Written by Dr. Andrew Stefani, UnityPoint Health Internal Medicine Hospitalist
Growing up as an aspiring physician while discovering my authentic self as a gay man wasn’t always easy. There weren’t many, if any, openly gay physicians I could look to. I knew I had to join the healthcare community while being true to myself.
Being a Member of the LGBTQ+ Community has Influenced my Care
I grew up during the height of the AIDS epidemic. Most of the messaging around LGBT folks regarding health care was negative. LGBT folks were being talked at and not talked to. Patients were “othered” often. This hurt someone like me who wanted so badly to a be a physician, but also be the right kind of physician — one that was inclusive, caring and unafraid to keep it real with patients while maintaining a professional level of excellence.
Fast forward to today, I’m someone who looks to help all the “others” out there who need an advocate and physician to guide them through the worst of days. I also see my medical career as a privilege — a chance for me to represent my community, so some young LGBT person out there has a beacon of light and hope.
Healthcare Inequities in the LGBTQ+ Community Still Exist
.png)
Unfortunately, our imperfect American society was built, and even maintained, with some inequities in place for those of us who identify outside the mainstream. The same is true in medicine. Specifically for LGBT patients in medicine, the biggest inequity has remained access to high quality care.
LGBT patients are much more likely to be uninsured or underinsured. We’re much more likely to experience homelessness, mental health disorders, suicide attempts, bullying and physical violence than our straight, cis-gendered (a person whose identity and gender correlates with their birth sex) friends. Without appropriate health care (including mental health and dental care), how does one grapple with the struggle of unsafe schools or unsafe housing with no professional in their corner medically/psychologically?
It amplifies the trauma people experience. Couple that with many (but not all) LGBT folks turning to maladaptive coping mechanisms involving addictions with drugs, alcohol, food, etc. Then, when they show up in the hospital or clinic with addiction issues, they’re again labeled as “bad” or “wrong” or a “lost cause,” because many healthcare providers have intrinsic biases regarding addiction medicine, and the addiction process itself. It leaves many within our community feeling abandoned.
There’s Hope for LGBTQ+ Patients
The upside is there are improvements being made to make the care delivered much more inclusive of all LGBT patients. At my UnityPoint Health location in Des Moines, the number of LGBT providers, RNs, physical therapists, occupational therapists, pharmacists and psychotherapists has tripled in recent years. In the hospital, specifically, not a day goes by where I’m not interacting with other LGBT healthcare team members and thus able to see and care for our LGBT patients.
Support is different in different areas of our health system, but I’m proud that my organization provides an LGBT-inclusive atmosphere across our three states.
I’ve experienced our LGBT inclusivity both as a resident and attending physician — and even on the patient side. My husband and I are grateful for our care team and have always been welcomed into any clinic, hospital or office setting with open arms. I’ve been able to have my husband insured on my health plan, even prior to our marriage, as he was my domestic partner. I have access to his health information, and I can spend the night in the hospital with him. That peace of mind has helped us both with medical uncertainty. It makes me even more proud to call UnityPoint Health my home.
Like my experience, we want everyone who comes through our doors to be their best selves. We want to know your story and meet your significant others. We want you to feel safe in the hospital at a time when people feel their most vulnerable or sickest. We want you to know it’s OK to be you and, even better, that being you is actually pretty fantastic.