Creating Latina Lesbian Inclusiveness in Health Services: Methods for Creating a Sustainable Latina Lesbian Health Agenda," the gathering will provide a broad slate of workshops and plenary sessions that is "comprehensive across the country, across issues and across the letters," said summit co-convener Stewart Landers, a senior consultant at the Boston-based public health research and consulting firm John Snow, Inc.

Summit co-conveners received 125 workshop proposals, according to Landers. "Right now we've confirmed over 75," he said. "There will probably be 100 to 125."

The lengthy list of presentations isn't surprising, given the diversity of the LGBTI community and its current challenges accessing appropriate health care, and Summit co-conveners who spoke to Bay Windows laid out a host of concerns.

"LGBTI health care consumers have a core set of issues that we've had for decades," said co-convener Shane Snowdon, the director of LGBT Resources for the University of California. Snowdon easily ticks off three of her biggest pet peeves: First, GLBTI people are traditionally underinsured and therefore have less access to the health care system - a problem Snowdon attributes partly to the widespread unavailability of domestic partner benefits, though she acknowledges progress on that front. Second, said Snowdon, research shows that gay people tend to avoid or delay health care because they fear being treated with bias. Lastly, once in care, GLBT patients often receive substandard care at the hands of biased practitioners, such as doctors who don't provide inclusive medical intake forms or practitioners who don't comprehend the term "domestic partner" or can't understand why a lesbian has no need for birth control, Snowdon explained.

In more egregious cases transgender people are actively denied care or treated with contempt; Snowdon said she has heard "shocking anecdotes" of trans people who have been mistreated by hostile health care providers. To understand what she's talking about, one need only recall the 1995 death of Tyra Hunter, a transgendered woman from Washington, D.C., who succumbed to injuries sustained in a car accident after an EMT ceased treating her on the scene when he discovered her male genitalia.

Summit co-convener David Acosta, the coordinator of HIV/AIDS prevention programs at the Philadelphia Department of Public Health, is concerned that data on LGBTI health is lacking because national health surveys do not account for sexual orientation. Acosta notes, for example, that there is historically a higher propensity for substance abuse and nicotine addiction within the LGBTI community and that lesbians are at higher risk for cancer. "While we know these things are high in the community," he said, "we don't know the extent of the problem because questions of sexual orientation are left out of surveys."

Echoing Snowdon's concerns, Acosta said that the unwillingness of many gay people to come out to their providers for fear of how the information will be used only contributes to the lack of hard data.

Adding to the medical establishment's shortcomings, summit co-conveners view the current political climate as a potential impediment to the LGBTI community's access to adequate health care. Acosta points out that current efforts in many states to ban same-sex marriage may also wipe out domestic partner benefits. "For a lot of people DP benefits are the only way that a partner's health insurance is covered," he said.

The intersection of marriage rights and access to health care will be addressed in part by attorney Mary Bonauto of Gay and Lesbian Advocates and Defenders, who argued the Goodridge case which legalized same-sex marriage in Massachusetts.

Acosta and Landers also cited the threat of legislation like the Conscientious Objector Policy Act, a bill passed by the Michigan House of Representatives in April that would allow medical providers to refuse to treat patients on religious or moral grounds. Opponents of the measure, which is awaiting action in the state Senate, say it would allow health care practitioners who oppose homosexuality for religious reasons to refuse care to gay people.

"There are real serious issues," Landers said of such legislative actions, "as well as sort of the ongoing struggle to get information about our health status."

Health care providers and advocates have their work cut out for them as they seek to close the gaps in LGBTI health care. Snowdon emphasized education as a means to that end. The summit's overarching goal she said, "is to continue to put LGBTI health issues on the map," not only by educating the medical system, but by educating the general public and the LGBTI community itself. While transforming the medical establishment is important, of equal importance, said Snowdon, is empowering the LGBTI community to take its health needs into its own hands.

She also sees the summit as a place where LGBTI health professionals can connect, strategize and coordinate their efforts, "rather than sitting in different parts of the country reinventing the wheel and being isolated."

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