How Health Professionals’ Ignorance Are Impacting LGBTQ Patients

The moment I left the doctor’s office, I broke down.
I was shaking from a combination of fury and frustration. My doctor was not only incompetent, under the firm belief that gonorrhea could not be tested from a urine sample, but he was also judgmental, completely unaware of how to treat me as a queer man.

After explaining to him what Truvada is and why I choose to take it, he informed me that most men wouldn’t need a pill to protect themselves from contracting HIV, and I wouldn’t have to “deal with all this” if I settled down with a nice woman.

And sadly, my experience isn’t anything novel and it’s not just sexual health related. Doctors, especially older doctors, aren’t trained to handle the specific needs of LGBTQ+ patients.

Take Chad*, who seven years ago thought he had testicular cancer. The radiologist was not welcoming or kind, despite his clear distress, thinking he’d have to live his life without one of his testicles or worse. Sharing his experience, Chad told me that the radiologist didn’t give him any instructions on how to proceed. In fact, after the exam, Chad asked if he could get dressed.

“He told me to do what I wanted,” Chad said. “As I was changing, I heard him say to someone in the hall, ‘The fag’s done.’ Then someone snickered. My doctor told me later that I was cancer free.”

Now, this is a particularly explicit form of homophobia. No one else who shared their stories with me experienced such blatant discrimination. Most of the time it was more insidious – more judgmental. Their queerphobia is only visible through the doctor’s tone and the assumptions they have about a patient given their sexuality.

John* wanted to get an anal pap smear. The doctor had no idea how to do it but said he’d look into it. The next time John visited the clinic, the doctor seemed eager to try the anal pap smear.

“[The doctor] brought in half the staff of the large clinic so they could watch him do it. He didn’t even ask me if I was okay with that. I felt like a guinea pig.”

Not surprisingly, the results came back inconclusive, and the doctor recommended John see a “gay-focused clinic.”

Many mental health providers are equally as inept at dealing with LGBTQ+ patients.

“She called me Lolita, instead of my real name,” Jennifer*, a proud bisexual-identifying woman told me about her therapist. “Probably not something you want to do to a CSA [campus sexual assault] survivor?”

“And she thought I was this ‘wild girl,’” Jennifer continued. “I feel like she assumed this because I’m bisexual.” Because of this, Jennifer’s therapist made her feel like she was not ready to commit to her girlfriend.

Not all doctors and mental health professionals are like this. Some are more than adequately prepared to handle the specific needs of queer patients. The issue comes with finding them, and then once found, seeing if they’re able to accept new patients with your health insurance. These clinics are often in high demand and don’t have openings for new patients.

And there may even be some hope with younger doctors these days. Many medical schools now have specific curriculum dedicated to addressing the specific needs of queer patients.

Chantal, who’s currently a medical student at the University of Vermont College of Medicine, told me about the integration of visit scenarios involving LGBTQ+ patients. “Instead of having three patients who are cisgender and heterosexual, you’ll have one patient who is transitioning, one patient who is lesbian and interested in getting pregnant and one patient who is cisgender/straight, so you get the opportunity to really discuss the specific needs of each different patient.”

However, even if there is some hope that still doesn’t help many people, including myself, now. Because these positive changes still do not affect the tens of thousands of doctors currently practicing medicine who attended medical school years ago.

So, it all remains a challenge even in places like New York City.

After my queerphobic experience with my Brooklyn doctor, I took to Facebook to voice my frustration, as well as ask for recommendations for LGBTQ+ doctors in the city. Callen-Lorde, a clinic that specializes in LGBTQ+ patients, came highly recommended, but unfortunately they weren’t accepting new patients [that weren’t either HIV-positive or transgender] at the time. They told me to call back in two weeks.

Years ago, when I was looking for a doctor at Fenway Hospital, an LGBTQ+ clinic in Boston, I received a similar response. The wait time to see a doctor would be weeks. There are just too many queer patients seeking medical attention, and not enough queer-friendly doctors.

In the end, I didn’t attend an LGBTQ-specific clinic, but a doctor who had specialized in HIV work. A friend highly recommended him, informed me he was a gay man, and insisted he was more than knowledgeable about PrEP and the specific needs of queer men. Luckily, there was a cancellation and I was able to see him just two days after I called to make the appointment. He was everything my friend described and more: knowledgeable and compassionate without any judgment.

While it’s uplifting to know that students in medical school are getting appropriate training to address the needs of queer patients, it’s disheartening to know the number of doctors now who still have preconceived notions about queer folks and are completely unaware of the specialized treatment we need.

Maybe, for now, the best way to go about finding doctors is through referrals from queer friends. They can offer doctors, programs, LGBTQ+ clinics, and more.

If no one else will have our backs, at least our queer brothers and sisters will.