Trans Pride Initiative’s health fair, held in conjunction with Parkland, is open to the entire community
PLAYING IT SAFE | Cd Kirven had a mammogram at last year’s Trans Health Fair and found a lump. (Photos courtesy Cd Kirven)
When Cd Kirven attended last year’s Trans Health Fair, she just wanted to support the Trans Pride Initiative’s event.
She and organizer Nell Gaither had been working together on the Dallas City Council’s LGBT Task Force. “She represents everyone in the community,” Kirven said of Gaither.
Kirven said she knew how important getting the LGBT community into healthcare was, so she decided to set an example by having a mammogram.
“Lots of women in our community haven’t had a Pap smear or a mammogram,” Kirven said.
She said the mammogram she had that day could have saved her life: the mammogram detected a lump. Although a biopsy determined the lump was benign, she plans to have it removed as a precaution after taking care of some other health concerns.
This year, Parkland hospital and UT Southwestern became major partners in the third Trans Health Fair. In addition to providing general wellness screenings for blood pressure, body mass index, glucose and cholesterol, Parkland would like people to remain in care. Representatives will review eligibility for Parkland health plans for those looking for health coverage.
A shuttle will run people between Amelia Court and the UT Southwestern Center for Breast Care for chest and breast screenings and diagnostic exams.
Discounted flu shots and free HIV testing will be also available.
Gaither said connecting people to care is a main goal of the health fair, noting that a number of barriers to healthcare exist within the trans community.
“Many people are simply afraid of not being affirmed at the doctor’s office,” she said.
One trans man drove down to the health fair from Little Rock last year. Gaither said she was sure she could connect him to care at home, but he said he had already tried all of the doctors who claimed to be affirming.
“They won’t look me in the eye,” he told Gaither. “They won’t address me by my preferred name.”
Rather than face what he called harassment and discrimination in a doctor’s office, the man chose to take the day off to drive to Dallas for basic medical care.
Gaither said a related barrier to healthcare is being disrespected in the doctor’s office by the staff. She said she went for a colonoscopy soon after she began presenting as a woman. After turning in her paperwork, the receptionist said, “Thank you, sir,” outing her to the others sitting in the waiting room.
Some doctors refuse transgender patients because they say they don’t understand how to prescribe hormones to trans men and women.
“For a healthy person with no co-morbidities, it’s not complicated,” Gaither said.
Gaither said those same doctors work with post-menopausal women and with men with low testosterone levels.
Insurance may be slightly less of a barrier than it was in the past since being transgender may no longer be considered a pre-existing condition. But that doesn’t mean policies cover everything. In addition, many trans men and women lose their jobs as they begin to transition, so they lose their benefits, including health insurance.
As part of the health fair, UT Southwestern will offer mammograms for anyone who is uninsured or underinsured. That category of underinsured would include someone with breast tissue who is listed on a policy as male. Most insurance wouldn’t cover a mammogram for a man.
Brad Walsh serves on Parkland’s Hospital Equality Index committee to address issues in Human Rights Campaign’s healthcare survey.
“Two years ago we took the HEI survey for the first time,” Walsh said.
He said studying the items was eye-opening for the committee but as they worked through several, they found, “Yeah, this is really working.”
Unisex bathrooms are now located throughout the facilities. While sexual orientation was already included in the hospital’s visitation policy, gender identity wasn’t, so that was added.
HRC asked about community participation. Walsh said the hospital participated in Pride. The Trans Health Fair is something else they can add in that category.
He said a number of employees participated in a cultural competency training class. A respectful use of pronouns by doctors and office staff, he said, helps a trans man or woman feel welcome in a hospital office or emergency room.
Walsh said the committee reviewed ways front desk staff should take a sexual history, and he said the HEI helped the committee make improvements that benefited many more than just LGBT families: Policies honoring domestic partnerships were aimed at same-sex couples, but also respect straight couples who may not be married.
Going through HRC’s guidelines, Walsh said, helped the committee help the hospital update parts of its online medical records. Instead of asking for a child’s mother and father, the records now list the child’s parents and guardians. He said that correction not only applies to children with same-sex parents, but children in a variety of family situations — children in blended families, children whose parents have remarried and have joint custody along with their new spouses.
Walsh said the goal at Parkland is for any doctor to be able to treat any patient, but at the same time, some physicians have more experience working with trans patients. So several doctors have taken the lead in caring for trans patients and are making themselves available for consultation with other staff members.
The health fair is open to everyone, Walsh said, adding that, “We’d love to show off what we do for the community.”
In addition, he said, the hospital is recruiting members of the LGBT community to participate in community needs assessment. Walsh said one area the HEI committee is studying is whether Parkland’s health coverage “takes care of the person where they are.” As an example, he said, a trans man might need a hysterectomy that other insurance won’t cover if his gender marker has already been changed to male.
Gaither also welcomed everyone to the health fair regardless of gender identity or sexual orientation. Parking is free at Amelia Court where the gates will be open for the day for easy access.
Nov. 8 at 11 a.m.–5 p.m. Amelia Court Clinic, 1936 Amelia Court. Chest and breast screenings at UT Southwestern Center for Breast Care, Third Floor, Seay Biomedical Building, 2201 Inwood Road. Tpride.org.
This article appeared in the Dallas Voice print edition October 31, 2014.
