Queer and trans individuals as a community have historically faced discrimination when seeking healthcare services. Whether during a time when homosexuality was categorized as a mental illness, queer and trans people were arrested or sent to conversion therapy, or in the modern age of “acceptance” where continued malpractice and insensitivity take place, it has always been a challenge to receive health services. This discrimination can take many forms, from legal attacks like the ones described in the Government Action archive, to the hostile culture of certain medical providers. Jonathan Santos-Ramos, the Director of Community Engagement and Strategic Initiatives at Callen-Lorde Community Health Center in New York City, explained the experience of queer and trans individuals in an interview we conducted with him in May of 2020. Callen-Lorde provides LGBTQ-specific, sensitive, and quality health care to residents of New York City. Patients often come to Callen-Lorde with a history of traumatic experiences from other medical settings.
“LGBTQ specific health is extremely important, because unfortunately our current sort of general medical system doesn't really support the nuances of queer health. Specifically around trans care or the insensitivity that we saw in the HIV epidemic. That stigma, and unfortunately those experiences, are still very much alive today. So the bulk of the patients who seek our care have either not found care that was inclusive of all their identities or have unfortunately experienced some sort of trauma in the medical field or with medical professionals. So they really come to us as we provide sort of trauma informed care, recognizing that the folks who come through the door have so many levels of trauma that may have happened to them.”
Jonathan Santos-Ramos, Director of Community Engagement and Strategic Initiatives at Callen-Lorde Community Health Center
A New York Times article detailing the challenges that community health centers are facing during the pandemic highlighted Callen-Lorde’s work, and reiterated a similar narrative. Anthony Fortenberry, a chief nursing officer with Callen-Lorde, had observed this trauma in his work.
“’I would tell them that they needed to go to the E.R.,’ Fortenberry recalls of some transgender patients. ’They would say: ‘Absolutely not. I would rather die than be misgendered or mistreated. It is not worth going through the trauma.’’ According to a 2017 poll, 18 percent of L.G.B.T.Q. Americans say that fear of discrimination has kept them from seeking medical care.’”
Mattathias Schwartz, "A Shadow Medical Safety Net, Stretched to the Limit"
Insensitive care is life-threatening. It is not just a matter of affecting individual mood or self-esteem; this is pervasive trauma that has a tangible effect of discouraging at-risk LGBTQ individuals from seeking treatment when they need it. During a global health crisis, this should be alarming to all of us.
While Callen-Lorde can provide some of this sensitive care to people who may otherwise go untreated, they are at absolute capacity and employees still say that more is needed. The community health center was brought on to work in two isolation hotels, one targeted to treat adults in the shelter system who are symptomatic or have tested positive for COVID-19, and another specifically for LGBTQ homeless youth. However, even with Callen-Lorde straining to cover the gaps in care, there is not nearly enough infrastructure to support everyone. The isolation hotel staff was quickly running short on gowns, masks, and other necessary equipment. While community members pitched in to help create makeshift gowns, there was a clear lack of support on the state and federal levels. Callen-Lorde does not have the capacity to treat the entire LGBTQ population of New York, meaning the rest of the burden falls on the hospital system.
Mount Sinai, a prominent health system and hospital network in New York City, is one of these institutions that many LGBTQ New Yorkers will be required to turn to. In an effort to increase the number of patients they could treat during the pandemic, Mount Sinai partnered with Samaritan’s Purse, an evangelical Christian humanitarian aid organization founded by Franklin Graham. Graham is the son of televangelist Billy Graham, and the family has a legacy of bigotry. In 1993, Bill Graham claimed that AIDS was a “judgment of God.” In April of 2019, Franklin Graham tweeted at then-presidential candidate Pete Buttigieg, “As a Christian I believe the Bible which defines homosexuality as sin, something to be repentant of, not something to be flaunted, praised or politicized.”
At the end of March 2020, Samaritan’s Purse put up their medical tents in Central Park to the vocal support of Mount Sinai President David L. Reich. Reich told hospital staffers to consider the tents “an extension of Mount Sinai.” The tents stayed up for about a month, concluding their work in early May 2020 after numbers began to decline.
Mount Sinai’s collaboration with Samaritan’s Purse sends a strong message to LGBTQ New Yorkers: you are not safe here. Let us remember the words Anthony Fortenberry relayed to us: “I would rather die than be misgendered or mistreated.” How many LGBTQ New Yorkers did not feel comfortable going to Mount Sinai for medical attention because they knew they could be mistreated? How many died?
The problem of discrimination and insensitivity in healthcare should matter to all of us, because it kills. We cannot tell the LGBTQ population that if they want sensitive healthcare they should just go to specialized centers like Callen-Lorde. That system cannot hold them all. More importantly, they shouldn’t have to be exiled to the outer corners of the healthcare system because the mainstream medical field refuses to change. As a global health crisis takes lives every day by the thousands, we are justifiably examining the way our health coverage must be expanded. However, we must also consider that changing the delivery of this care could save lives, too.
Interview with Jonathan-Santos Ramos
"A Shadow Medical Safety Net, Stretched to the Limit"
"The Soul Crushing Legacy of Billy Graham"
https://www.rollingstone.com/politics/politics-news/the-soul-crushing-legacy-of-billy-graham-200536/
"Treating Coronavirus in a Central Park 'Hot Zone'"