From The GAPHR Advocate
Letters from a Country Doctor:
Can Our Own Homophobia and Fear Lead to Discriminating Against Ourselves
Could you discriminate against someone because they were gay or lesbian? The answer is probably yes. I discovered last week that I possibly could.
As most of you know, I am a family physician in a small private practice (two physicians and a PA) in very conservative Forsyth County. As many of you also know, I am currently looking for a new partner to join us when my current partner retires. We have interviewed several physicians, a couple of whom have been gay. Before one of the interviews, my husband and I were discussing what the impact of adding another gay physician to the practice.
Its not actually an issue of how an openly gay physician would be accepted in Cumming. I am mostly out in my practice: to my partners, other physicians in the area, office and hospital staff, and some patients. I have been well received. Even when I applied, I asked the older physician I was joining about being openly gay in Cumming. He replied, "I think youll do just fine. As long as its not the first thing people find out about you, theyll get to know you, and they wont care." I was relieved, and I accepted the job.
However, one gay physician in a respected, established, practice is one thing; two is another. How would the PA or our staff feel about that? Would we become known as "that gay practice"? What if it hurt business? Its easy to be self-righteous and defiant and say, "well it shouldnt matter. They will just have to deal with it." However, when it could hurt financial livelihood, its not so easy to dismiss. We also reminded ourselves that maintaining diversity in the practice is important. You do not want too many of the same type of provider.
Ricky and I were both a little troubled by our conversation. We feared that we were feeling homophobia. Could we discriminate against an applicant because of their sexual orientation? Employment discrimination is clearly wrong, but these are valid considerations that could affect my practice. I of all people should realize that a gay physician can be both out and successful, even in a place like Forsyth Co. How much easier is it for a straight person to discriminate, even if they werent really homophobic, because of concern over the response of their customers.
I decided to discuss this with my partners before the interview. During my own job search, I felt it was important to be out, to avoid entering a situation where I was uncomfortable. Now, I thought it was important to discuss this with my partners, to avoid creating a situation in which they would be uncomfortable. I was pleasantly reassured (and a little ashamed) when they both said that they did not think it would be a problem. The PA said, "I wouldnt even have thought about it if you hadnt said anything." The doctor said, "The most important thing is that you hire a good physician, that will interact well with the patients, the staff, and you."
That would make a nice ending to this article, but it is not the whole truth. I realize I am very fortunate to have found such a wonderful, open-minded group of people to work with. However, there is still homophobia and discrimination in our world, and it does affect businesses and careers. These are complicated issues that are not black and white, but often gray and confusing. I dont think my reservations about hiring a gay partner were based on homophobia as much as fear of being "too out." We all have to decide how out to be; and no matter how long we have been out and how comfortable we seem, it is sometimes scary. Only by recognizing ones biases and concerns can one move pass them to do the right thing. My concerns were not totally unfounded and are not totally dismissed, but I have addressed them. I now feel much more comfortable choosing the best candidate, regardless of sexual orientation, gender, race, etc
Planning an LGBT Health Fair
We are planning an exciting new project this year. We would like to host an LGBT health fair. The purpose of the fair is to promote better health in our community, by educating people about common health problems, screening for some common problems, and offering referrals to LGBT-sensitive providers. The fair will also provide publicity for GAPHR, as well as publicity and referrals for participating providers and organizations. We plan to have booths for a variety of health screenings and education. Some of the screening ideas include: blood glucose, blood pressure, cholesterol, height/weight (BMI), glaucoma, skin cancer, bone mineral density, and depression. Some of the educational booth ideas are substance abuse, hepatitis, STDs, HIV prevention, depression, domestic violence, smoking cessation, travel, weight loss, various cancer screening information, self breast exam information, advance directives/power of attorney for healthcare, etc. We will also have booths for exhibitors. This is primarily planned for physicians to promote their practices, but may also be opened up to other health-related organizations or products. Because this is a GAPHR sponsored event, our members will be given first priority for booths to exhibit. We are planning this for a Saturday during the month of Pride. We are looking for a site in Midtown to host the fair. This is a great opportunity for GAPHR to grow and shine. This may even turn into an annual event.
We need volunteers for the committee to help plan the health fair. We also need sponsors to help us out early with funds to get the fair going. We would also like a response from our members to gage the level of interest in helping with screenings, providing educational materials, and having booths for their practices.
LGBT Medical Watch
Pediatric Care for Children Whose Parents are Gay or Lesbian. Perrin E, Kulkin H. American Academy of Pediatrics. 1996;97:629-635.
A growing number of children have at least one parent who is gay or lesbian, and no research has been done regarding the pediatric care of these children. It is estimated that there are 3-5 million lesbian mothers, and 1-3 million gay fathers in the United States. While the majority of gay men and lesbians who are parents conceived children in the context of heterosexual relationships, an increasing number are becoming parents in the context of ongoing homosexual relationships. The objective of this study was to describe the experiences lesbian and gay parents and their children have had with the pediatric health care system. To accomplish this, 255 parents completed an open-ended questionnaire. The questions were requests for descriptions of affirming or supportive experiences, problematic or troubling experiences, and suggestions for changes in pediatric offices, clinics, emergency departments, and hospitals.
Overall, a large majority of parents reported positive experiences with the pediatric care they had received, with 86% reporting at least one affirming, positive characteristic. Comments such as "Maintaining equal eye contact with both of us made us both feel like real parents," were frequently noted. Affirmation of both partners as parents was by far the most frequently voiced example of a positive experience. Thirty-three percent of respondents reported troublesome experiences specifically related to their sexual orientation. Problems included lack of understanding or acceptance of same-sex parents, generalized homophobia, and the need to explain that both partners were the childs parents repeatedly, especially to emergency room staff or to cross covering physicians during off-schedule times. Also frequently noted were heterosexist assumptions made in written materials, office forms, and medical questionnaires. Forty percent of parents described exclusion of the non-biological parent from the evaluation and treatment process.
The prevalent societal stigma still associated with homosexuality lends a gay or lesbian parent to live with pervasive fear of disapproval, exclusion, and physical and emotional violence. The pediatrician or family physician plays a crucial role in the lives of these parents, and are a valuable resource for these families. Taking into account both the affirming and troublesome experiences with pediatric care sited in this paper lead to two categories for changes. The largest impact can be made with changes in the office environment and with increased sensitivity and recognition of the special circumstances of children whose parents are gay or lesbian.
Cigarette Smoking Among Gay and Bisexual Men. Stall RD, Greenwood L, et al. American Journal of Public Health. 1999;89:1875-1878.
Large-scale epidemiological studies of tobacco use among Americans rarely measure sexual orientation. Therefore, data on the patterns of tobacco use among gay and bisexual men are limited, and current beliefs hold that gay men are more likely to smoke then the general population. The objective of this study was to measure the prevalence of cigarette smoking among gay men and identified associations with smoking. 2,593 gay men were surveyed from Portland and Tucson. Bar-based surveys were performed on 1,897 men, and home-based surveys done on 696 men. Forty eight percent of all sampled reported current smoking, a rate far above the 28.6% prevalence seen in men in the United States. In the home-based sample, 41.5% reported current smoking, and in the bar-based sample 50.1% reported current smoking. Significant associations with smoking included heavy alcohol consumption, frequent gay bar attendance, HIV seropositivity, greater AIDS-related losses, lower health rating when compared to members of the same age cohort, lower educational attainment, and lower income.
The authors conclude that the rates of cigarette smoking are very high among gay men. Half of the youngest cohort of gay men aged 18-24 years were current smokers, suggesting that the smoking will be a danger to gay mens health for many years to come. These data stress the need for tobacco prevention and cessation campaigns to be designed to reach this population at risk.
Making Schools Safe
Making Schools Safe is an ACLU program (in cooperation with GLSEN and PFLAG) to ensure Georgia's gay and lesbian youth have a safe educational environment in the schools, free of harassment or violence due to their sexual orientation or perceived sexual orientation. A team of one student, one ACLU attorney, and one teacher hold an in-service training with school administrators and teachers. The student tells how it felt being harassed or beaten in school, the lawyer explains the legal liability to the school district and individual teachers if they do nothing to stop the harassment, and the teacher conducts role-playing scenarios to teach the teachers how to stop harassment in its tracks.
The program has a 2-year commitment from the ACLU of Georgia. If you would like to contribute to this cutting edge program, bring your checkbook to Februarys meeting. If you cant make it to this months meeting, write a check to ACLU of GA and write "for MSS" on the check. Send it to:
ACLU of GA
Atlanta GA 30303
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GAPHRs Legacy and Outreach fund
Please consider a donation to GAPHRs Legacy and Outreach fund. This fund is earmarked to fund service and outreach to our community and to other doctors. The fund helps send medical students to LGBT medical conferences, pays for GAPHR exhibits at medical conferences, and allows us to help other groups such as Lesbian Cancer Initiative with LGBT health related projects. Without your donations, these important functions can not continue. Help us expand GAPHRs outreach to LGBT physicians and patients.