Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.
This is a series of posts covering Corey’s work in Puerto Rico for the Salud LGBTT conference.
There is a human right to have competent health care that preserves the dignity of all people, said Ericka Florenciani, launching the Salud LGBTT summit’s panel on trans healthcare. While trans issues were woven throughout the summit, this panel was one of many efforts to ensure that the issue of trans health would be front and center – a necessity given the difficulty the trans communities face getting care in Puerto Rico.
One of the speakers, Zil Goldstein of the Persist Health Project and Beth Israel Medical Center, noted that many trans people attempt to leave Puerto Rico to get transition-related care. Improving trans care here “has to start with hormone treatment,” she said. In New York, Zil sees sixteen to eighteen patients a day to provide hormone treatment; here in Puerto Rico, advocates say it is nearly (if not entirely) impossible to access.
But even in New York, the trans communities face many barriers to receiving quality care. “Anytime a trans person accesses healthcare, we’re dealing with transphobia,” Zil noted. This explains why, for example, 30% of trans youth in the U.S. put off receiving medical care out of fear discrimination, said Susan Mash of the Trans Youth Equality Foundation.
The problem is certainly national. Lambda Legal attorney Dru Levasseur noted that in their 2011 report on LGBT health, When Health Care Isn’t Caring, it was the trans population that faced the most obstacles in the field of healthcare. And the roots go deeper than health, starting with the socioeconomic position of trans individuals in our society; according to the study, seven percent of trans individuals reported that they had no income at all, which makes even basic health care an impossibility.
Speaking to doctors, Dru said, “You don’t have to be a specialist,” but you do need to take the time to educate yourself on the basics of trans care so that you are not turning people away. Noting that Lambda can connect them to resources, “there really is no excuse,” he added.
Dr. Carmen Milagros Vélez of the Universidad de Puerto Rico has been working on improving services for trans people in the community health clinics across Puerto Rico. Often, medical personnel think that LGBTT people want special treatment, and do not want to do anything different than they do for their other patients. But given the unique health needs of the community, and the disparities it faces, LGBTT people do need specially-tailored care – although this is about basic equality, not about “special” treatment.
And the need for that equality is urgent: in Dr. Milagros Vélez’s research, 35% of clinic respondents said they were not prepared to work with trans clients. The advocates at the summit agree that that needs to change.
Stay tuned to the Network blog and my twitter account, @LGBTadvocacy, for lots of live coverage of the summit!