I attended a “listening” event in Richmond last week (Friday, Oct. 26, to be exact) hosted by Equality Virginia. The listeners were the LGBT community in central Virginia, as well as two US Dept. of Health & Human Services staffers whose portfolio mandates direct engagement with LGBT citizens, and others interested in LGBT issues.
I fall in to the 2nd category there – I’ve long said that I’m a gay man trapped in a woman’s body. In other words, I’m hetero but I have always believed that sexual orientation and gender identity were legitimate issues only for the individual. Society at large doesn’t get a say in who one loves. Yes, that means I support gay marriage.
Now, back to our programming already in progress.
Here’s a short outline of what I learned by mostly listening, and talking a little:
- First, I give HHS big points for having LGBT issues on their list of “stuff we care about.” I also applaud their appointment of a member of the LGBT community, AJ Pearlman, as an external affairs specialist engaging with this segment of our community.
- I’m still flummoxed by the fact that most LGBT issues are huddled under the HHS’s SAMHSA (Substance Abuse and Mental Health Services Administration) umbrella. That makes it seem as though the healthcare view of LGBT folks is that their gender/sexual identity is somehow tied to their mental health status. Progress needs to be made there.
- As ICD-10 – the list of Holy Billing Codes that are used by providers and insurer/payers to determine cost and reimbursement in healthcare – replaces ICD-9, and the system moves from 17,000 service codes in ICD-9 to 68,000 in ICD-10, there is still a diagnostic code for transgendered individuals. There is NOT a code for heterosexual individuals. Again, progress is needed here. Gender reassignment surgery getting a dx code makes sense. Once the person has transitioned, though, why classify them? Why classify at all?
- Teens who are struggling with gender/sexuality identity issues have very few resources, particularly if they become homeless when their families reject them for their sexuality. ROSMY, the Richmond-based non-profit that works with sexual minority teens, brought up the issue of teen homelessness, noting that as much as 40% of kids living on the streets are LGBT. Finding a suitable fostering situation for kids in that situation has got to be incredibly tough. It seems to me that we could demonstrate some real leadership here by working on a solution, one that includes a supportive-housing model that helps kids get back in school and rebuild their lives, circumventing a cycle that can lead to lifelong mental health challenges, as well as physical health problems like HIV.
- Cultural competency in healthcare is still lagging. Most family practitioners aren’t experts in LGBT issues, and pediatricians who are LGBT-informed are scarce as hen’s teeth. Medical schools need to step up education on working with LGBT patients of all ages.
- On the topic of teen bullying, the HHS folks pointed out the StopBullying.gov web campaign. Take a look, get involved, spread the word.
When it comes to health and healthcare, we’re all in this together – and by all, I mean ALL. Someone’s sex life can certainly impact their physical health – the biggest risk there is not recognizing that sex and sexuality are part of everyone’s life. Education and acceptance are what are desperately needed there.
Let’s get to work.