The LGBTQ+ community faces healthcare discrimination, even with basic care.
Across rural parts of America, the LGBTQ+ community’s needs remain largely unmet by healthcare professionals. Despite media portrayal of the group mainly inhabiting large cities, the LGBTQ+ community represents somewhere between three and five percent of adults and roughly 10 percent of youth in rural parts of America, which approximately mirrors the rest of the country, according to the Movement Advancement Project.
Unfortunately, this does not mean people in the LGBTQ+ community who live in rural areas have equal access to all resources, such as healthcare.
To Ari James, the executive director of Ardmore Literacy Leadership who uses the singular pronoun “they,” “right now the main issue is whether or not providers will be affirming.”
This institutional invalidation of the LGBTQ+ community includes a lack of medical knowledge — such as not knowing what conditions for which the community is at risk, what tests to run for those conditions, and preventative treatment to put their patients on — to a lack of the proper etiquette, such as not using the right pronouns or using old and offensive terms.
“For example,” said James, “[in the case of] a cisgender woman who identifies as a lesbian and is not engaging in sex with people who produce sperm, that perhaps routine pregnancy tests are not needed, especially if those patients do not have insurance and are paying cash for those services. For gay-identified men, whether they are cisgender or transgender, further testing needs to be done for sexually transmitted infections.”
Alex Wade, the Medical Services Coordinator at Oklahomans for Equality in Tulsa, explains that the issue is often worse for the transgender community as doctors often ignore the person’s symptoms and instead only focus “solely on the person’s trans identity.”
Wade added, “For instance, a friend of mine was told by an orthopedist that they would not perform a previously scheduled surgery on them because they had ‘transgender bones.’”
Treatment such as this largely brings those discriminated against to either travel far distances to find affirming healthcare or avoid doctors at all. According to the National LGBTQ Task Force and National Center for Transgender equality, 19 percent of transgender or gender non-conforming patients reported being refused care for their identity and 28 percent reported frequently postponing taking care of their health due to discrimination.
Currently, Oklahoma does not have any protections in place against healthcare discrimination for anyone on the LGBTQ+ spectrum. According to the Movement Advancement Project, Oklahoma only scores one out of 40.5 possible points for their “LGBT Policy Tally,” which ranks states on their existing laws. Oklahoma is one of 26 states to rank low or in the negatives on this scoring system.
One reason James believes people in the LGBTQ+ community continue to travel long distances to find necessary healthcare is because doctors in rural communities have often served that community for decades without additional education on how to serve people on the LGBTQ+ spectrum.
“Is there additional education mandated for LGBTQ+ people? Of course not. So those physicians who have been in place for decades do not have the terminology or understanding of those issues even for primary care.”
While traveling to larger cities like Tulsa and Oklahoma City provides more opportunities for healthcare than rural parts of Oklahoma, finding affirming specialists sometimes requires patients to travel much farther.
“We’ve had people who’ve traveled as far as Thailand, leaving the country,” said James. “There’s a large portion of trans and intersex people who are doing the practice of medical tourism, where they are going to other countries, specifically for surgery, medication, or both.”
For Oklahoma State Senator Allison Ikley-Freeman, the issue of the lack of LGBTQ+ affirming healthcare is a personal one. She lives in Tulsa with her wife and is the first person openly on the LGBTQ+ spectrum to hold political office in Tulsa County.
In healthcare, she has experienced physicians trivializing her identity, as well as medical professionals not knowing how to refer to patients.
Ikley-Freeman said, “A form that says ‘homosexual,’ or a staff member who asks ‘Are you a practicing homosexual?’, the examples are endless but those are two that I have personally experienced. I have heard many complaints of physicians who act like someone’s sexual orientation is a burden or bother to their practice of medicine.”
She believes some of the most important things to change this pattern of ignorance and neglect are relationships, education and advocacy. “Positive bills are introduced every year; unfortunately, without more education and advocacy towards legislators these bills will continue to not progress.”
Until change happens, Ikley-Freeman suggests, “If you’re reading this and are deeply bothered by the treatment of LGBTQ+ people talk to your doctors and see if they’ve done the work to get educated, talk to your legislators to see how much they need to learn and be willing to teach them over time.”
In Tulsa and around Oklahoma, some places Wade suggests for LGBTQ+ affirming healthcare include the University of Oklahoma, Oklahoma State University and Planned Parenthood.