In 2019, someone I love dearly confided in me that they identified as a member of the LGBTQ+ community. They also shared this news with a close friend who betrayed their trust and told other people. Many incidents of bullying followed, and my friend no longer felt safe.
They were struggling to find acceptance and safety and that took a toll on their mental health. They felt suicidal and asked me for help. As a practicing nurse, I have cared for people in the LGBTQ+ community, but admittedly, my knowledge was limited regarding disparities, hardships, biases, stereotypes, and resources available to LGBTQ+ individuals. In my journey to help this person, while simultaneously educating myself, I was disheartened to discover the enormous roadblocks they face in healthcare every day.
The start to find solutions for my friend led me to the obvious: a family physician—the go-to person for all things health! To my dismay, their response went a little like this: “I don’t handle those kinds of things. You need to call a therapist.” We decided to assume the response came from a lack of knowledge versus not wanting to do it. (I was more positive at that point in this journey.) So, onward we went in search of a therapist with no recommendations from the family doctor.
The search for care was nothing more than abysmal—it was nearly impossible to find. Everyone was booked, and if they weren’t booked, they either had no interest in helping a queer person, or they just didn’t know how. I remember thinking at the time, “Is this real? Why is this so hard? What am I missing?” Most importantly, “How did I not know this gap of care was a very real problem?”
In desperation, I began researching. I found a local organization whose mission was to support families and friends of LGBTQ+ people and immersed myself in the group. I wanted help, but I also needed hope.
I spent countless hours in meetings listening to testimonies. I watched as children and teens gut-wrenchingly cried in search of love and acceptance. People talked of losing family, losing friends, losing jobs, losing housing, being harmed, and being declined help and healthcare due to their sexuality and gender preferences. It was the most painful and eye-opening experience of my life. Not only was my entire community failing these people, my very own beloved field of medicine was failing them as well.
During my time in the group, I was able to secure a list of local providers who were willing to help LGBTQ+ people (a good majority of those providers identified as LGBTQ+ themselves). This list was made in collaboration with the people experiencing disparities. I also received the “blacklist” of providers to absolutely stay away from. As thankful as I was to have guidance, the limited list still posed challenges of overbooked and understaffed providers. We did eventually find help, and I am happy to report that my friend made it to the happy side of this story. However, my nurse brain still defaults to the question, “What happened to the people who didn’t have the list? Did they make it out to the other side?” More importantly, “Why do we need a list to begin with?”
In late 2021, I was able to garner support from the college where I teach to host an awareness seminar highlighting these disparities. With the help of Transgender Assistance Program of Virginia (TAP), persons within the transgender community came to our campus to speak openly about their own healthcare hardships. It was very informal, with just a small amount of time spent on providing statistics and research.
The real learning came with the testimonies. Putting a human face to an unimaginable story has an impact that far surpasses PowerPoints, websites, and textbooks. The seminar was well received, and a lot of my coworkers had positive comments and expressed interest in incorporating some element of LGBTQ+ care in one or more of their lectures. It felt like we did something that evening; maybe not much, but if only one professor shared the information learned, who knows what butterfly effect that may have?
Since the seminar, professors and students have called me to inquire about specific LGBTQ+ resources for patients. I have even had the occasional call from an LGBTQ+ coworker needing assistance for themselves. I want to make it clear—I am a nurse who specializes in delivering babies and teaching nursing students. I am, in no way, an expert in LGBTQ+ care. What I am, however, is the only person they knew who had THE LIST. Healthcare access, education, and representation hold the key to decreasing disparities.
In my journey to establish a more formalized “rainbow list” (as I affectionately call it) for my own friends and family, I ran into an incredible website that has done a lot of the footwork already.* I wanted to share it with you in hopes that you keep it bookmarked for the next person/patient who may need it. Lists do save lives; I promise.
*I am in no way affiliated with lgbtqhealthcaredirectory.org, but I do think it is an amazing resource.
Denee Hollins, DNP, RN, is an assistant professor in the nursing program at Sentara College of Health Sciences and a member of Sigma’s Chi Kappa Chapter.