By Kauree Bennett, Youth Advisory Council member.
The following reflects Kauree’s lived experiences, thoughts, and opinions.
Being open as a member of the LGBTQ+ community in the current political climate can be intimidating. Why should our healthcare reflect that? The fear of being exposed, lack of access, and ridicule are among the many consistent experiences of the group, and this is specifically represented in teens within rural environments. Treatment for queer youth should be no different than it is for anyone else, yet it seems as though it has become one of the most marginalized groups within healthcare. When treatment is hidden under broad umbrella terms (for example, gender-affirming care), the true substance and necessity of that care are lost.
To begin, one of the biggest fears I have faced as a queer teen seeking medical attention has been a lack of anonymity. It seems like exposure and vulnerability are always at the forefront of my mind. What is the cost of confidentiality? Do I have to risk the care that I need to ensure I won’t be “outed” to my community? An abstract from the Journal of the Pediatric Orthopedic Society of North America addresses the link between being a member of the LGBTQ+ community and having poorer health due to mistreatment. The abstract states that women in same-sex relationships had a significantly lower health insurance rate, clearly displaying the unequal healthcare landscape [1]. In my experience, rural healthcare systems create such an intimate environment that it can hinder one’s vulnerability. Confidentiality only goes so far when the conversation leaves the exam room.
When you mention a rural healthcare system, you are likely looking at small towns that have access to one health center, one primary provider, or even none at all. Many small towns do not even have a healthcare system within their city limits, meaning they do not have access to specialized care either. So, how can youths obtain care that they do not have access to? They have to travel. Due to recent legislative change, 25% of Americans aged 10-17 travel over twenty-four hours just to receive medications like hormones to assist care. Before, the number was just shy of 2% [2]. This leaves teens all across the country without already prescribed medications, not just the ability to be prescribed.
Finally, the understanding of queer teens within healthcare is vague and limited. When should a teen be able to medically transition? Should a child be allowed to make these decisions? While answers vary widely, the smaller areas of the U.S. tend to lean towards more conservative conclusions. This limits comfort, safety, and trust in healthcare, which are arguably among the most important attributes of a successful system.
Teens should not be denied access to the healthcare they deserve just because of their differences. Discrimination has begun to disguise itself as concern, but at the root, it is still bigotry. Education and understanding among all healthcare workers should be encouraged, especially in rural areas. Neither your sexual orientation nor your gender identification should determine your eligibility for healthcare.
References:
[1] Poorer Health in the LGBTQ+ Community Due to Fear of Mistreatment – ScienceDirect