As this Pride
Month concludes, queer activists everywhere should consider what health equity
means for queer liberation. Then we should get to work to fight for the health
care our queer bodies deserve.
In Bodies
and Barriers: Queer Activists on Health, contributing author Laura A.
Jacobs wrote, “Every trans-identified person I’ve ever met has experienced it;
a medical interaction during which we felt fetishized or insulted, when a
provider used insensitive or inappropriate language, where a professional pried
for information not relevant to the clinical issue. Rather than encouraging a
bond, these moments only amplified the resistance.”
So many queer
and trans people I know have had a negative past experience with a health care
provider because of our queer or trans identity. And this frequently translates
into a fear of seeking health care in the future. So it’s not a surprise that
our community experiences lower rates of both preventative screenings and
access to primary care clinicians. And what follows is also not a surprise:
that our communities experience higher instances of chronic diseases, including
HIV, cancer, and diabetes. The social conditions of our lives lead many of us
to engage in higher-risk behaviors for these and other chronic diseases, but
our lack of preventative screening means we as a population aren’t accessing
the lifesaving early treatment that we need.
This is not
the fault of any one of us. And it is antithetical to queer liberation to shame
anyone for engaging in behavioral risk that some consider “risky.” Our
population has experienced enough shaming and judgement to last a lifetime, and
we shouldn’t be shaming each other. Judging others also doesn’t address the
real reason we as a population experience such severe health disparities. There
are simply too many barriers to care — literal stumbling blocks — standing in
between us and the affirming health care we need. These barriers to care are
even more burdensome for trans communities, BIPOC queer communities, rural
queer communities, queer youth, and queer older adults. Barriers to care can be
geographic (for example, entire rural counties without a trans-affirming
endocrinologist), clinical (such as gender- restrictive intake forms), or
structural (insurance that doesn’t cover certain LGBTQ health care needs.)
Sometimes health care providers haven’t received enough training to adequately
provide care for our communities. Other times it’s government policies that are
slow to change. Barriers to care are pervasive, and they hold us back from our
full potential.
My vision of
queer liberation includes long, healthy, and vibrant lives for queer and trans
people. We exist in the future, and we should be able to achieve longevity to
enjoy the victories our community has fought so hard to achieve (while always
striving for more). To make that vision a reality, we must incorporate health
equity into our queer liberation work. This includes coming out to our health
care providers, or when that isn’t possible, switching to an LGBTQ-affirming provider
where being out will feel safer. It includes annual physicals and preventative
cancer screenings. It includes quitting tobacco. It also includes changing the
broken health care system that has left all queer and trans bodies behind. We
deserve a Medicare for all system, one where people matter more than corporate
profits, and decisions are made based on what is best for our health and our
lives.
In the
foreword to Bodies and Barriers current U.S. Assistant
Secretary of Health Dr. Rachel Levine wrote, “The multidimensional degree of
systemic inequalities calls for significant action among health care providers
and policy makers. It’s unacceptable for providers and policy makers to
continue to turn a blind eye to this issue.”
I agree with
Dr. Levine. Our bodies, our health, our community are too important. Our
liberation includes our continued striving toward health equity. We have to
fight for it. We have to tell our stories about the health care challenges we
have had, and we need to speak loud enough so that even our doctors can hear
us.
Health equity
is in fact an unmet dream. But as Kate Kendell wrote in Bodies and
Barriers, “Our movement for equality, for liberation, has been
breathtaking in its gains. But we still fight for our humanity, our health, and
our happiness. The priority for a new generation must be the health of every
one of us and the promise of a long, healthy, fully-embraced life.”
Adrian Shanker is editor of Bodies
and Barriers: Queer Activists on Health (PM Press, 2020) and
executive director of Bradbury-Sullivan LGBT Community Center. He lives on
unceded Lenape Land in Allentown, Pa.
SOURCE: ADVOCATE
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