Tuesday, May 13, 2008

Healthcare Equality Index for LGBT Americans

AP today is carrying an article by David Crary entitled “Gay Rights Groups Launch Hospital Rating System” (http://ap.google.com/article/ALeqM5gFeQQMopw_H3K0LPMtaz7ttAZB2QD90KH7R81).

The article reports that Human Rights Campaign and the Gay and Lesbian Medical Association have collaborated on a Healthcare Equality Index. The index ranks 88 hospitals on indicators including patient nondiscrimination, visitation and decision-making rights for partners, diversity training for staff, and nondiscriminatory employment practices.

Of the 88 hospitals ranked, about half fail to satisfy the criteria of the index.

This is one of those areas about which I wish there were some way to establish a forum so that the “merciful” churches of Main Street USA could hear real-life stories from the mouths of real-life LGBT persons who sometimes find dealing with the medical establishment a gruesome experience.

And these experiences have everything to do with the fact that the churches of Main Street USA do not foster a humane attitude towards LGBT human beings. How the churches behave, what they say and do, affects the culture in significant ways.

The churches bear responsibility for homophobia in Main Street USA. And until they practice justice by recognizing that this is the case, and working to change the culture to inculcate a more humane perspective, they cannot justifiably claim credit for being merciful.

I have heard and read many horror stories about gay people who have been prevented from visiting a dying partner in the hospital, who have received shoddy medical treatment from prejudiced medical workers, and so on. I have seen LGBT friends treated with disdain in the hospital.

The stories I want to tell here, though, are my own. They are first-hand accounts of what some American citizens experience on a routine basis, when they deal with the medical industry all over our country.

Over a decade ago, when Steve and I lived outside Charlotte, NC, where we taught for a brief period at Belmont Abbey College, we had an auto accident that resulted in a need for Steve to have shoulder surgery. The surgery took place in Charlotte at Presbyterian Hospital.

In my family, when any family member goes to the hospital, other family members accompany him or her. We have always done so. I suppose if anyone asked us why we do this, the answer would be that our family member may need something that is not provided by hospital staff in a timely fashion, or that we assume people get better medical care when a family member is there to oversee the care.

Of course, I sat through the surgery in the waiting room, accompanied by our neighbor, a medical social worker whose kindness on this occasion I will never forget. And after Steve was in recovery, I spent the day sitting with him in his hospital room, bringing him ice or something to drink as he needed these, seeing that he was comfortable and lacking for nothing.

I spent the night with a friend, and the next day, sat again with Steve until he was discharged.

The discharge was eye-opening. As we approached the nurses’ station to retrieve the paperwork, a nurse sitting at the desk muttered something extremely ugly under her breath, commenting on my having spent two days with my partner. Another nurse beside her giggled and shook her head.

A third nurse offered to assist as I took Steve in a wheelchair to the car. The entire time, she dug for information about who we were, what we did. Her interest was clearly prurient, not sincere. I knew full well that anything I told her, she’d take back to her co-workers at the hospital desk.

Frankly, this experience puzzled me. In retrospect, I am not sure why I was puzzled, since I know that gay couples receive treatment like this on a routine basis.

Yet I was puzzled, since all I had done was what any member of my family normally does for any other family member who is hospitalized. I watched, waited, assisted, listened for Steve’s needs.

Something about the fact that this solicitude was being expressed by members of a gay couple for one another sent the nurses we encountered around the bend.

It should not be this way, not in any hospital, church-founded or otherwise. People who enter the helping professions must stop dishing out such demeaning, shoddy treatment to people simply because they are gay.

When someone is sick, has had surgery, is on painkillers, he/she (and his/her family members) will often let treatment like this slide. What’s an ugly sotto voce comment, in the face of a splayed-open shoulder, after all?

Those of us who are LGBT and accompanying a partner to the hospital often have to bite our tongues, too—or so we tell ourselves—for fear that we’ll receive worse treatment if we protest. One is virtually helpless—or one has the illusion of virtual helplessness—when one is in the hands of doctors and nurses, particularly following surgery or in extreme illness.

A few years down the road, Steve and I lived through another scenario very like the preceding one. This one took place at St. Vincent’s Hospital in Little Rock.

On this occasion, Steve had a hip replacement, following years of premature deterioration of one of his hips. The doctor who did the surgery couldn’t have been nicer. Most of the medical staff were superb.

One of the night nurses, though, was clearly unhappy that I chose to spend two nights in the room, in case Steve would call for something or needed assistance. The room was set up for family members to stay overnight, with a fold-out easy chair. Other family members were staying in other rooms at the same time, to assist someone who had had surgery.

I was merely there. I was as quiet as a church mouse the entire time.

Yet a night nurse was clearly discontent with my being there. She would routinely come into the room at all hours of the night, clicking on the lights and talking in a loud voice, even when Steve had fallen sound asleep.

We knew this was deliberate, and not merely a form of medical care, when Steve asked one night for a painkiller that had been prescribed for him. The post-op pain was beginning to climb. The doctor had told him on no account to let the pain get out of control, and to ask for the painkiller at any time he needed it.

The nurse refused to give him the painkiller. In desperation, Steve called the hospital liaison who handled complaints, told her the story, and the painkiller was provided.

But there was a price to pay. The next night, the same nurse came in to give Steve an i.v. I did not know what had happened until months later, when he told me: she took the i.v. direct from the refrigerator, hooked it up, and forced it into his veins as rapidly as she could, ice cold.

When Steve told me what the nurse had done, he told me that this was one of the most intensely painful experiences of his whole life. Since he was raised in a stoical Teutonic family, he rarely complains about pain. The experience has to have been exceptionally painful for him to have noted this.

In both cases, sad to say, the nurses who engaged in this behavior were members of racial minority groups. I note this, and remember it, because it always surprises and saddens me to discover that people who should understand what unjust treatment feels like, and whom one would expect to know better, are willing to dispense such treatment to other minority groups.

Unfortunately, I have discovered as well that medical personnel can treat not only LGBT persons, but members of our families, unprofessionally and inhumanely, simply because these family members are connected to someone who is LGBT.

Several years ago, when my mother’s gerontologist insisted that I place her in a constant-care nursing home in Little Rock, I did so, reluctantly, but convinced by the gerontologist that Steve and I could no longer provide the quality of care she needed at home.

Almost immediately, we began to notice that our being a couple made a difference to some of the staff in the nursing home, and in the kind of care they provided my mother. The activities director was a man with whom my mother had worked; that is, they had worked for the same organization.

He was also a bible-toting and bible-spouting Christian who, I am convinced, is a closeted and self-hating gay man. In our initial interview with the nursing home staff, we had to endure a barrage of scripture quotes from this defender of the right and the true. Again and again, when we visited my mother, we would receive snippy, hostile treatment from this healthcare provider.

Following my mother’s death, when I took all the flowers from her funeral to the nursing home for the staff and patients to enjoy, I asked this staff member to assist me in placing them on the main desk. He was doing nothing else. He turned his back on me. This is the last time I have seen the man.

Again, I might have complained. I probably should have complained. I didn’t, though. How was I to know whether, if I made any complaints, he and other hostile staff members would take out their hostility on my poor mother, whose mind was gone?

The head nurse was another cold fish, routinely unhelpful to us, while she was wreathed in smiles when “normal” families came to visit their loved ones. On the day my mother died, my aunt, Steve, and I gathered around the bed to be with her until her death.

As soon as she died, the head nurse entered the room. She did not say to me that she was sorry. She expressed not a word of regret. She simply informed me in the coldest way possible that I was no longer allowed to touch my mother until the coroner had arrived and pronounced her dead.

These folks—all of them, insofar as I could determine—are good “Christians.” All gave every indication of being motivated primarily by their religious convictions.

How is it possible, I have to ask, to choose a care-giving profession, to be motivated by religious ideals, and to provide such hateful treatment to some of God’s children, under the guise of providing medical attention? I just don’t get it.

And I continue to ask, over and over, what the churches intend to do about these problems.


Dad said...

These stories of ill-treatment that you and Steve have experienced from health-care workers really tug at my heart, Bill. You are right about the feelings of powerlessness one has when dealing with people in this profession. You just don't know what treatment they will dish out next! I join you in prayer about these so-called Christians: harden not their hearts.
Thanks for your blog. I enjoy reading it.
Michael G-G

William D. Lindsey said...

I appreciate your response very much, Michael. Thanks for reading and listening to my stories. I hope the churches will one day wake up to the pain they are enabling, totally without justification, in the world today against gay human beings.

As I approach 60 and think more and more about the legacy I will leave for the next generation, I think of the stories that need to be told, from my life and the lives of others. Even if we can't totally heal the world here and now by telling these stories of our lives, someone will hear and will struggle in the next generations to make such cruelty impossible, cruelty practiced against simply because of the sexual orientation of those being mistreated.

Unknown said...


I am saddened by the description of treatment you got by medical professionals due to your sexual orientation, but at the same time I have to tell you that you had it easy. At least you got treatment.

The very real reality of most trans people in this country is that they cannot get treatment. I have been post-op for years, and I have no primary care physician because I cannot find one that agrees to treat me. I go to overcrowded McHosptials (what my sister calls urgent care clinics) and get seen by a nurse practicioner when I get too sick to just stay home and throw up. It is not that I do not have insurance, in fact I have some of the best medical/dental/vision insurance available in the country because my industry uses the benefits as a way of recruiting and keeping scientific talent.

Go see the writings of Leslie Feinberg about how ze almost died because hospital staff refused to treat. Two weeks ago a trans woman moved into the area and was looking for a local physician to take over the prescribing of hormones and meds. She was told that because of their religious views that they really couldn't treat her. What if she was black? Do you think that they could have gotten away with saying that because of their religious views about people of color they couldn't treat her?

When I returned home after my surgery and needed a hospital and gynecologist to treat me, again I found no one willing. I was referred to the local downtown "big" hospital that treats "everyone," which is Harbor View in Seattle. Harbor View is not a religious affiliated or founded hospital. When I explained my needs to them on the phone I was asked where I had had my surgery done. I replied that it had been done in Thailand and was told that I should go back there where they "treat people like you."

This is the day-to-day reality of our lives. I have no one to manage all of my health care or meds. I have to do it. You will find that every transwoman and transman you meet can tell you more about appropriate dosages, methods, and medications for transgender folks than any 10 doctors you can pick out of the yellow pages in your town; its because we have to out of necessity.

William D. Lindsey said...

Shannon, I really appreciate your helping me see a bigger picture re: the lack of health care for trans people in our country. It's shameful that this goes on.

Colleen, who often responds to postings on this blog, and whose Enlightened Catholicism blog is linked to mine, posted an article some weeks ago about a Catholic hospital in California that was denying surgical treatment to a person in gender transition.

If I remember rightly, the hospital was eventually forced to provide treatment. But the story helped me understand better some of the many obstacles trans people face routinely.

I know one person undergoing gender transition, and from what I know of her life, it's not at all easy. She's subject to many forms of persecution daily, including harassment from neighbors who report her for supposed civil infractions like not maintaining her lawn.

For a period of time, I often went to the local Quaker meeting, and I found that they were one of the few places of refuge for this child of God in our local area. I admire the Friends for the support they give to this person in need.

And I appreciate your sharing your story.