♪ ♪ ♪ ♪ WHICH PROCEED NOUN WE USE IS JUST THE BEGINNING.
WE MUST ALSO ADDRESS PSYCHO SOCIAL CHANGE.
PLEASE JOIN US AS WE TALK WITH Dr. KAREN KRIGGER AS WE TALK ABOUT PROVIDING CARE TO THE LGBT COMMUNITY NEXT ON KENTUCKY HEALTH.
YOU ARE WHO YOU SAY YOU ARE.
THE SIMPLE CONCEPT IS OF SUCH GREAT IMPORTANCE THAT THE FIRST OF THE THREE INSCRIPTION WRITTEN AT THE TEMPLE OF APOLLO AT DELPHI IS KNOW THYSELF.
KNOWING THAT IS NOT AS EASY AAS IT MAY SEEM.
THE GREEK FLOSS TER SAID THE MOST DIFFICULT THING IN LIFE IS TO KNOW YOURSELF.
ONCE A PERSON ACCEPTS AND UNDERSTANDS WHO THEY ARE, THE NEXT STEP IS FOR US TAKING A PAGE FROM THE NAVI OF AFTER AVATAR FAME TO SAY TO THEM, I SEE YOU.
WHETHER WE ARE AGREE OR NOT, EVERYTHING IS NOT BINARY.
ISSUES OF SEXUAL ORIENTATION, GENDER IDENTIFICATION AND THE ASSIGNMENT HAVE COME TO THE FOREFRONT FAR FASTER AND MORE INTENSE THAN MANY WERE PREPARED TO HANDLE.
PEOPLE ARE PEOPLE AND THE FOIBLES, ILLNESSES AND PROBLEMS OF OUR NEIGHBORS SHOULD BE OUR CONCERN, NOT AN FRONT TO OUR PERSONAL BIASES.
MOST TIMES THE HEALTHCARE CONCERNS OF THE LGBTQ COMMUNITY ARE MUNDANE AND THE SAME OF THOSE AS THOSE IN OTHER COMMUNITIES.
HOWEVER, SOMETIMES THEY'RE UNIQUE AND RESOLVING THEM REQUIRES TRUST AND GOOD FAITH EFFORTS.
TO TALK TO US ABOUT HEALTH ISSUES OF CONCERN WITHIN THE LGBTQ COMMUNITY, WE HAVE AS OUR GUEST Dr. KAREN CRAIG ERR, GRADUATE OF THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND LATER COMPLETED CERTIFICATION BY THE AMERICAN ACADEMY OF H.I.V.
MEDICINE AND NOW SERVES AS THE IMMEDIATE PAST CO-CHAIR OF THAT ORGANIZATION'S SOUTHEAST REGION.
Dr. KRIGGER IS A PROFESSOR IN THE DEPARTMENT OF FAMILY AND GERIATRIC MEDICINE, FOUNDATION FOR HEALTHY KENTUCKY ENDOWED CHAIR AT THE UNIVERSITY OF LOUISVILLE AND IS THE DIRECTOR OF HEALTH EQUITY AT THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINES OFFICE OF DIVERSITY AND INCLUSION.
GERMANE TO TODAY'S TOPIC, Dr. KRIGGER HAS A SPECIAL INTEREST IN LGBTQ ISSUES.
THANK YOU VERY MUCH FOR BEING WITH US.
>> THANK YOU FOR THE INVITATION.
>> PRONOUNS, WE ARE WHO WE SAY WE ARE.
WHAT DOES A PRONOUN REALLY TELL US ABOUT OURSELVES?
>> WELL, FIRST OF ALL, YOU CANNOT ASSUME ANYONE'S PRONOUN.
YOU NEED TO ASK HOW THEY WISH TO BE ADDRESSED.
SOME MAY IDENTIFY THEMSELVES AS HE, HIM OR HIS.
SOME MAY SAY HER/SHE/HERS AND SOME SAY THEY OR THEM.
AND TO BELIEVE WHAT THOSE MEAN, HAVE YOU TO KNOW A LITTLE BIT ABOUT THE LANGUAGE AND DO UNDERSTAND THAT SOME PEOPLE MAY WISH TO BE CALLED BY THEIR NAME.
BUT YOU HAVE TO ASK.
YOU HAVE TO NOT ASSUME, AND THEN WHEN ASKING, SEPTEMBER.
AND YOU NEED TO ACCEPT IN YOURSELF THAT IF SOMEONE LOOKS TO BE ONE KIND OF A PRONOUN, THAT THEY IDENTIFY THEMSELVES AS SOMETHING DIFFERENT YOU ARE GOING TO MAKE MISTAKES HOW AWE DRESS THEM.
-- HOW YOU ADDRESS THAT.
ACKNOWLEDGE IT, APOLOGIZE AND MOVE ON.
THEY WILL GIVE YOU A BYE ON THAT BECAUSE THEY KNOW YOU ARE TRYING.
>> I REMEMBER TALKING TO A WOMAN WHOSE CHILD COMMITTED SUICIDE AND BUT SHE NEVER ASKED HER CHILD IF THEY WERE WORRYING BECAUSE SHE DIDN'T WANT TO INTRUDE.
SHOULD WE WORRY ABOUT THE PATIENT OR INDIVIDUAL THAT WE MAY MEET IN BUSINESS DEALINGS OR WHATEVER, IS THAT AN INSULT TO THEM IF WE HAVE TO ASK WHAT IS THEIR PRONOUN?
DO SOME PEOPLE TAKE AFFRONT TO THAT?
>> NO.
2 I THINK ESPECIALLY FOR LGBTQ PEOPLE, THEY CONSIDER IT AN HONOR FOR YOU TO GIVE THEM THAT HONOR OF ASKING HOW THEY WISH TO BE ADDRESSED.
THE CLOSEST THING I CAN GIVE EQUIVALENT TO THAT IS IN MY OFFICE WITH MY LEARNING STUDENTS, I DON'T ALLOW THEM TO CALL MY PATIENTS BY THEIR FIRST NAME IF THE PATIENT IS OLDER THAN THEM.
IT'S Mr. OR Mrs. AND THAT TELLS THE PATIENT WE ARE GIVING HONOR TO YOU BY USING YOUR TITLE THE SAME THING WITH LGBTQ WHEN YOU ASK ABOUT HOW DO YOU WISH TOSH KNOWN AS?
WHAT IS YOUR PRONOUN YOU WANT US TO CALL YOU BY.
>> MOST PEOPLE ARE VERY HAPPY.
THE NON-LGBTQ COMMUNITY PATIENTS, THEY'RE OKAY WITH THAT?
CR.
>> YOU KNOW THAT IN A CERTAIN AGE GROUP, PARTICULARLY OURS, A LOT OF THE LGBTQS DIDN'T HAVE THE VOCABULARY TO IDENTIFY HOW THEY FELT OR HOW THEY WERE VIEWED IN SOCIETY AND THEY MAY OR MAY NOT BE CLOSETED.
SO THEY MAY NOT BE OUT YET BUT WHEN YOU ASK ABOUT PRONOUNS, YOU ARE TELLING THEM THAT YOU HAVE A SENSE OF AWARENESS THAT THE WORLD IS DIFFERENT AND THE WORLD IS ACCEPTING AND YOUR MEDICAL OFFICE IS ACCEPTING OF THEM WHEN WE TALK ABOUT SEXUAL ORIENTATION AND I'M NOT SURE THAT'S THE RIGHT TERM, BUT WE GO FROM, AGAIN, WITH THE LGBTQ CONCEPT, WHAT DOES THAT ALPHABET SOUP REPRESENT?
>> I'M GOING TO TRY TO DO IT IN TWO WAYS.
IF IT'S A WOMAN WHO HAS BREASTS AND ALL THE ACCOUTREMENTSES OF BEING FEMALES AND ACCEPTS HERSELF AS BEING A FEMALE, A CYST FEMALE.
IF SHE IS ATTRACTED TO MALES SHE IS HETEROSEXUAL AND IF SHE IS ATTRACTED TO FEMALES SHE IS A LESBIAN OR HOMOSEXUAL.
IF YOU HAVE A PERSON BORN MALE AT BIRTH AND HE IS COMFORTABLE BEING A MALE.
HE IS WHAT WE CALL A SIS MALE.
IF THAT PERSON, WHO IS COMFORTABLE BEING A MALE FIND THEMES EMOTIONALLY, PHYSICALLY, SEXUALLY ATTRACTED TO ANOTHER MALE, WE CALL THAT PERSON HOMOSEXUAL OR GAY.
SO YOU'VE GOT THE LG THAT'S LBZ AND LESBIAN AND GAY.
THE GAY IS FROM THE MALE.
LGBT, BISEXUAL, PEOPLE ATTRACTED TO BOTH MALES AND FEMALES.
THAT'S THE B, THE T IS TRANSGENDER.
YOU HAVE INDIVIDUALS THAT ARE BORN ONE WAY, FOR INSTANCE, MALE, BUT IN THEIR HEARTS OF HEARTS, THEY BELIEVE THEMSELVES TO BE FEMALE.
THEY WISH TO BE FEMALE.
THEY MAY MOVEMENTS MEDICALLY BY HORMONES OR SEXUAL AFFIRMATION TO BECOME FEMALES, TRANSGENDERS TO FEMALES OR YOU MAY HAVE A GIRL BORN GENETICALLY ON HER BIRTH CERTIFICATE, IT SAYS GIRL BUT IN HER HEARTS OF HEARTS GROWING UP SHE IDENTIFIES AS A MALE, SHE WISHES TO BE A MALE, SHE TAKES THE HORMONES TO BE A MALE, SHE MAY HAVE SURGERY TO ACHIEVE THAT.
THAT'S A TRANS MALE.
THEN YOU HAVE PEOPLE THAT ARE NOT QUITE SURE IF THEY'RE MALE OR FEMALE.
THEY QUESTION THEIR ATTRACTIONS, THEY MAY QUESTION THEIR SEXUAL ORIENTATION AND WHETHER THEY'RE MALE OR FEMALES AND WE CALL THEM THE Qs.
THE QUESTIONERS OR QUEERS.
THAT'S A DIFFERENT PART.
THAT'S WHERE THEY DON'T FEEL THE IDENTIFICATION OF GAY OR LESBIAN FITS THEM.
THEY'RE DIFFERENT.
SO THEY'RE THE Qs.
SO THAT Q COULD BE QUESTIONING, I DON'T KNOW WHAT I AM OR WHO I'M ATTRACTED TO OR IT COULD BE I DON'T FIT THE LABELS SOCIETY HAS SAID I SHOULD BE.
ADDITIONALLY, WE'VE GOT PEOPLE THAT ARE NON-BINARY.
YOU MAY HAVE HEARD THAT TERM.
I THINK ONE OF THE FAMOUS NON-BINARIES, WHEN A DOCUMENTER WAS MADE BY AMAZON PRIME THIS PAST OCTOBER IS ON POLLY MURRAY, A BLACK NON-BINARY FEMALE, LAWYER AND ACTIVIST, POET AND AUTHOR, SHE WAS ACTUALLY ONE OF THE SIX WOMEN WHO WERE FIRST PRIEST AND FIRST BLACK FEMALE AS A PRIEST.
SHE LIVED FROM 1910 AND DIDN'T DIE UNTIL 1985.
THE TERM NON-BINARY WASN'T AVAILABLE TO HER, BUT SHE DIDN'T IDENTIFY AS BEING MALE OR FEMALE.
AND SO NOW HISTORICALLY WHEN WE LOOK BACK AT HER, WE GIVE HER A LABEL OF NON-BINARY.
MOST PEOPLE REFER TO HER IN PRONOUNS AS HER, SHE OR HERS.
THAT MAY CHANGE.
>> WHAT YOU'VE DESCRIBED THOUGH, IN THE CLASSIC SENSE, AND TOO OFTEN WE LOOK AT IT, THE CHILD IS BORN, PENIS MALE.
VAGINA FEMALE.
BUT THERE IS A CONTINUUM THAT DOES NOT DEFINE WHAT THE GENDER ACTUALLY IS OR DOES IT?
>> MORE IMPORTANT FOR THE PERSON, WHETHER IT'S THE CHILD OR THE TEEN OR THE ADULT FEEL THAT THEY FIT THE ROLE.
SO IF THEY'RE BORN A MALE, BUT THEY DON'T FEEL THAT'S THEIR INCLINATION, THEIR ATTRACTIONS, THEN THEY WISH TO BE A FEMALE.
AND THERE ARE WAYS TO ACHIEVE THAT.
THE PROBLEM IN OUR SOCIETY IS THAT BINARY DESIGNATION THAT YOU SPOKE OF, MALE OR FEMALE BECAUSE YOU HAVE THESE PARTS, AND YOU KNOW THERE ARE PEOPLE THAT ACTUALLY HAVE PARTS OF BOTH.
AND SOMEONE AT THE TIME THIS PARTICULAR CHILD WOULD HAVE BEEN BORN, MADE THE DECISION THAT THIS IS GOING TO BE A BOY.
THIS IS GOING TO BE A GIRL.
AND AS THAT PERSON GROWS, THEY HAVE TO DISCOVER THIS JOURNEY THEMSELVES AND WHAT THEY WANT.
IT IS VERY HARD IN OUR SOCIETY THAT IS BINARY TO PROPOSAL MAKE-- HARD TO MAKE A LIFE.
I'M GOING TO GO BACK TO POLLY MURRAY.
PART OF THE FILM IN THE BEGINNING TALKS ABOUT THE SUPPORT HER FAMILY HAD RECOGNIZING VERY EARLY ON THAT SHE WAS A VERY DIFFERENT CHILD.
THEIR SUPPORT AND THE SUPPORT WE CAN LEND TO OUR RELATIVES AND OUR PATIENTS AND OUR FRIENDS AND CO-WORKERS, ACCEPTING THEM OF WHO THEY ARE AND THEIR ROLE SO THAT THEIR GIFTS THAT THEY WERE GIVEN BY A HIGHER POWER CAN BLOSSOM.
BY NOT ACCEPTING THEM WE CONSTRAIN THEM AND CAUSE A GREAT DEAL OF MENTAL ILLNESS.
AND SO IN SOME OF THE POPULATIONS WE HAVE TALKED ABOUT, WE HAVE A VERY HIGH RATE OF SUICIDE AND MENTAL ILLNESS.
THERE IS A BOOK CALLED GENDER QUEER.
AND I LIKE THIS BOOK.
IT'S ACTUALLY, I CALL IT A COMIC BOOK BUT YOU'VE.
>> GRAPHIC NOVEL.
>> IT'S A VERY EASY READ AND I THINK IT'S PERFECT FOR PARENTS THAT ARE STRUGGLING WITH THIS CONCEPT OF MY CHILD HAS TOLD ME THEY'RE QUEER.
IT IS A MEMOIR AND IT EXPLAINS THE JOURNEY AS A CHILD REALIZING HOW DIFFERENT SHE WAS THROUGH COLLEGE AND YOUNG ADULTHOOD.
SO THERE ARE RESOURCES OUT THERE THAT PEOPLE THAT I CONSIDER MYSELF A LUDITE IN MOST THINGS.
COMPUTERS AND MOST THINGS THAT ARE NEW, THR THINGS OUT THERE THAT HELP US TO UNDERSTAND THE PERSPECTIVES OF THE PEOPLE WE ARE AROUND AND IT BEHOOVES US, ALL OF US, TO UNDERSTAND THAT.
MINISTERS INCLUDED.
>> ALONG THAT SAME LINE, PARTICULARLY THE MENTAL ILLNESS FACTOR.
IT SEEMS LIKE THE SUICIDE RATE IS VERY HIGH, PARTICULARLY WITHIN YOUNG PEOPLE IN THIS COMMUNITY.
IS THAT BECAUSE OF THE STRESSES AND STRAINS OF SELF AWARENESS THERE IS A LOT OF STRESS AND STRAIN IN OUR CULTURE THESE DAYS.
YOU TAKE AWAY COVID AND ADD IN THE FACT THEY'RE TEENAGERS TRYING TO FIGURE OUT THEIR SEXUAL ORIENTATION.
AGAIN THERE IS THIS ACCEPTANCE.
I HAVE BEEN TAKING CARE OF PATIENTS IN THIS POPULATION FOR 35 PLUS YEARS AND THOSE WHOSE FAMILIES ARE ACCEPTIVE AND SUPPORTIVE OF THEM, THEY'RE COMMUNITIES, WE ARE SOCIAL BEINGS AND I WANT TO SAY ESPECIALLY FOR AFRICAN-AMERICANS WHERE THE CHURCH PLAYS SUCH AN IMPORTANT PART IN OUR UPBRINGING AND OUR SOCIETY, IF THEY FEEL THAT THEY'RE NOT MEETING THOSE ROLES OR EXPECTATIONS AND THEORY STRANGED FROM THOSE SUPPORTS, THEY HAVE A WORSE OUTCOME PHYSICALLY, MENTALLY AND EMOTIONALLY.
WE HAVE TO BE VERBALLY SUPPORTIVE, NOT JUST BYSTANDERS SAYING I'LL CALL YOU ON YOUR BIRTHDAY.
COME INTO THE FAMILY, HAVE DINNER, EDUCATE US, SHARE YOUR LIFE, BE THEIR ADVOCATES AS THOUGH EVERY PARENT I THINK TRIES TO BE AN ADVOCATE FOR THEIR CHILD IN SOME WAY.
BUT SOMETIMES THESE JUDGMENTAL STIG MATTA GET IN THE WAY AND WE THINK WE CAN CHANGE THIS PERSOND THAT'S ANOTHER STRESSOR ON THEM.
WE WANT TO HELP THEM NAVIGATE THE WORLD THEY'RE SEEING BECAUSE NOT EVERYBODY IS GOING TO LOVE THEM, WE SHOULD LOVE THEM AS OUR CO-WORKERS, PARENTS, SIBLINGS.
>> NOT ONLY DO YOU FIND THAT IN THE AFRICAN-AMERICAN CHURCH BUT IN A LOT OF RURAL PARTS PARTICULARLY RURAL KENTUCKY, EAST AND WEST, THE CHURCH STILL PLAYS THE COMPANY ROLE.
>> GOD IS GOING TO JUDGE FOLKS.
BEE DON'T HAVE TO DO THAT.
>> YOU ARE RIGHT ABOUT THAT.
>> ALL WE HAVE TO DO IS ACCEPT WHO THEY ARE.
>> ISSUES LIKE THIS NORTH CAROLINA WHERE THEY'RE DEFINING BATHROOMS IS THAT A SIGNIFICANT PROBLEM FOR PEOPLE IN THIS COMMUNITY?
>> THE ISSUE OF BATHROOMS ISN'T JUST A PROBLEM.
IT'S A DANGER.
IF YOU ARE VIEWING YOURSELF AS A FEMALE EVEN THOUGH GENETICALLY YOU MAY BE MALE AND YOU MAY HAVE THE ATTACHMENTS OF A MALE BUT YOU VIEW YOURSELF AS A FEMALE, IF YOU GO INTO A FEMALE RESTROOM BATHROOM, YOU MAY HAVE THE DANGER OF BEING EMOTIONALLY ACCOSTED IF NOT PHYSICALLY.
IF YOU GO INTO A MALE BATHROOM, IT'S EVEN MORE DANGEROUS BECAUSE YOU MAY NOT BE PRESENTING AS A MALE THAT'S ACCEPTABLE IN THEIR CULTURE IT IS VERY IMPORTANT THAT WE HAVE SAFE SPACES FOR PEOPLE AND AGAIN I'M GOING TO GO BACK IN HISTORY WHEN AFRICAN-AMERICANS WEREN'T ALLOWED TO GO INTO PUBLIC RESTROOMS AND HAD TO GO BLOCKS, BUILDINGS, STAIRS, TO GET TO A BATHROOM THAT THEY WERE ALLOWED TO GO INTO.
PEOPLE THAT HAVE ISSUES LIKE THIS ARE IN A VERY SIMILAR SITUATION FOR THEIR OWN SAFETY NOW.
>> TELL ME WHAT DOES GENDER REASSIGN MANY SURGERY, NOT NECESSARILY THE PROCEDURE ITSELF, BUT WHAT IS THE THINKING THAT GOES INTO HAVING THAT SORT OF PROCEDURE?
>> IF YOU ARE A FEMALE AND YOU DECIDE AND SOMETIMES IT'S NOT A CONSCIOUS DECISION FOR A LONG TIME.
IF YOU DECIDE YOUR LIFE WOULD BE BETTER AS A MALE BECAUSE THAT'S THE CULTURE AND THAT'S HOW YOU RESPOND, YOUR GOAL IN BECOMING A MALE WOULD BE TO RID YOURSELF OF THE PARTS THAT ARE FEMALE.
THAT WOULD INVOLVE HYSTERECTOMY, GETTING RID OF THE WOMB SO YOU DON'T HAVE A MONTHLY PERIOD.
THAT WOULD INVOLVE MASTECTOMY, GETTING RID OF YOUR BREASTS SO YOU ARE NOT BINDING THEM GETTING YEAST SFEX EFFECTSES UNDER THEM BECAUSE IT'S SO WARM.
THAT WOULD INVOLVE GETTING YOUR OVARIES TAKEN OUT SO THE ESTROGEN IS NOT PRODUCING.
YOU CAN GET THE EFFECTS YOU WANT BY GETTING SUPPLEMENTAL TESTOSTERONE SO YES, IT COULD ALSO INVOLVE HAVING THE SURGERY TO CREATE A PEE PENIS.
THOSE THINGS.
IF YOU ARE A MALE AND YOU WANT TO BE A FEMALE BECAUSE THAT'S WHERE YOU FEEL YOU TRULY ARE A FEMALE, WHAT YOU ARE GOING TO INVESTIGATE IS HAVING YOUR PENIS REMOVED, PERHAPS CREATING A VAGINA.
HAVING BREAST AUGMENTATION AND TAKING ESTROGEN TO DEVELOP THE PERSONA BY YOUR SKIN TONE, YOUR BODY STRUCTURE OF BEING A FEMALE, YOU WANT TO BE WHAT YOU PERCEIVE YOURSELF TO BE.
>> WHEN WE THINK ABOUT GOING THROUGH MEDICAL REASSIGNMENT OR SURGICAL, PRIOR TO THAT, SHOULD OR DOES THE PATIENT UNDERGO PSYCHOLOGICAL EVALUATION OR IS THAT IMPOSING SOMEONE ELSE'S STANDARDS ON THAT INDIVIDUAL.
>> FOR YEARS IT WAS A MANDATE THAT YOU HAD A PSYCHIATRIC CLEARANCE BEFORE YOU ENGAGED IN SURGICAL REASSIGNMENT, PEOPLE WERE BUYING HORMONES UNDERGROUND OFF THE STREET, BLACK MARKET TO ACHIEVE THE EFFECTS THEY WANTED.
NOW IT'S NOT SO MUCH MANDATED ALL PLACES BUT STRONG RECOMMENDATION THAT YOU HAVE AN ASSESSMENT PSYCHOLOGICALLY HOPEFULLY WITH SOMEONE HIGHER THAN A MASTERS OR HIGHER LEVEL, TO HELP YOU DISCERN FOR YOURSELF, WHEN DID YOU FEEL THAT YOU WERE NOT LIVING IN THE APPROPRIATE BODY, HOW WOULD THAT CHANGE YOUR LIFE IF YOU WERE GIVEN THE BODY THAT YOU ARE COMFORTABLE WITH.
WHAT ARE YOUR REASONS FOR DOING THIS BECAUSE YOU DON'T WANT TO DO SOMETHING THAT ISN'T REVERSIBLE, YOU DON'T WANT TO DO SOMETHING THAT FIVE YEARS DOWN THE ROAD YOU BREAK UP WITH THE PERSON AND DECIDE THAT'S NOT WHAT YOU WANT TO BE.
SO YES, THERE IS AN INVESTMENT OF TIME FOR PEOPLE TO EXPLORE THE REASONS FOR MAKING THIS CHANGE AND SOMETIMES PEOPLE DON'T COME TO THIS POINT UNTIL THEY'RE ADULTS AND THEY'VE ESTABLISHED LIVES IN ONE KIND OF A GENDER WHEN THEY DECIDE THAT'S NOT ME THEN THEY HAVE TO FIGURE OUT HOW DO I TELL MY SIGNIFICANT OTHER, MY SPOUSE, HOW DO I TELL MY CHILDREN, HOW DO I CHANGE MY JOB, IF YOU HAVE BEEN LIVING THE LIFE OF A MALE, HETEROSEXUAL MALE AND THAT JOB REQUIRES THAT PERSONA, WHAT JOB DO I DO NOW TO RETRAIN TO BECOME A FEMALE THAT I MAY DESIRE TO BE.
THERE IS INTRASECTIONALITY OF THIS IN THAT IN ADDITION TO HAVING ALL OF THESE ISSUES ABOUT GENDER AND SEXUALITY, WOMEN ARE IN THIS MARGINALIZED COMMUNITY, JUST MAIN OLD WOMEN ARE MARGINALIZED AS WELL AS PEOPLE THAT HAVE THESE IDEAS ACHED THOUGHTS AND FEELINGS ABOUT THEIR GENDER AND SEXUALITY AND THEN IF YOU ARE OF A MARGINALIZED RACE, IF YOU ARE HISPANIC OR AFRICAN-AMERICAN, YOU HAVE ANOTHER INTERSECTIONALITY.
SO WHEN YOU TALK ABOUT STRESSORS AND HOW PEOPLE ARE ABLE TO COPE, HAVE YOU TO LAYER IT ON ALL OF THE THINGS THAT ARE HAPPENING TO THEM.
>> WITHOUT GETTING INTO THE COMPLICATIONS OF SURGERY BECAUSE SOMETIMES THINGS DON'T ALWAYS GO THE WAY YOU WANT, EVEN WHEN WE TALK ABOUT MEDICAL REASSIGNMENT THERE ARE COMPLICATIONS ASSOCIATED WITH SOMEONE TAKING ESTROGENS?
>> OH, WELL I THINK WHEN A MALE DECIDES TO BECOME A FEMALE AND HE IS GIVEN THESE ESTROGEN SUPPLEMENTS HE NEEDS TO UNDERSTAND THAT HIS RISK OF CARDIOVASCULAR DISEASE HAS GONE UP MULTIFOLD.
HIS RISK OF DIABETES BECAUSE OF THE WEIGHT GAIN THAT COMES FROM THE ESTROGENS, THE RISK OF HYPER LIP DEEMIA, HIGH CHOLESTEROL CAUSING STROKES AND HEART ATTACKS, ALL OF THESE ARE-- OSTEOPOROSIS, ALL OF THESE ARE PART AND PARCEL OF THIS PROCESS OF CHANGING YOUR GENDER.
>> ANY PARTICULAR ILL-- ILLNESSES WE THINK ABOUT H.I.V.
AND ANAL CONDOLOMA.
ARE THERE HIGH CONCENTRATIONS THIS THIS COMMUNITY.
>> WHEN WE SPEAK ABOUT MEN WHO HAVE SEX WITH MEN OR GAY POPULATIONS OF MALES OR ANYONE WHO ENGAGES IN ANAL SEX, YOU HAVE AN INCREASED RISK OF CANCER HUMAN PAPILLOMAVIRUS OR HPV IS STONL STD KNOWN TO CAUSE CANCER.
WE HAVE A HPV VACCINE ADMINISTERED AT AGES 11 TO 12.
CAN BE GIVEN FROM AGE 9-26.
IN 2020 THE RULES CHANGED A BIT.
AS A PHYSICIAN, I CAN DISCUSS MEN AT RISK FOR ANAL CANCER AND DIDN'T HAVE THE OPPORTUNITY TO GET THE HPV SERIES OF THREE SHOTS UP UNTIL THE AGE 45 WE CAN HAVE THIS DISCUSSION ABOUT THEIR NEED AND GET THAT TAKEN CARE OF.
>> I WANT YOU TO GIVE ME YOUR BIG TAKE HOME POINTS THAT WE IN THE COMMUNITY AT LARGE, WHAT SHOULD WE THINK ABOUT.
>> WE SHOULD THINK ABOUT UNCONDITIONAL LOVE ACCEPTANCE OF THE GIFTS WE HAVE.
NOT MAKING ASSUMPTIONS AND NOT LABELING AND PUTTING JUDGMENTS ON PEOPLE.
WHEN WE MAKE ASSUMPTION AND PUT LABELS AND DON'T ACCEPT PEOPLE.
THEY HIDE MEDICATIONS HIDE THEIR ACTIONS THEY DON'T CONVERSE.
YES, 50% OF TRANS WOMEN HAVE H.I.V.
AND THEY HAVE LIAR INCIDENTS OF SUICIDE AND THEY HAVE HIGHER INCIDENTS OF DRUG USE AND HIGHER INCIDENTS OF CARDIOVASCULAR DISEASE.
AS A SOCIETY, WE DON'T NEED TO AFFORD THAT.
THAT'S PREVENTIBLE IF WE ALL WORK TOGETHER TO ACCEPT, NOT MAKE ASSUMPTIONS AND MAKE EVERY EFFORT WE CAN TO ACCEPT PEOPLE.
IN HEALTHCARE ARE WE DOING A GOOD JOB ACCEPTING PATIENTS?
>> WE STILL HAVE WORK TO DO.
SO IF SOMEONE WHO IS ELIGIBLE-- >> YOU SAID SOMETHING ABOUT THE CHURCH.
>> WHEN AN LGBTQ PERSON WALKS INTO A MEDICAL OFFICE, IF THEY SEE THAT THERE ARE SIGNS THAT THAT OFFICE IS ACCEPTING OF THEM, A RAINBOW FLAG, RAINBOW PIN, IF THEY SEE THE NAME ON THEIR CHART IS REFLECTIVE OF WHAT THEY CONSIDER TO BE THEIR NAME AND THEIR PRONOUN, THAT'S REASSURING TO THEM THAT THEY MAY FIND A MEDICAL HOME THAT'S ACCEPTING OF THEM THAT DOESN'T GUARANTEE THAT THE PROVIDER INSIDE BECAUSE DOCTORS ARE HUMAN AS WELL AS MINISTERS AND IT MAY TAKE A BIT OF EDUCATION AND THAT'S WHEN I ASK PATIENTS TO BE PATIENT WITH ME.
IF I MISUSE A PRONOUN, GIVE ME A COUPLE OF VISITS BEFORE I GET IT STRAIGHT.
YOU ACKNOWLEDGE YOUR MISTAKE, YOU APOLOGIZE, YOU MOVE ON.
>> AT THE END OF THE DAY WE ARE ALL INDIVIDUALS BUT WE ARE ALL ONE AND TREAT PEOPLE FAIRLY, HOW WOULD YOU WANT TO BE TREATED.
TREAT SOMEONE THE WAY YOU WANT TO BE TREATED US OR YOUR FAMILY.
>> EXACTLY.
>> THAT ALWAYS WORKS.
THANK YOU VERY MUCH FOR BEING WITH US.
I WOULD LIKE TO THANK YOU FOR BEING WITH US, ALSO.
THERE ARE MANY HEALTH ISSUES PECULIAR TO THE LGBTQ COMMUNITY THAT WARRANT OUR ATTENTION AND CONCERN, INCLUDED AMONGST THESE ARE THE STRESSES SOBERED WITH UNDERSTANDING SEXUAL IDENTITY AND GENDER IDENTIFICATION.
THESE ARE MATTERS ARE CONCERN, NOT ONLY TO THE PATIENT BUT ALSO TO FAMILY AND FRIENDS.
IT IS INCUMBENT THAT WE, HEALTHCARE WORKERS, FAMILY AND FRIENDS, BE FAMILIAR WITH THE HEALTH ISSUES OF THE LGBT COMMUNITY AND ADDRESS THEM MEANINGFULLY AND AVOID PERPETUATING NEGATIVE STEREOTYPES OR IGNORING WARNING SIGNS.
ITER IS NOT THOSE PEOPLE.
IT IS RATHER OUR PEOPLE.
IF YOU WANT TO WATCH THIS SEGMENT AGAIN OR SEE PAST SHOWS, PLEASE GO TO KET.ORG/KENTUCKYHEALTH.
THANK YOU VERY MUCH FOR JOINING US.
AND I'LL LOOK FORWARD TO SEEING YOU ON THE NEXT KENTUCKY HEALTH.