Medical, nursing and social-work students from around the country gathered in Chicago for the third annual LGBT Health Student Symposium April 20-22, organized by Howard Brown Health Center, Center on Halsted and the University of Chicago School of Medicine.
The symposium kicked off with a networking reception at Howard Brown Health Center April 20, featuring a differential diagnosis challenge and spoken word. At the reception Dr. Magda Houlberg, chief medical officer of Howard Brown Health Center, was awarded the conference's LGBT Health Achievement Award for 2012. The Gay and Lesbian Medical Association spring mixer followed the reception.
National experts in LGBT health lead workshops, presentations and discussions to help medical and allied health students close the gaps in LGBT health disparities.
Dr. Harvey J. Makadon, a clinical professor of medicine at Harvard Medical School and director of the National LGBT Health Education Center at the Fenway Institute in Boston, was the conference's keynote speaker. His report for the Institute of Medicine indicates LGBT youth have an elevated risk for attempted suicide and depression, and sexual minority youth may have higher rates of substance use than heterosexual youth. The report also found that LGBT people fear discrimination in health are settings, which prevents them from seeking routine care.
"Always ask about sexual orientation and gender identity to best care for the patient," said Makadon.
Makadon also spoke in depth on transgender healthcare, defining transgender and related vocabulary, as well as explaining the importance of transition related care.
"Someone once said, 'The source of identity is in your soul,'" said Makadon. "It's not so much a transition, but an affirmation of what has always been."
"Transgender people often have to teach doctors because it's hard to find a physician in the area who knows anything about transgender people," said Makadon.
There is very little research on LGBT-specific healthcare over the long term, so no doctor has all the answers on treating LGBT patients; however, Makadon explained that creating a respectful, culturally competent environment during exams can foster a dialogue on uncomfortable or unknown topics.
"There's oppression everywhere; it will impact us. We have to recognize it impacts mental health and the ability to access healthcare when people need it," he said.
Houlberg presented on Howard Brown Health Center's patient-centered care that focuses on informed consent and harm reduction. Currently, 65 percent of the clinic's primary care patients are LGBT, and many patients live in poverty and have no health insurance.
"[Howard Brown Health Center] actually serves patients from 30 states and one Canadian province. People travel very far for our services," said Houlberg. "This illustrates the great need for LGBT health centers … We have a high percentage of folks who don't have access to care outside our center or county services."
Houlberg also addressed the normalization of HIV-related care, something that has traditionally been a specialization but has become so much more manageable with medication that it will begin to fall under primary care.
"Doctors are going to have to get over it. It can be learned. It will be learned," she said.
Representatives from Chicago Black Gay Men's Caucus (CBGMC) discussed the HIV epidemic regarding Black men who have sex with men (MSM), who account for 52 percent of new infections nationallyapproximately twice that of their white and Latino counterparts.
"When 2 percent of the population makes up 52 percent of infections, hello, we've got some issues," said Craig Johnson of CBGMC.
Stigma around HIV was identified as an issue for Black gay men. Said stigma affects a person's decision to get tested for HIV, maintain treatment if they test positive and disclose HIV status to sex partners.
"We are unapologetically Black and gay. We want to mobilize everyone who identifies that way while recognizing not everyone identifies that way," said CBGMC's Keith Green.
Stigma around sexual orientation, gender identity, race and social class can also affect access to medical care, according to Piper Coutinho-Sledge, a sociology doctoral candidate at the University of Chicago.
"Medical professionals have to be a fierce advocate for people who may not want to walk through your door," said Coutinho-Sledge.
John Stryker, a clinician at Howard Brown Health Center, led an introduction to transgender health, defining sex, gender identity and preferred gender pronouns, and explained feminizing and masculinizing transition services.
"I don't think any of us [at Howard Brown Health Center] had any idea how many people are seeking trans healthcare," said Stryker. "Since the beginning of the year, of 150 new patients … 40 were transgender."
Howard Brown Health Center uses an informed consent treatment model for hormone replacement therapy, explaining the benefits and risks of taking hormones and allowing transgender patients to decide what is right for them.
Other speakers tackled LGBT inclusion in medical school curriculum, the sociology of healthcare and LGBT mental health.
"Changing medical care for LGBT people will positively impact many people's lives," said Nathan West, a second year at the University of Chicago and an organizer of the symposium. "LGBT stigma interferes with patient care. Engaging medical students on these issues early in their training helps integrate critical LGBT health concepts into clinical practice, allowing for more comprehensive patient care for this patient population."