I have a confession to make. I went seven years between doctor’s appointments. I work for a health care association and I refused to let one near me with a stethoscope or a speculum. In researching this article, I realized I had become a statistic in the LGBTQ community.
According to the U.S. Department of Health and Human Services, lesbian, gay, bisexual, and transgender (LGBT) individuals are less likely to visit doctors than straight people, particularly to take advantage of preventative care and routine screenings. They cite a lack of health insurance, fear of discrimination, and bad experiences with previous healthcare providers.
For me it’s been a combination of all three over the years. I came out during my first year of college and I also went to my first gynecologist appointment. The two were not remotely connected, because there was no way on earth I was telling anyone, especially not the young resident wielding a weird and wicked instrument and looking scared. I complained of cramps and the attending physician said, “We could treat them with birth control, but they’ll probably go away when you have your first kid. Of course, we should talk about birth control anyway at your age.” Yes, I can quote her verbatim all these years later. It was a memorable moment.
I walked out of there with a prescription and ripped it up. I didn’t go back until I was out of college on my first employers insurance and could go to somebody else. I was half sure I was not going to tell her either, but giving your medical history and avoiding coming out takes a significant lie of omission at the very least, one that I was sort of worried would come back to bite me.
I was sure I couldn’t get AIDS or at least I was sure no women had from another woman. I figured I should ask if I was at risk of something I hadn’t even heard of yet. By the way, I was misinformed; though rare, there have been document instances of HIV transmission between two women. My doctor didn’t have any better idea than I did.
She was accepting though— more than accepting. She was practically gleeful to be presented with a real life sexual minority (her term) and proceeded to quiz me on the proper labels, the proper way to ask someone if they’re having sex with somebody of the same sex, and what I was worried about health wise. I couldn’t help thinking, Shouldn’t you know?
I did keep going to her, but always came away worried she was missing some vital test or that I had ruined it for the poor kid who would come after me and be subjected to a gauntlet of misinformation I picked up online. After she moved, I delayed for one reason or another—a stint without insurance, a couple years overseas—before low and behold, almost seven had passed.
This allergy to the medical community (or perhaps it is the medical community’s allergy to us) has led to some unfortunate health outcomes for LGBTQ people and not just in the realm of sex and sexuality. According to the Center for Disease Control, LGBTQ women are at higher risks for cervical cancer, breast cancer, polycystic ovary syndrome, anxiety, and depression. Transgender people have even higher instances of disparities, particularly since disparities in employment are tied up with health insurance and the ability to even access care.
None of these disparities are related to any inherent trait of being LGBTQ. All of them are due to stigma and discrimination. This makes sense, of course. If there’s no biological basis for a disease, it’s probably social or cultural.
Thus the reason I seem to take a U-turn whenever approaching a doctor. I finally went this year. Why? Because I got the flu, which is probably because I avoided getting a flu shot. I didn’t even go because I had the flu. I went because after I missed a week of work, I was worried if I kept calling in sick and I didn’t go see a doctor, I’d get fired. The doctor managed to schedule a pap smear and a take a medical history in 15 minutes. Apparently times have changed; when I told him I was gay, he said, “Okay.” I had to wait 24 hours to get blood drawn though and that is definitely still on the agenda for sometime really soon…