Arkansas doctors and activists are searching for ways to provide better health care for homosexuals, bisexuals and transgender people after a recent survey revealed that many in the community are not "out" to their physicians.
The Human Rights Campaign, an advocacy group for lesbian, gay, bisexual and transgender (LGBT) rights, sponsored an "Equal Care for Equal Lives" event at Arkansas Children's Hospital in Little Rock on Thursday in hopes of bridging gaps between the LGBT community and medical professionals in regard to health care.
A Human Rights Campaign survey of 1,000 LGBT Arkansans found that 42 percent of respondents didn't consider their doctors to be LGBT-friendly. And 50 percent of those surveyed were not "out" to their health care providers, said Kendra Johnson, Arkansas' director for the Human Rights Campaign.
"So the question becomes, 'How do you get adequate care if you don't talk about the issues that affect your life?'" Johnson said.
Dr. Sara Tariq, an associate professor of internal medicine at the University of Arkansas for Medical Sciences in Little Rock, said skipping care or not disclosing information to a doctor because of fear of discrimination can have an impact on a person's health.
"We have concrete consequences that show they don't get treated for illnesses," Tariq said of those in the LGBT community.
"No. 1, they don't even come to the doctor for illnesses because it's too much of a risk. It's too much of a psychological risk and a personal risk to see their doctor. We know they underutilize health care because of that. So if they have something simple, they won't get care, and then it will become something really much bigger. So we know the outcomes are much poorer."
Figuring out how to best serve the LGBT community has been the subject of ongoing research for the National Institutes of Health. In 2011, the organization commissioned a study that identified depression, suicide, obesity, cancer risk, long-term hormone use, HIV and AIDS, sexually transmitted infections and substance abuse as top issues in the LGBT community. It also stressed a need to better understand how to help.
"They have their own subculture," Tariq said. "And just as we have put in an effort to learn about other subcultures, this subculture needs to be identified and prioritized as well, because they do have some unique health care needs."
Tariq and Dr. Janet Cathey, an obstetrician-gynecologist, said treating people in the LGBT community was not something that was taught while they were in medical school. That's changing now at UAMS, in part because medical students have expressed a desire to learn how to treat people in the LGBT community.
Tariq coaches medical students on how to be more inclusive. That often starts with making sure intake forms offer options that allow LGBT patients to disclose relevant information, and it extends to having doctors use verbal cues and body language when talking with patients to build trust.
"In health care, there are so many challenges. I honestly don't think that addressing these issues in our LGBT community have been a priority," Tariq said.
And more options are emerging for those in the LGBT community as awareness spreads in the medical community.
Transgender people looking for hormone therapy can now be treated in the Gender Clinic at UAMS. Created in October by Cathey and her colleagues, the clinic treats patients from all over the state. The clinic has partially filled a void in the Arkansas transgender community.
"I'm so thankful because as a primary-care doctor, I had nothing to offer," Tariq said.
"And I only had three or four patients out of my hundreds. But as you can imagine, when as a doctor you have to say, 'you have to go to Dallas. There's nothing we have in the state to offer you,' it's extremely disheartening for our patients. It's extremely expensive for our patients. It's not realistic. So a lot of my patients never did anything about it, which is a horrible way to live."
Patients still have to leave the state if they want sex-change surgery, but Cathey hopes the UAMS clinic will grow into a comprehensive unit. Cathey is currently the primary doctor for the clinic, but she expects others to be added because of the demand.
"You see someone and they come in, and you put them on hormones -- and they come back two months later, and they say, 'I've just had the best two months I've ever had in my life,'" Cathey said. "And, I mean, it's just very moving. And that's what physicians want to do."
Metro on 06/13/2015