I don’t speak about it, nor do the other parents, but the thought doesn’t escape any of us as we watch. I fear that in one quick hit, my son will not get back up. Most of the boys on the team, my son included, are fearless on the football field and, in spite of ourselves, we all cheer for the great tackles. But our worry remains, universal and constant.
I suspect, though, that my fears are a bit more nuanced than those of most of the other parents. Sure, I worry about my kid getting hurt. But I also worry that if the worst-case ever occurred, and something happened to my son, once he is packed up by the EMTs and delivered by ambulance to the hospital, we will have arrived at a place where I am relegated to a waiting room.
I am one of my son’s fathers, but he has another and two moms. And though our kids call both of us dad, in the wrong setting my son could potentially lay on a stretcher alone in a cold, antiseptic exam room while awaiting comfort from another of his parents.
Truth be told, I am petrified that someone unfriendly, perhaps only because of lack of experience with gay families like ours, might keep me from holding my son’s hand while he is poked and prodded.
My fears are not unfounded. Indeed, in a recent study, one out of five of almost 1,300 lesbian, gay, bisexual or transgender Coloradans surveyed were refused medical services simply because they were LGBT. More than half, 55 percent, feared that if their providers found out their sexual orientation or gender identity, they would be treated differently. It’s a fear that keeps people in the closet, even with someone they should trust the most — their doctor.
It is a fear that I share.
It’s a fear that even affects going to the doctor, as 28 percent of LGBT Coloradans reported that their sexual orientation had actually kept them from seeking health care services. An overwhelming 78 percent of transgender respondents feared coming out as they worried that their provider would treat them differently or that they would lose their health care coverage for being honest about who they are.
One Colorado Education Fund, a statewide LGBT education and advocacy organization, undertook the health assessment, including 10 community forums and an online survey, to better understand the needs and perceptions of the LGBT community related to health care.
As a physician, I believe that all my patients should feel safe and welcome in my office. Indeed, a trusting patient-provider relationship is central to being able to deliver effective health care services. When barriers arise that prevent those relationships from developing, public and personal health is impacted.
The One Colorado health survey makes clear that concerns about affordability and health care coverage ring as true for LGBT respondents as they do for all Coloradans. Unfortunately, coverage alone is not sufficient to ensure culturally responsive care. For many LGBT families in Colorado, unique barriers exist.
Coloradans identifying as LGBT, even when they have insurance, still felt their care was lacking. Only 46 percent of all health assessment respondents felt that they have sufficient choice of and access to providers that could address the unique needs of LGBT people and families.
As a gay parent, I welcome the fact that my family’s primary providers are LGBT-friendly. But the survey underscores the fact that these LGBT-friendly doctors are often too far away, too hard to find, and too few in Colorado, leaving many families underserved.
Families like mine are left to wonder what kind of provider they might encounter when rushing into the emergency room.
And why is this important? It is not solely because of my son, and my fears. It is because the data suggest that people with medical providers perceived to be LGBT-friendly actually report better care.
In fact, those participants who considered their medical provider to be LGBT-friendly were more likely to have seen that provider in the last six months, more likely to have received a wellness exam, more likely to have received a flu shot, even more likely to have seen a dentist than those who felt their provider was not friendly.
Though many Coloradans are limited in their ability to choose a provider by where they live or by their coverage plan, there is no reason they should be denied culturally responsive care when they do see a clinician.
Expansion of health care coverage will undoubtedly benefit all Coloradans — gay and straight. But the One Colorado study illustrates that, to improve public health and the personal health of our neighbors, we must immediately address the unique needs of the estimated 200,000 LGBT Coloradans and their families.
Health care systems must begin to collect demographic data on sexual orientation and gender identity in order to continue to define the disparities that exist in our LGBT communities. At present, many LGBT patients are invisible. The status quo is don’t ask, don’t tell, but with a medical spin.
Even if the systems of care in which they work don’t take this on, individual providers should open a welcoming door to their LGBT patients by simply asking about identity and relationship status. Most of us would embrace those questions; we would love to share who we are with you.
And we, the LGBT community, are not off the hook. We must face our fears and come out to our medical provider. We should use every health care interaction as an opportunity to educate clinicians on who we are and what we expect from a compassionate caregiver.
I hope that my son has a long, successful career in sports. I pray that I am never left in a waiting room, separated from my child, feeling helpless. He would be courageous, I am sure, as 10-year-olds are. Indeed, my son is reaching an age where he no longer wants to be seen holding his fathers’ hands. But that should be his choice, not the decision of a poorly experienced medical provider.
Mark Thrun is a public health physician in Denver and an adviser to One Colorado. The full health report is available at .
