By Bryan Garcia
We all deserve to be able to take control of our wellness, advocate for ourselves, and find autonomy in our well-being. We deserve to feel welcomed with dignity and respect when we step into the waiting room at a doctor’s office and have a health care provider (HCP) that wants to know who you are so that you receive treatment according to your specific needs. Queer people of color should be asked about their sexuality and quality of life without the person who is asking the questions being afraid of what the answers might be.
Unfortunately, right now, the standard of health care for queer people of color is lower than ideal. It is reported that 1 in 5 transgender people have been turned away by a health care provider. In a large Harris Interactive Poll, 75% of lesbians reported delaying health care. Feared discrimination and cost were the two main reasons. Emory University Rollins School of Public Health in Atlanta, told US News and World Report: “If you are African-American or Latino and you present to the emergency room with a broken leg or a kidney stone, for example, you’re less likely to be given analgesics/pain killers at the recommended level… it doesn’t matter what part of the country you’re in, it doesn’t matter what type of place you’d present to, that we’ve seen fairly consistently.” These disturbing facts create fear that causes many to not go to the doctor or to not feel comfortable disclosing important information and as a consequence routine testing or screening may be missed. This dramatically increases the risks for multiple diseases, including cancer.
The goal of your HCP should be to create a therapeutic bond with you and develop rapport to balance out or offset the discrimination or stigma expreiencd in the past when accessing health care. So what are some steps we can take to increase the chances that we are taken seriously and that our health is promoted? Here are some things that were useful for me when I decided to seek health care support from a medical doctor in the hopes of it helping me create a life that I love after a decade of avoiding a doctor’s office at all costs.
One thing you have the right to do is to ask questions to see if they are the right fit for you or at least are not explicitly anti-LGBTQIA+. You can try to find something that is within your insurance network or you can search for one that might either be free/low cost or sliding scale.
You can then call that prospective physician’s office and try asking, “Is this practice affirming of non-binary and transgender people? Are there any practitioners of color? Will this provider work from a HAES (Health at Every Size) perspective that celebrates body diversity and is not fatphobic? Is this office sex worker-positive?” You can do this anonymously, or feel free to use a fake name. If you feel good after that initial conversation, then you can call back and make an appointment.
With that said, even with some insurances and/or health coverage, it is entirely possible that you may not be able to choose your provider or find someone who may not be the most sesittive to queer folks and their needs, so the following are more tips on how to navigate these situations.
Take a moment to jot down your goals for the visit, any symptoms you may be experiencing, questions or concerns you want addressed, numbers (temperatures, blood glucose levels, blood pressure), and any research you have done on your own. A trusty composition notebook and pen is all you need. It is normal to feel nervous and you may even feel like you bringing things up you wrote down could interfere with a possibly good doctor-patient relationship, but this couldn’t be farther from the truth.
You can try saying, “I have a personal questions I would like to ask you…”
The total time of your visit may be an hour and you may actually only get 10 -15 minutes with an actual doctor, so the reality is that you are not going to have a lot of time face-to-face with your provider. This is why it can be super helpful to come in knowing what you want to leave with. You can practice and rehearse these questions with someone you trust if it will help ease some of that discomfort. This can help you get past the typical “doctor talks, I listen” pattern.
Maintain Your Records
Electronic health records have made it easier to keep track of your own health information. It can be the key to protecting your own health. Having access to them can help if you ever have to switch providers so that your new doctor has a better understanding of your medical history and needs that includes medications you are taking, surgeries you’ve had, allergies, lab work results and doctor’s notes. Think of it like an instruction manual for your health. Your judgment is important when it comes to your health and you can make sure certain details are up-to-date. When medical information is shared in a rush or medical jargon confuses you, this can help you take as much time as you need after an appointment to do your own research that helps you understand your health better.
Become the CEO of Your Own Body
You can negotiate your needs and desires and still have a respectful dialogue with your doctor.
Advocating for yourself is not a bad thing. It can save you time and money. I remember going to the doctor about some lower back pain that started after I had done some heavy lifting. Their response was that I needed to lose some weight. I was ready for that recommendation and replied with how I have been this same weight for at least a decade now, so the lower back pain was probably due to the recent heavy lifting I had participated in and asked if they could elaborate more on why they thought differently. The tone immediately changed and this led to more questions and attention spent in regards to my concerns and requests to look into treatments that would be given to a thin person for their lower back pain.
One thing I was also ready to use, but didn’t have to was a tip I credit to the Black Twitter community where you ask a doctor to “make a note of this [they’re not taking what you are saying into consideration]” or to “document refusal.” The experiences around using this have resulted in folks more likely getting the treatment that they need. So you can subtly let your doctor know that you are aware of the statistics around queer patient’s of color treatment in health care settings or stories that you have heard about people in similiar situations that have caused for you to be concerned and should cause them to have some too. You can also ask for explanatory notes on your medical records for things you think might be biased and/or you can add notes yourself. You CAN have a say in your healthcare experience.
Have an Advocate
Having someone you trust – a family member, friend is another idea. Given that we are in COVID times, bringing someone with you to an appointment is most likely not possible unless someone has medical power of attorney. So while they may not be physically present, you may be able to call them so that they can hear what is being shared and help you come up with questions to ask and offer options or advice. This can also just be someone you make time to speak with after your appointment to debrief over your experience and receive validation. You deserve to feel supported and not go through this alone.
Remember that healthcare is much more holistic than what the system leads us to believe. This means that there are not only physical factors to consider, but emotional/mental, spiritual, and social ones too. Sometimes, we can only do what we are able to since there could be limitations that are out of our control. Go at your own pace and with what feels right.
What have been some of your experiences in accessing medical care and what barriers have you noticed or encountered? Let us know on Twitter, Facebook and Instagram @allgoqpoc!
Join us on Friday, September 25th from 1- 3 PM to discuss Accessing Health Care as Queer People of Color as we support one another in our journeys towards health and wellness. Register here!