LGBT patients search for healing

October 10, 2011|By Neena Satija, Globe Correspondent

A ll Jessica wanted was a doctor who would treat her like everyone else. A doctor who was comfortable with her self-identification as queer - a term sometimes used as an umbrella for any variation of lesbian, gay, bisexual, or transgender orientation.

But it wasn’t until she moved to Boston, in her 30s, that she was ready to even try to look for one. Before that, “the only office I went to was the dentist,’’ said the Jamaica Plain resident, who asked to be identified only by her first name to protect her privacy.

Despite overall strides in the attitudes toward people who identify as lesbian, gay, bisexual, or transgender many argue that the medical community has lagged behind. In 2009, fewer than a quarter of 1 percent - .21 percent - of publications related to human health included an LGBT-related keyword, as indexed in PubMed, an online library of research abstracts run by the National Institutes of Health.

Yet researchers say that LGBT people are more likely to experience a variety of health problems - from mental illness to drug abuse to sexually transmitted and other diseases - than their straight counterparts. The reason is largely that they don’t seek health care for fear of being stigmatized in the doctor’s office.

“These are not LGBT health issues,’’ said Dr. Alex Gonzalez, medical director at Fenway Health, where Jessica is a patient. “They become LGBT health disparities because LGBT people have had an alienating experience with health care in the past.’’

But providers at Fenway, which has specialized in LGBT-competent care since the time when homosexuality was still officially considered a mental disorder, and elsewhere in Massachusetts say many of these heath disparities could be eradicated if doctors just asked better questions in a better way.

Starting with asking for the patient’s name.

“How do you like to be called?’’ is one example that comes to Dr. Carole Allen’s mind when she thinks of ways to make a patient who may be transgender more comfortable. For Allen, who is chief of pediatrics at Harvard Vanguard Medical Associates, such approaches are key for adolescents who may be questioning their sexual orientation or gender.

“As soon as you say to a patient, ‘Do you have a girlfriend?’ You’ve automatically cut off that conversation,’’ Allen said. So about 10 years ago, Allen came up with asking, “Have you noticed any attraction to boys or girls or both?’’

And while Allen wasn’t sure how teens would react, she found that most weren’t at all offended. “Some kids will laugh. But I’ve had some kids say, ‘I haven’t decided’ or ‘I don’t know.’ ’’ Some of those kids hadn’t talked about their sexuality with anyone until Allen asked.