Closing gaps in healthcare for our community

“Don’t ever call an ambulance for me. I don’t care if I get hit by a car, let me die on the street. Just do not call an ambulance,” Arlene admonished me. I’d heard the horror story about the last time she went to a hospital so I couldn’t really blame her, but still, it was sad. No one should fear the medical system. But Arlene, like many other transgender people, has a learned and warranted fear of the medical system. Yet fear of the medical system isn’t the only problem out there.

As a cultural competency trainer, I know the stats all too well. Doctors and nurses feel free to openly express their personal disdain for LGBT people. Far from being a helping profession for us, accessing healthcare can be a minefield where political ideologies and personal prejudices trump the Hippocratic oath.

And while discrimination can be deadly, it is the more often the widespread ignorance that more often hurts us. Does a doctor know how to prescribe hormones for a transgender person? Have intake forms that don’t alienate LGBT people by asking about marriage? Have trained front-line staff who know to treat all with respect? Do the staff understand what health problems are more common for LGBT people? Do health care providers understand how to talk to us without stumbling and steering awkwardly clear of any issues of sexual orientation or gender identity? Lots of questions. And our community deserves not answers but solutions.

Well, I’m happy to say that this week the federal government made a major stride in both acknowledging and prioritizing LGBT health disparities. The U.S. Department of Health and Human Services released the historic Institute of Medicine Report on LGBT Health. The Institute of Medicine imprimatur carries the highest regard among health professionals, so the mere existence of this report is a great step forward in prioritizing our health disparities. The report reviews the highest level of science available about our health disparities and makes strong suggestions for action at every level.

One of the most important suggestions is the simplest, count us. When the Census or health surveys don’t ask who is LGBT, it’s like locking us in the closet. It effectively hides our lives and all evidence of the disparities we struggle against. This is one simple step that LGBT advocates have been asking for ages and it is too long overdue.

I applaud the National Institutes of Health for commissioning this prestigious and comprehensive study, for not leaving transgender people behind, for taking due care to ferret out as much information as possible on LGBT communities of color. Each of these actions is a great stride. As the director of the Network for LGBT Health Equity I’ve been advocating for LGBT inclusion in health policy for many years, so trust me when I say, this is a truly historic moment.

But there is much to do. I think of my vulnerable young queer nephew and cousin. I don’t want them to take the path I did, and try to commit suicide. But I can see their isolation, I know how they struggle to find people who accept them. It’s going to take a lot to change their reality. So, at the end of the day we must remember this Institute of Medicine Report on LGBT health is just a book. The real change will come when federal officials, policymakers and medical providers take this book off their shelf and turn it into action. Action that cannot come a moment too soon.

Scout is the director of the Network for LGBT Health Equity at The Fenway Institute. A longtime LGBT activist, Scout is an openly transgender person living in a small town in Rhode Island and struggling to get his three kids through the trials of being a teenager.