When sorting through life’s chores and adventures, there are some things we automatically think to share with others, and some we simply plan alone. If I want to see a movie, I start by looking for a friend to accompany me, even though I am perfectly capable of going alone. The same goes for buying new eyeglasses or planning a vacation. On the other hand, I tend to exercise alone, buy groceries by myself and read a book solo.
I also go to the doctor alone, as do all my friends. We are a tight-knit group going back over 20 years; we share secrets, books and restaurant recommendations. I can tell you all their clothing and shoe sizes, yet I don’t know the names of most of their doctors. But of all things, medical care for LGBT people should absolutely be a community activity. We have more fear and more negative experiences with the healthcare system, and we could use additional support. Imagine trading the strained silence in the medical waiting room for the clamor of chatter among friends. Imagine how much easier it would be to come out to your doctor, knowing your friend is within shouting distance. Imagine the cumulative educational experience for healthcare providers when a succession of patients all come out to them on a given Tuesday morning.
The greater the fear, the more we need to have allies in attendance. My friend Jackie figured this out two years ago, after worrying aloud to her friend Barbara about her upcoming mammography appointment. (The dreaded squish is recommended every two years for women between the ages of 50 and 74, or younger for those with a family history of breast cancer.) It turned out that Barbara used the same radiologist as Jackie and had scheduled her own appointment for the following week. They vowed to go together this year; that appointment happened this past Tuesday.
Jackie and Barbara are both lesbians; they are also both white. As a group, lesbians have a cluster of risk factors that increase our likelihood of getting breast cancer. We drink more alcohol, smoke at significantly higher rates, are less likely to have had a biological child before the age of 30 (which would have offered some protection) and are more likely to be overweight. African-American women have a lower risk of getting breast cancer than white women but are, paradoxically, more likely to die from it.
The studies are mixed, but many show that despite the increased breast-cancer risk, lesbians are less likely to get the recommended mammograms, increasing the odds of having the cancer detected at a later stage. The reasons for avoidance of the healthcare system in general, and of mammograms in particular, are understandable. As a group, LGBT people have historically had lower rates of health insurance, although the Affordable Care Act is changing our access to coverage. Many lesbians and bisexual women underestimate their risks for breast cancer, and, taking into account the history of ignorance and/or discrimination by providers, they simply avoid the subject. Trans men without top surgery can add to the list a denial of the existence of body parts that don’t match their gender identity. But our health depends on our ability to push past all these barriers and fight for our lives.
I applaud Jackie and Barbara, both for their diligence in being screened and for hatching their plan of mutual support. Most of us complain that we don’t see our friends often enough, yet we fail to see this opportunity for catching up on our lives, instead sitting nervously alone in waiting rooms across the country, often for an hour or more. Yesterday in New York City, Jackie and Barbara gossiped, laughed, and squeezed each other’s hand after being called in. They also were there for each other when the radiologist read the results. Both sets of mammograms were clean. Shwooo!
I think we can all take our cue from Jackie and Barbara and turn medical appointments into a team sport. If we went as a gang, we would also be better able to encourage that friend who always avoids the doctor to come along with us. From annual physicals to recommended cancer screenings, make a day of it. A movie and a mammogram! Cocktails and colonoscopies! Pap smears and pasta! Our lives depend on it.