All Tea, No Shade to many who paved the way for positive gay representation in the US Virgin Islands. However, we really must say a huge thank you to the community of St. Croix for the support and representation of the LGBTQ+ community they have received at the ongoing PRIDE 2022 events. Organizers say they had no anticipated the love and acceptance they encountered on June 18, 2022. For a moment, we felt like we were all equal, united, as one people on Strand Street in the city of Frederiksted. The beloved Ingeborg Nesbitt Clinic was adorned with a rainbow of diversity. FHC has been a great inspiration as a host. We are grateful for the incredible presence of the FHC nursing team led by LaTonya Nesbitt, Director of Nursing. Nesbitt is a direct descendant of the historic buildings namesake.
Together, many people from our community came out and celebrated each other’s uniqueness with dancing and laughing. There was no divide. For a moment, everything and everyone was beautiful. We felt safe being crossed, black, Latina, brown or white and LGBTQIA2S+ (an acronym for Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, Intersex, Asexual, Two-Spirit, and the countless ways affirmatives with which people choose to self-identify).
We are grateful to the unstoppable minds of Masserae Sprauve Webster (FHC-CEO, Edwin Nieves (FHC-DSCP), Robert “Bobby” Thompson (VI-DOH & 1LUV), STX Pride Inc., and the owners of Sand Castles Resort and the many stakeholders who participated in the health fair.
However, we cannot take our eyes off the oppressive forces that lurk in the corridors of injustice. According to GLAAD, Black and Brown LGBTQIA2S+ people are more likely to experience economic insecurity than their non-LGBTQIA counterparts, with a majority (56%) of Black LGBTQ people living in low-income households and in the southern United States ( 51.4%), where most states lack protections against discrimination. This marginalized population of people have their own unique life experiences, different from their non-Black and Brown LGBTQIA2S+ and non-LGBTQIA2S+ counterparts.
It is important that media and communications professionals in both the public and private sectors in the U.S. Virgin Islands are aware of these statistics and do not, unwittingly or otherwise, perpetuate stereotypes or stigma associated with these factors. Also consider how the use of language, source selection, and framing could exacerbate the already volatile conditions of this community on these Virgin Islands.
LGBTQIA2S+ health care disparities are still a significant and growing issue as they are affected by many external factors. The physical, emotional and mental health of our peoples (i.e. gay people), including lower incomes, lack of paid sick leave and discrimination in access to health care due to class, race, sexual orientation, gender identity and/or gender expression. Proximity to environmental hazards can also affect health. Additionally, LGBTQIA2S+ individuals and youth experience health disparities due to lack of supports at home, school, or other unsafe social spaces on our islands. In other words, the key to LGBTQIA2S+ health is not a theoretical difference in biology or behavior between LGBTQIA2S+ people and cisgender heterosexual people, but in the many challenges and stigmas that make LGBTQIA2S+ people vulnerable to disease. . In fact, the LGBTQIA2S+ population has been identified as a health disparity population by the
The National Institute on Minority Health and Health Disparities needs increased research from the National Institutes of Health. Data on LGBTQIA2S+ health is lacking. One of the biggest barriers to understanding the reality of LGBTQIA2S+ health is the lack of data collection. Many national LGBTQ organizations have made data collection one of the most critical priorities during the COVID-19 pandemic, when data on the impact on LGBTQ people was not collected until months after it began. . Existing data shows deep disparities for LGBTQ people and significant differences between LGBTQ patients and providers, including providers’ mistaken belief that most patients will not discuss the sexual orientation or identity of kind if asked. This lack of data will have ongoing and compounding effects on LGBTQ people, including the study and impact of other diseases and epidemics such as cancer rates.
Frederiksted Health Care Inc. has taken significant steps to ensure it has healthcare professionals who are allied with the LGBTQIA2S+ community. The FHC team receives ongoing training in LGBTQ sensitivity, and healthcare professionals such as Dr. Annetta Alexander, Josephine Kozloff, Physician Assistant, and Janette Bowers, Nurse Practitioner, P.HD., have medical care training and certifications beyond basic HIV healthcare to help patients live longer, healthier lives.
While blatant discrimination may be illegal, the healthcare sector is still plagued by societal homophobia, biphobia, and transphobia, which negatively affects the quality of healthcare LGBTQ people receive. According to a 2021 public statement from GLMA: Health Professionals Advancing LGBTQ Equality, more than half of all medical schools have no LGBTQ-focused health education beyond HIV treatment.
A 2018 Kaiser Permanente report found that more than half of lesbian, gay and bisexual people said they had experienced instances of providers refusing care, using harsh language or blaming sexual orientation or gender identity. of the patient as the cause of a disease. Up to 39% of transgender people have faced some type of harassment or discrimination when seeking routine healthcare, including being denied care outright or encountering violence in healthcare settings. There are currently just over 200 LGBTQ-specific health centers in the United States, but not all provide services such as mental health or have pharmacies. Thirteen states have no LGBTQ-specific health centers. LGBTQ people who live in rural areas or in these 13 states have little or no access to LGBTQ-specific care.
Anti-LGBTQ activists target access to health care. In May 2021, President Joe Biden rolled back Trump-era policies and restored federal protections for LGBTQ people seeking health care. While protections have been restored at the federal level, some states are still targeting and limiting LGBTQ health care.
In 2021, for example, Arkansas and Ohio passed laws allowing providers to deny care to LGBTQ people based on religious objection. And two states, Arkansas and Tennessee, passed laws in 2021 banning or limiting gender-affirming care for transgender youth. Other states have proposed bills that penalize parents who provide gender-affirming care to their trans children, as well as bills that punish school employees who conceal transgender identity from others. a student to their parents.
Gay and bisexual men face far more health disparities than just HIV. Stigma and discrimination can lead to a host of mood and substance use disorders for gay and bi men, including depression, anxiety, PTSD and alcoholism. Gay and bisexual men also report higher levels of eating disorders, including anorexia and bulimia, than their heterosexual counterparts.
Gay and bi men are also still subject to a discriminatory exclusion period when donating blood or plasma. It’s now a three-month waiting period instead of a one-year or lifetime ban, thanks to the advocacy efforts of medical organizations as well as LGBTQ organizations, including GLAAD. GLAAD continues the Federal Department of Agriculture to remove the deferral period altogether in favor of risk-based screening, noting that basing any policy on sexual orientation alone is unscientific and discriminatory.
The American Medical Association has stated that treating gender dysphoria is medically necessary care that may involve changing the body to align with a person’s gender identity (their internal sense of their own gender). . However, until very recently, private insurance companies treated transition-related medical care as if it were cosmetic – routinely inserting “transgender exclusion clauses” into health insurance plans. This can make access to care difficult, if not impossible, for most transgender people. In 2016, the Department of Health and Human Services issued a rule stating that under the Affordable Care Act 2010 people are protected from discrimination based on gender identity and gender stereotyping in health institutions that have a link with federal funds, which includes the vast majority of health funds. This was a big step forward in improving access to healthcare for the transgender community. However, not all procedures associated with medical transition are covered by this ruling, and any policy that does not receive federal funds may still be discriminatory. Also, even if a transgender person has a health insurance policy that will cover medical transition, it can still be quite difficult to find healthcare providers who are knowledgeable about transgender healthcare and force many queer people to leave. the island for medical attention.
Yet as these intersectional injustices have moved to the forefront of public consciousness, several aspects of major and long-standing issues around health care disparities have returned the movement – in some ways, to its protest origins.
Here in the US Virgin Islands, we should celebrate every small victory as if it were a major event. However, by staying true to a territorial agenda for equality for all, while actively supporting national platforms for LGBTQ-IA people.
Rodney Santiago Kidd
Editor’s note: Rodney Santiago-Kidd is the Director of Human Resources and Corporate Compliance at Frederiksted Health Care Inc. in St. Croix.