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National Coming Out Day

Those of us that have ever had to “come out” know that it isn’t a one-time thing.  We come out to different people, we come out as we learn more about ourselves and our identities, we come out by sharing our likes and dislikes, and we come out by talking about our loves and heart-breaks.

We come out in different places: at work, at school, at home, and at our places of worship.

We also come out in health care.

Coming out to your medical provider is not always easy, but it is extremely important.  Coming out to us helps us know you better, know better what questions we need to ask, what tests to order, what treatments to offer, and above all, how to treat you with respect and dignity.  To paraphrase a wonderful educational video from the National LGBT Cancer Network: To treat you, we need to know who you are.

Unfortunately, not all healthcare services are provided in safe spaces.  There are way, way too many stories of people “coming out” in healthcare services only to be turned away, to be treated poorly or differently, to be judged, to be attacked verbally, and even physically.  Lambda Legal’s “When Health Care Isn’t Caring” reported that more than half of Lesbian, Gay, and Bisexual individuals, and more than 2/3 of Transgender individuals have had at least one of these experiences. Coming out is an act of courage, it’s a right, but it can also be dangerous.

As our communities become more visible, as we come out in bigger numbers and in louder ways, coming out may seem easier.  Discrimination overall has less places to hide and opportunities to expose those at fault in viral ways are often-times at the touch of our fingers, but the confidential nature of the medical provider-patient relationship may provide a reservoir for these behaviors, and frequently the brunt is shouldered by those most vulnerable.

Because of all of this, it is still vital that places like Callen-Lorde continue to exist as safe spaces in health care where coming out is celebrated and valued.  Thankfully, Callen-Lorde is not alone.  The provider directories of GLMA (formerly known as Gay and Lesbian Medical Association) and WPATH (World Professional Association for Transgender Health) are filled with medical and behavioral health providers that look forward to work with LGBT patients, and The Human Right’s Campaign Health Equality Index provides institutional guidance. Centers like Callen-Lorde also provide trainings to other medical providers, hospitals and healthcare institutions to increase knowledge and awareness around LGBTQ health issues and the barriers that LGBTQ people face in accessing care. And just today in New York, Governor Cuomo signed legislation requiring organizations that care for homeless youth to undergo LGBTQ competency training to help ensure that when young people interact with social services and with the shelter system, that they are treated with dignity and respect.

These are just a few of the resources available and advances being made to help improve the safety and wellness of LGBTQ people in health care – and although none of them are perfect, they point towards a brighter landscape.

Coming out is more than telling someone our sexual orientation, gender identity, or expression – it is the courageous act of introducing ourselves as deserving of the utmost care and respect.  The exam room should provide that in every single instance to every single patient.  That might not be the case today, but we will continue our work training new generations of health care providers competent in LGBT health until every patient can comfortably and confidently come out to those who have sworn an oath to care for them.  In the meantime, we pride ourselves in being a safe space and we invite you to come out and be yourself.

– Dr. Uri Belkind, Clinical Director of the HOTT (Health Outreach to Teens) Program