UCSF Director Calls for Open Communication at National LGBTI Conference

UCSF was well-represented at the National Lesbian, Gay, Bisexual, Transgender & Intersex (LGBTI) Health Summit, held last week in Philadelphia. This year's theme, "Beyond Boundaries: A Blueprint for LGBTI Healthcare Equality," focused on getting all LGBTI communities across the country to come together to develop a long-term strategic plan for LGBTI health and wellness. The biannual conference focuses on a wide range of LGBTI health issues, from longstanding concerns like HIV/AIDS, lesbian breast cancer risk, substance use, and mental health to leading-edge topics like microbicides and anal pap smears for men who have sex with men. It also addresses grassroots "health challenges" for lesbians, bisexual health priorities, health insurance coverage for transsexuals and medical attitudes toward intersex people. UCSF Director of LGBTI Resources Shane Snowdon, who co-convened the National LGBTI Health Summit in 2002 and 2004, spoke at the 2007 summit's opening plenary, which examined the impact of the frequent use of phrases like "high-risk," "at risk," and "in need" to describe LGBTI people's health. While affirming that LGBTI people as a group are, in fact, often at risk and in need, Snowdon suggested that prevailing ideas of LGBTI health risks and needs be substantially broadened to avoid unintended stigmatization of LGBTI individuals. She cited three much-overlooked "overarching health risks" for LGBTI people: * Poor self-care, because of the damage done to self-esteem by experiences of bias, hostility and worse; * Delayed or avoided medical care, because of negative experiences with the health care system; and * Substandard medical care, because providers may be unprepared, uncomfortable or even biased in relation to LGBTI patients. Snowdon called on LGBTI people to "engage in, yes, risky behavior" to bring an end to these problems. "Let's engage in radically open and honest community conversation about self-care-self-care not just to avoid risk, but to experience power and joy," she said. "Let's come out to our providers, rather than avoiding them. Let's bring them The Lesbian Health Book, Men Like Us, Transgender Care and The Medical Normalization of Intersex the way women used to bring Our Bodies Our Selves to their doctors. And let's protest incidents of substandard care. Let's respond when a medical office tells a transsexual patient, 'We don't deal with people like you,' when a fertility doctor tells a lesbian couple, 'We don't inseminate people like you,' when a nurse walks out of a hospital room where a gay man is tenderly holding his partner's hand and says, 'I can't believe I have to deal with people like you.'" Outreach Strategies Other UCSF attendees included Master's Entry Program in Nursing (MEPN) student Jay Dwyer, also known as Sister Constance Craving of San Francisco's Sisters of Perpetual Indulgence. As Sister Constance, Dwyer recounted for summit participants the Sisters' "28 years of community service work in queer centers around the globe, including our rise during the '80s and the HIV crisis and our role in developing outreach strategies for other marginalized queer health communities." Dwyer, who has lectured at UCSF on harm reduction, went on to plan a "bar ministry" for the following evening, when summit attendees visited several Philadelphia gay bars, wearing white T-shirts on which they invited patrons to write comments that had "created shame and guilt for them as queer people." (One patron told a shirt-wearer that he had been considering committing suicide that night until the "summiteers" began talking with him.) The next day, summit attendees encountered chairs draped with dozens of T-shirts bearing hate-filled, anti-LGBTI epithets-phrases that had lost much of their sting in being transferred to the shirts. Also in attendance at the summit was Jeff McConnell, a senior research associate at the UCSF-affiliated Gladstone Institute of Virology and Immunology, who discussed "serosorting," the practice of choosing to engage in sex only with a partner of the same HIV status. McConnell based his summit presentation in part on his work as project director of the Positive Partners study, which presented the first data suggesting that serosorting "has a role in mediating constant HIV incidence among San Francisco MSM [men who have sex with men] despite increasing unprotected intercourse." The Philadelphia summit also featured a "lesbian health town meeting," co-convened by Snowdon and Diane Sabin, executive director of the UCSF Lesbian Health & Research Center, at which two dozen activists from around the nation discussed their visions of lesbian and bisexual women's health. Snowdon and Sabin also spoke at a moving tribute to LGBTI health pioneer Eric Rofes, a San Francisco-based author, teacher, and activist who died in June 2006. Related Links: UCSF LGBTI Resources