Charleston Reporter

Carolinas Hospital System issued the following announcement on April 8.

Attendees at the inaugural LGBTQ+ Health Equity Summit at the Medical University of South Carolina came away optimistic and excited about the work that is happening to address health disparities that affect members of this community. Participants described the sessions as powerful, educational, informative and thought-provoking.

The two-day virtual summit came about as MUSC sought to increase its health care providers, students and staff members’ understanding of the challenges facing the LGBTQ community. Very quickly, staffers in the Department of Diversity, Equity and Inclusion realized that there was a need beyond MUSC for such an educational opportunity and opened it up to everyone. The result – people from across the U.S., and even Europe, tuned in to hear from medical providers, researchers and members of the community.

The conference began with a keynote by Assistant Health Secretary Rachel L. Levine, M.D., the first openly transgender person to be confirmed by the Senate.

“Diversity in all of its wonderful aspects should be not just tolerated and not just accepted. Diversity should be welcomed, and actually celebrated, for the way it strengthens and enhances any organization, in any community,” she said.

She noted, as did several other speakers, the alarmingly high rates of suicidal ideation and attempts among LGBTQ youth.

“One thing I do want to emphasize,” she said, “is that while the LGBTQI+ community does face higher rates of anxiety, depression, suicide and addiction, there is nothing inherent with being part of our rainbow family that predisposes us toward these mental health challenges.

“It is the bullying. It is the harassment. It is the overt discrimination that we face that leads to these increased risks. That is why it is so important to continue to advocate – for all of us, and for our most vulnerable.”

She also talked about the importance of conducting more research to understand the health care needs of the LGBTQ community more fully, noting that those needs differ even within the community. One group that has not received as much attention is the intersex community, she said.

“I’ve had the opportunity to hear from the intersex community and the stakeholders. It was quite enlightening. We tend to have a more medical model for the intersex community, as opposed to a biopsychosocial model, and I think we need to hear from the community about their health care needs, to adjust our standards of care, not just looking at specific medical issues but approaching it more holistically,” she said.

“We need to do that across the alphabet soup and the wonderful rainbow of our community to make sure we have research and data about all aspects of our community.”

People going into health care and related fields need to be educated about the needs of the community and about ways to signal that LGBTQ members are welcome. And the workforce needs to realize that they will be serving and interacting with members of the LGBTQ community, whether or not they realize it, said Ilan Meyer, Ph.D., distinguished senior scholar of public policy at The Williams Institute.

He developed a model of minority stress that shows how living with the stigma, discrimination and even internalized bias against LGBTQ people can lead to poor health outcomes. At the same time, strong identification with the minority group can ameliorate this stress, as the tight bonds provide more resources for coping.

Meyer highlighted an instance when he spoke to a group of social work students.

“I asked the students, who were graduating social workers, ‘How many of you expect to see LGBT people?’ Maybe there were five hands out of 50 – because they heard, ‘This is what I want to specialize in.’ But what I told them, and what I’m telling you – you're all going to see LGBT patients.

“Some of them may not be able to tell you they’re LGBT, and some of them will tell you. But you need to be prepared. This goes from the physician to the nurse to the staff to the administrative staff.”

Chase Anderson, M.D., a child and adolescent psychiatrist, shared his own life story in talking about how sexual minority status interacts with racial minority status. Minority stress is socioculturally based and is additive, he said.

“The way I like to think about it is imagining one papercut. You get one in a day, and it heals by the end of the day, and you think, ‘OK, that was annoying. It stings, but I’m fine. Imagine getting a hundred paper cuts per day. You have no idea where the paper cuts are coming from eventually. You have no idea how to staunch the wounds, and you have no idea how to heal,” he said.

He spoke of the microaggressions he and others encountered in medical school and residency – for example, someone telling him the only reason he was elected class president was because he was Black and gay.

“I had to remind that person that I was the only person who gave a PowerPoint presentation and wrote a full speech,” he noted.

He also called attention to senior members of the LGBTQ community.

“Elderly populations also experience minority stress,” he said. “There are a lot of LGBTQ+ Americans who, when they get older, even if they were out when they were younger, will go back in the closet because they feel unsafe being out if they have to go live at home with family members or if they have to go to a skilled nursing facility, because many of them have heard horror stories about how LGBTQ+ people are treated.”

Tonia Poteat, Ph.D., PA-C, an associate professor at the University of North Carolina at Chapel Hill, provided additional context for the intersection of race and sexual minority status, focusing on disparities in timely access to care for breast cancer.

Poteat, who worked as a physician assistant for 15 years and then went back to school to earn her doctorate, because both she and her patients had questions that no one seemed to be answering, looked into studies of breast cancer care and found a dearth of information about breast cancer care for Black sexual minority women – or even for Black women overall.

 Dr. Tonia Poteat presented the results of a study looking at delays in care for black sexual minority women.

She set about designing a study in cooperation with several advocacy and resource groups so that she could be sure to get enough respondents to have a good study size.

She found that Black sexual minority women experienced five times greater delays in accessing care than white heterosexual women. Reasons for the delays included structural barriers, such as cost or transportation; distrust; embarrassment; institutional barriers like an inability to reach a health care provider; and even the feeling that seeking care was pointless.

Even institutional resources intended to help patients may become a barrier if thought isn’t put into them. For example, one lesbian breast cancer patient reported that she asked about a support group for her partner but was told that the support group was for husbands.

Poteat said she was surprised by how much stigma and shame around a breast cancer diagnosis was revealed by her study. She mused that the “strong Black woman” stereotype might have something to do with it.

“For this study population, what I saw in the qualitative data – and even among my friends – it's wrapped up in this notion of the Black superwoman complex. We are supposed to always be strong. Always be sassy. Always make a way out of no way,” she said. “That trope really makes it challenging to say, ‘I have a life-threatening condition that requires a great deal of care and support, and I’m going to need rides to the doctor, somebody to bring me food, somebody to take care of my children, somebody’s shoulder to cry on. I might need financial support.’

“All of those things require someone to be vulnerable enough to express a need, and Black women in this society are not given permission for that.”

Gauging by the sheer number of grateful and positive comments that streamed in over two days, the summit was critically needed, and, it was an enormous success.

To say that Chase Glenn, director of LGBTQ+ Health Services and Enterprise Resources and host of the inaugural summit, was proud of the all-encompassing impact of the event would be an understatement.

“I simply could not be more pleased at the turnout for the event and especially the incredible energy surrounding every conversation. To have that many thought leaders in one place leaves me speechless. We left the last session on such a high note. Dr. Willette Burnham-Williams’ parting words were both meaningful and inspirational, charging each of us to take back what we’d learned and to be an integral part of the solution. Now, we move forward putting all of this into practice.”

Glenn added that this summit was an important opportunity for MUSC to shine and lead.

“We created something special that brought together people not only from around the state but from around the world. Wow! What an event. It was truly better than I ever could have imagined. This certainly was a jumping off point to build something even better for the future.”

About the Author

Leslie Cantu

MUSC Catalyst News

Categories: Features, MUSC Leadership, Trending Topics

Original source can be found here.