On Being Well

Once a month, Mazzoni Center brings you “On Being Well,” a column that aims to address a broad range of health and wellness issues that impact LGBT communities. Mazzoni Center recognizes that wellness means more than just an annual visit to the doctor: It’s about having access to health insurance,and a culturally competent provider who understands your unique health concerns, as well as counseling/mental health and recovery support. It’s about making smart, informed decisions about your body. And it’s also about your social environment, and feeling safe, confident and empowered in your identity and within your community. For more about Mazzoni Center, Philadelphia’s home for LGBT health and well-being, visit www.mazzonicenter.org.


Gay, lesbian or bisexual people are 10 times more likely to experience discrimination in all aspects of their lives, based on sexual orientation, as compared to heterosexual people.

Discrimination can take many forms, including:

• Obvious acts of prejudice and discrimination (for example, someone who is open about being transgender being refused employment or housing), or

• More subtle, but no less harmful, discrimination that reinforces negative stereotypes and feelings of difference (for example, seemingly benign jokes and verbal insults).

Transgender and gender non-conforming people in particular face discrimination in healthcare settings, are regularly denied needed care, and experience a range of health risks because they are transgender or gender non-conforming, according to a 2010 report by the National Gay and Lesbian Task Force and the National Center for Transgender Equality.

According to the 2015 U.S. Transgender Survey (USTS)—the largest survey examining the experiences of transgender people in the United States: 

• 23 percent of respondents did not see a doctor when they needed to out of fear of being mistreated as a transgender person,

• 33 percent of those who saw a health care provider in the past year reported having at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. This included being refused treatment, being verbally harassed, physically or sexually assaulted, or having to teach the provider about transgender people in order to obtain appropriate care.

Trans, or Transgender is a word commonly used to describe people who identify with a gender different from the one assigned to them at birth. Gender non-conforming refers to individuals whose gender expression does not conform to society’s expectations of gender roles.

Even though there is an increasing acceptance of trans and gender non-conforming people in society, and greater visibility in the media and public life, many trans and gender non-conforming people still experience discrimination in all aspects of their lives.

So what can we do?

We can create spaces for ongoing dialogue and learning. Providers can seek out continuing education to learn effective and affirmative ways to support trans and gender non-conforming people. By responsibly taking ownership of the quality of services for our communities, providers will break down barriers to healthcare for our trans community.

The discrimination experienced by trans and gender non-conforming people has serious impacts on mental health, which can cause isolation and feelings of shame. However, when we can share these experiences and struggles with others who understand them, we find community and support. Every moment of visibility is a way our community can illustrate the words of Lourdes Ashley Hunter, “Every breath a trans person takes is an act of revolution.”

Working together on our self-acceptance and love increases our capacity to take care of our physical and mental health. We’re worth a trip to the doctor, and the effort it takes to connect with the resources we need.

Riley Marcano is a Medical Case Manager at Mazzoni Center. Joniece Greer is the Community Engagement Specialist at Mazzoni Center. Airen McClure is the Legal Services Office Administrator. To learn more about Mazzoni Center’s Trans Care services, visit https://www.mazzonicenter.org/health-care/trans-care

The numbers are staggering. According to the CDC, in 2016, African Americans accounted for 44 percent of all HIV diagnoses, even though they comprise only 12 percent of the U.S. population. More than half (58 percent) of those diagnosed with HIV were gay or bisexual men, and 39 percent of those were aged 25 to 34.

 

Influenza, more commonly referred to as the flu, is a contagious respiratory illness, spread by a virus. It causes a miserable but relatively mild illness in most people. For most of us, getting the flu means a couple of weeks out of work or school, then life goes back to normal. But for others, the flu is a severe illness. Young children and the elderly are at the greatest risk for the flu and its complications. The flu can be more serious, even deadly, if you have a health condition like asthma, heart disease, diabetes, a weakened immune system or HIV. 

Alcohol and drug abuse is a significant problem in the LGBT community — our community. It affects LGBT individuals in higher rates than it does their heterosexual counterparts. In a 2016 SAMHSA study, it was estimated that illicit drug use among members of the LGB community was twice as high as it is for their heterosexual peers (39.1 percent versus 17.1). Alcohol use was also alarming, if not as much of a disparity, at 63.6 percent for LGB individuals vs. 56.2 percent for their heterosexual counterparts. This study did not include the transgender community; however, in a 2012 study that did, it was found that 20-30 percent of LGBT individuals abused substances compared to 9 percent of their heterosexual peers.

Thanksgiving is upon us again. It is a time to be thankful for the many gifts life has to offer. Mazzoni Center’s patients and clients receive an abundance of vital services, none more so than our food bank. What better time is there to learn more about one of Mazzoni Center’s oldest services than at a holiday that focuses on food and being thankful?

Renewal of the Children’s Health Insurance Program (CHIP), which has provided low-cost health insurance to 9-million children for over a decade now, is in limbo across several states, including here in Pennsylvania. While it looks very likely that the CHIP program will be passed here in Pennsylvania soon, it may come with an amendment that removes trans services for youth. There is a battle to get trans services back into CHIP in Harrisburg, and as of presstime some services were restored, except for surgery. Despite the outcome of this effort, Mazzoni Center will continue to provide service for all youth, ages 14-24, with or without health insurance.

After watching the last episode of “American Horror Story,” a moment during the episode stuck with me for the rest of the night. No, it wasn’t the clowns, but the scene that mentioned PrEP. It was a monumental occasion because this meant that PrEP has finally hit the mainstream media. While this is great for PrEP gaining exposure to a larger audience, the real work of getting the information and services to those who need it is nowhere close to being finished. And this is a journey that many should consider taking.

These three words are the theme of the 16th Annual Philadelphia Trans Health Conference. These words honor the transgender community, which continues overcoming obstacles and moving forward. Some of those obstacles are of a personal nature and may involve self, relationships, families or health. For others, they may be related to age, ability, ethnicity or race. Gender identity and gender expression, along with our diverse individual characteristics, can and often do, call on our reserves of strength and power to preserve as we move forward.

Something’s missing

I was baffled. Was this guy serious? He just asked me if I was “having fun yet” now that I was no longer using drugs or alcohol. “Are you kidding me? Absolutely not,” I said. And, damn, I meant it.

On June 27 we will mark National HIV Testing Day, a federally designated event that has been observed annually on this date since 1995. It is a meaningful one for those of us who work at Mazzoni Center, since HIV testing, counseling, medical care and supportive services have been a core element of our history and organizational purpose for decades, and continue to be a central focus of our day-to-day work.

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