How do day-to-day decisions about being “out” affect health?

Our last few blog posts on Lavender Health have touched on the challenges of being “out” – and indeed I had a recent conversation that brought the health implications of this challenge to the forefront.  The conversation reminded me that each and every day, and usually several times a day, even those of us who consider ourselves to be “out” and very open with our LGBTQ identity, encounter situations when we have to decide, once again, out&proud“am I going to come out?”   A couple of people in the conversation commented on the typical approach that is akin to “don’t ask, don’t tell” or “I don’t make a big deal of it – if someone asks I will be honest but I don’t go around waving a flag.” I shared an occasion with a supervisor on a new job approached me during my first week on the job and warned me not to talk about being a lesbian!  Surely, these day to day challenges affect our health.  I know they make me tense, they distract me from attending to aspects of a situation that I might need to focus on instead, and the emotions and mental memories linger for a long long time.

Consider these scenarios:

  • You are on an elevator with your partner, and someone asks “are you sisters?”
  • You have ordered take-out on the phone and your partner will be picking up the order.  You know that if were in a heterosexual relationship you would say “my wife” or “my husband.”  You have to decide if you are going to use one of these terms, or simply say “my friend.”
  • A person taking your reservation for a trip asks you for your emergency contact, and the relationship of that person to you.  You have to decide how to label your relationship in this particular situation.
  • You are introducing yourself to a new group, and everyone else has shared something about their family.  What are you going to say about yours?

So what do you think? Share experiences you have had, and also ways in which you deal to compensate!

 

Posted in Activism, Coming out, Join the discussion, LGBT Health, Mental Health, Minority Stress, Stories of our lives | Leave a comment

Back-to-School Health for LGBTQ Families

With only a few weeks left in August, students will be returning to school soon. LGBTQ families (which I define as families that include LGBTQ parents or children or both) have the same concerns about school health as heteronormative families, but there are also some additional concerns.

Parents and students can make effective use of the professional skills of school nurses. According to two University of Connecticut School of Nursing faculty, Dr. Art Engler and Dr. Annette Jakubisin-Konicki, school nurses’ comprehensive practice includes:

  • First aid for minor injuries such as scrapes and cuts.

  • Emergency services for anaphylactic reactions and other life‐threatening conditions.

  • Emotional support for normal developmental events, from baby teeth falling out to the beginning of puberty and menstruation.

  • Input in required planning for students with special health and other needs such as 504 Plans and Individualized Health Plans.

  • Screening and referral for hearing and vision and other state‐mandated health indicators.

  • Administering prescribed medication, such as Ritalin and Concerta.

  • Education about health promotion and disease prevention.

  • Leadership and advocacy in health‐related school concerns.

  • Supportive care for children with such conditions as seizures and diabetes.

More information can be found from the National Association of School Nurses.

Dr. Jakubisin-Konicki also offers students Back to School Tips to Boost Brain Power that include maintaining physical activity, good nutrition, and adequate sleep.

Same-sex parents may have additional challenges. Legal provisions and social attitudes may be quite varied from state to state in the United States, and not all teachers or school administrators may be comfortable with LGBTQ parents or their relationship status. The American Association for Marriage and Family Therapy offers guidance for same-sex parents. The Family Pride Coalition also offers a more detailed handbook for parents, children, and educators, Opening Doors: Lesbian and Gay Parents and Schools.

Although we hope that school is a secure and supportive place for LGBTQ students, the reality is that both families and schools may harm their queer students. In August 2016 the U. S. Centers for Disease Control and Prevention issued a groundbreaking study of health risks among sexual minority students. This study found that,

While many sexual minority youth cope with the transition from childhood to adulthood successfully and become healthy and productive adults, others struggle as a result of challenges such as stigma, discrimination, family disapproval, social rejection, and violence. Sexual minority youth are also at increased risk for certain negative health outcomes. For example, young gay and bisexual males have disproportionately high rates of HIV, syphilis, and other sexually transmitted diseases (STDs), and adolescent lesbian and bisexual females are more likely to have ever been pregnant than their heterosexual peers.

Among its recommendations:

  • Focused public health and school-based actions and policies that support safe and supportive environments for LGB students are key.

  • Youth-serving agencies and organizations, including schools, communities and youth-friendly health care centers and providers, can help facilitate access to education and information, health care services, and evidence-based programs and interventions designed to address the health-related behaviors that impact LGB youth.

  • Outreach efforts and educational programs can provide parents and families with the information and skills they need to help support LGB youth.

Adolescent and young adult students should seek out queer-friendly adults for support and advice. You are not alone! Some states, like Connecticut, are fortunate to have advocacy and education organizations such as True Colors to support sexual minority students, their teachers, counselors, and parents.

Young adults preparing to choose a college, should consider campuses that are supportive of their LGBTQ students. The Princeton Review offers a variety of resources on its Guide to College for LGBTQ Students.

Posted in Education, Family, LGBTQ youth | Leave a comment

Queer

I attended the Rainbow Health Ontario conference in March of this year. During the question period at the end of the session in which I was a presenter, one of the persons in attendance asked about the meaning of the word queer. Many shared their definition of the word. One person shared that some of their straight friends identify as queer. My initial thoughts on this involved feelings of discomfort, anger even. I have been working on various things since the conference but my mind keeps coming back to this. Recent events and interactions with members of the queer community where I live has caused me to deeply reflect on the meaning of queer. I have been having rich and meaningful politically inspired conversations about difference, action and change. These conversations have provided me with the sense of community that I have been searching for. But these conversations are mostly being had with straight people.

 
In March I would have adamantly refused the possibly of straight people being queer however now I am not so sure. I have looked beyond the queer community for a sense of belonging and have never felt such acceptance. I look to people like my straight white cisgender brother who is happily married to a straight white cisgender woman. Their heterosexual partnership has not and will not produce children and I identify with their departure from the norm. I identify with it because it is queer. They subvert the heterosexist narrative so beautifully and the family structure that we form together is impeccably queer. It is within this space that I am beginning to expand how I understand queerness so that I may build a community that would disrupt dominant ideologies and begin having meaningful, actionable conversations about difference. Perhaps this is a strategy that would build capacity within dominant groups that would someday create a center that holds difference. The current system of marking and marginalizing difference does not work.

 

I am unsure of what system would support a center that holds difference. I imagine that divisive politics would suggest there is a lot of healing that needs to happen before we can begin the process. Until we all admit that we are all socialized as racists within a white supremacy, moving a mass based movement forward will (and should) be impossible. I imagine there is a lot of capacity to build before the “all lives matter” rhetoric is exposed and accepted as a tool that serves to reinforce the white supremacy in which we are socialized. Of course all lives matter but for the first time in history let’s agree that #blacklivesmatter because all evidence up until this point would suggest otherwise! Then maybe communities of Colour can begin to heal. Dominant groups can do work that supports this healing insofar as a collaborative center that holds difference must be the reparative goal. I believe there is much work to do before the healing process will end and the trust to collaborate has been earned.

Posted in Join the discussion | 2 Comments

When your patient asks you if you have a boyfriend…and you’re a lesbian

I started working in the hospital at the end of January. Since then, I have been asked about my relationship status by what present as mostly cisgender white heterosexual men on a number of occasions. Sometimes it’s someone your own age. Sometimes it’s someone older. Sometimes it’s someone who’s really old. Up until now, I have been pretending I didn’t hear the question or just smiling and saying I don’t have a boyfriend. Lately, I’ve been reflecting on how I am going to react moving forward. As a cisgender white femme who apparently doesn’t “look gay”, perhaps I could leverage my privilege to start having conversations about difference. Of course, I have considered continuing to skirt or avoid answering these questions, which frankly have nothing to do with our relationship as nurse and patient, however my silence is a privilege that benefits no one. Of late, I figure perhaps the next time one of my patients asks me about my boyfriend, I will clarify that what I have is a girlfriend. I would smile and I would do it generously, careful to protect our therapeutic relationship. The thought of making my queerness visible at work with my patients scares me. What if someone doesn’t want me to care for them when they find out? What if they say awful things? It’s a vulnerable place for me to go which makes me reflect on just how privileged I am to have the ability to feel safe because I can hide my difference. 
 
I am beginning to wonder if this is an opportunity for some sort of upstream patient teaching about difference. Nursing is my leverage point as it expands my access to the center. This is where my work is and it is where I can effect real change. I imagine there are other people like me who can begin to normalize difference from the center. People who are of difference and occupy structural positions of power could begin having conversations about what makes us different. People listen to white people so white people need to have difficult conversations with other white people about white privilege. We need to start to figure out what we can do with our privilege that will begin to pull differences from the margin and into the center. So that those who have been historically marginalized – specifically and intentionally Black, Indigenous and People of Color – see themselves represented in a way that white people take for granted. This is a time that calls for change. Queer nurses have a unique opportunity to challenge normative scripts by initiating generous conversations with people who don’t see us as different because they can’t see our difference. I don’t imagine that this involves outing ourselves to every patient however given an opportunity to clarify that I don’t have a boyfriend and in fact, I have a healthy, loving relationship with a woman means that I can leverage my privilege in a way that disrupts heteronormative spaces that fail to reflect difference. This would also entail having conversations with colleagues that gently challenge heteronormative narratives that govern workspaces. I have found that this feels like a safer space for me to challenge the narrative but it’s time to move outside that space now. It’s time to get to work on expanding the center so that difference is an expectation, not a surprise.
Posted in Join the discussion | 6 Comments

Clinical Advisor: Healthcare issues of the LGBT community

Designed for healthcare professionals, the website ClinicalAdvisor.com offers regular updates. A recent topic includes “Healthcare Issues of the LGBT Community.”

The article is open access: http://www.clinicaladvisor.com/practice-management-information-center/healthcare-issues-of-the-lgbt-community-what-the-primary-care-clinician-should-know/article/509329/

 

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