Inadequate medical care is a common complaint for the GLBTQ* community
Last spring, Barbosa told his family doctor he wanted to transition from female to male. After that, he would often leave the doctor’s office crying. “I definitely had a lot of extra dysphoria about myself because of the things he would say to me,” said Barbosa, a student at the University of Winnipeg completing the prerequisites for a veterinary program.
Barbosa’s doctor made him look in the mirror. He asked him what he saw. “I wasn’t sure how to answer and then he was like, don’t you think you’re a pretty girl?” Barbosa answered, “I guess,” but felt uncomfortable. “Obviously I don’t want to be a pretty girl. I want to be a handsome-looking young man.”
Barbosa’s experience with this doctor worsened when he talked about the possibility of receiving bottom surgery. “It’s something that I want. It’s something that will make me more comfortable with my body. But he just kept persisting with calling it mutilation.”
Barbosa’s bad experiences with medical professionals didn’t end there.
The doctor sent Barbosa to a gynecologist for a Pap test who assumed he was sexually active with men. “After it was done she asked me, ‘I thought you said you were sexually active. Why was it so painful for you?’” Barbosa told the gynecologist he’s only sexually active with women and she responded, “You should have told me that before we started because then you didn’t have to get it done.”
However, Barbosa’s gynecologist was wrong. Women’s Health Matters, a Canadian website about women’s health, started campaigns promoting Pap tests for trans men and queer women precisely because of the “dangerous misconception that women who have sex with women don’t need Pap tests,” according to the website. Women or trans men who have sex with women (WSW) are at a lower risk of HPV and cervical cancer, but are still at risk, according to CancerCare Manitoba. Their website states that anyone who has ever been sexually active (including oral sex, sex with toys, and sex with fingers) needs a Pap test every three years, starting at age 21.
This is just another one of the medical misconceptions around GLBTQ* health. Considering Barbosa’s experiences, it’s no surprise that GLBTQ* people get screened less for cancer, which means they’re at higher risk of dying from the disease. The New York-based National LGBT Cancer Network reports that one in five transgender patients reports being turned away by a health care provider. The experience of Jennifer Blair, a 62-year-old American woman who sought a free mammogram after she found a strange growth in her breast, made international headlines after Blair was denied a mammogram because she was born a male. Some transgender men who have undergone breast reduction instead of reconstruction may not know they should undergo breast-screening mammograms, as well.
Bradley Tyler-West, a service provider trainer in human sexuality, helps educate medical professionals about GLBTQ* topics for Sexuality Education Resource Centre Manitoba. His training sessions address assumptions that gay men have HIV or Syphilis, and that lesbians don’t need pregnancy options. But even though his training sessions take us a step forward, he believes that medical associations should make GLBTQ* education a requirement for health care professionals. “There is still a minimization (of) the complexity of human sexuality and they think that, ‘OK, we did a one-hour presentation, they’re good to go.’ They need to do a lot more.” To ensure people are getting the care they need, Tyler-West recommended researching GLBTQ*-friendly clinics and asking questions or voicing concerns to a health care professional. “But we understand that disclosure is risky. And if a person has had historical bad experiences with the health care system, then they’re going to carry that past experience.” He added that past experiences might stop people from opening up to their doctor.
Tyler-West said he hasn’t had a bad experience with a doctor because he has always gone to Klinic Community Health Centre. Klinic has a transgender health program and family physicians trained in GLBTQ* topics.
Ian Whetter, a physician in the transgender health program at Klinic, said a big problem with how healthcare professionals treat GLBTQ* people are the assumptions they make. “The testing that we do, or the line of questioning that we do, is universal. We should make no assumption about anybody’s sexual orientation, sexual behaviour, or gender identity,” he said.
Whetter said he thinks about behaviour and risk factor regardless of a person’s gender identity or sexual orientation. “For example, if you have a cervix, then it needs to be screened for cervical cancer. If you have a prostate, then you have to be screened for prostate cancer after you pass a certain age.”
If you experience discrimination from healthcare professionals, Whetter recommends contacting the College of Physicians and Surgeons Manitoba. Physicians at Klinic Community Health Centre are available as family doctors for those who are in the catchment. Call (204) 784-4090 to find out if you live within the catchment.
Do you have an experience with medical professionals that you would like to share? Tweet @OutWords, email us, or message us on Facebook.
– Danelle Cloutier is the music editor of OutWords.
- GLBTQ*-friendly clinics in Manitoba
- Klinic Community Health Centre
- Four Rivers Medical Clinic
- Nine Circles Community Health Centre
- Mount Carmel Clinic
- Corydon Primary Health Care
- Only 49 per cent of bisexual women aged 50 to 59 have had a mammogram in the past two years, compared to 71 per cent of heterosexual women (Canadian Cancer Society).
- GLBTQ* communities experience multiple risk factors for developing cancer, such as higher smoking rates, being less likely to have a family doctor and stress from discrimination (Canadian Cancer Society).
- Lesbians and bisexual women have higher rates of breast cancer than heterosexual women (American Cancer Society).
- Gay men are much more likely than straight men to have an eating disorder such as bulimia or anorexia (Rainbow Health Ontario).
- Lesbians are more likely to be overweight or obese than heterosexual women (Rainbow Health Ontario).