(Illustration by: Bob Scott)
While Virginia’s lesbian, gay, bisexual and transgender community is still rejoicing in last June’s Supreme Court landmark legalization of same-sex marriage, health care is surfacing as the next issue to tackle.
Same-sex couples who were married in Washington, D.C., or any of the 17 states that authorize same-sex marriage, now are entitled to equal access to spousal insurance coverage, no matter where they currently live or where the policy is offered. But the ruling doesn’t extend to couples in domestic partnerships or civil unions and so stops short of true equality for the LGBT population. And advocates say it’s an especially troubling inequality for the uninsured living in Richmond, a city that boasts a wealth of medical marvels — from basic health care to fruitful research, groundbreaking biomedical discoveries, and a nationally ranked medical school. For those in domestic partnerships or civil unions, and those who cannot afford health care coverage, they say it’s like standing on the outside looking in.
Discrimination and mental health
Members of the lesbian, gay, bisexual and transgender population are often stigmatized by society, which can lead to health issues. According to Healthy People 2020 (healthypeople.gov), a federal initiative focused on health promotion and disease prevention, discrimination against LGBT individuals has been linked to high rates of psychiatric disorders, substance abuse, and suicide. LGBT youth are two to three times more likely to attempt suicide or become homeless. Other research finds lesbians are less likely to get preventative services for cancer, and, along with bisexual women, are more likely to be overweight or obese. Gay men and transgender individuals are at a higher risk for contracting HIV and other sexually transmitted diseases, and LGBT populations have the highest rate of tobacco, alcohol and drug use. Many have had experience with violence, including bullying.
According to James Parrish, executive director of the LGBT advocacy nonprofit Equality Virginia: “Some people might be surprised to learn that Virginia has no law that requires places of public accommodation to serve gay and transgender people.” Parrish cites restaurants, hotels, theaters, doctor’s offices and hospitals as places where LGBT individuals could be denied service without recourse.
Richmond dentist Dr. Jeffrey Shirley says he finds it difficult to understand discrimination in health care. “We treat all people,” Shirley says. “It has never been an issue with my office. If you need help, that is what we are here for, we help people.”
The omnipresent need for health care combined with an inability to pay for medical services is a grim reality for many Richmond citizens, and it is especially difficult for members of the LGBT population, who must navigate through often difficult financial and privacy issues.
And that is where Fan Free Clinic comes in.
Meeting the needs of the LGBT community
Fan Free Clinic, at 1010 N. Thompson St., was formed in 1968 and modeled after a similar wellness clinic in San Francisco’s Haight-Ashbury neighborhood. It was incorporated in 1970 and became the first free clinic in Virginia. Its focus initially was on women’s health and the prevention of transmissible diseases. During the HIV/AIDS epidemic in the 1980s, the clinic responded by establishing Virginia’s first community-based HIV/AIDS outreach program, and it continues to be seen as a leader among HIV/AIDS service organizations. The clinic offers adult general medicine services, chronic disease management, referrals to specialists, gynecology and birth control, pregnancy testing, sexually transmitted disease testing and treatment, medication management, mental health counseling, and transgender health.
Patients must complete a financial screening to determine their eligibility to receive free services and medical care.
Its mission is to provide quality health services, especially to those least served, in a compassionate and non-judgmental environment. The clinic is able to offer health care through the generosity of professional volunteers, including doctors, physician assistants, nurse practitioners and registered nurses. From July 1, 2014 to June 30, 2015, the clinic served 1,457 patients.
Gratitude for FFC
Tamara Cox first came to the Fan Free Clinic after she changed jobs and lost her health insurance. She subsequently was diagnosed with lupus, which has caused complications and limits her activities. Cox has seen a rheumatologist, an orthopaedist and an ophthalmologist, all for complications from lupus. She has even had both hips replaced. She says she feels safe at the clinic. “Everyone is on a first-name basis,” Cox says. “It’s relaxed.”
Alex Badecker is a transgender man from New Jersey who came to Richmond to attend Virginia Commonwealth University. Upon the recommendation of friends, he sought hormone treatment at the clinic. He had not found acceptance and support in the medical community when he began the transition process. “It’s frustrating, time consuming and then you have the social aspect of staff who don’t accept you,” he says. He found it easy to trust the clinic family and is grateful for its compassionate, nonjudgmental care.
Fan Free Clinic is the only agency offering integrated primary care for the transgendered in Richmond. It served 119 transgender patients from across the state in the medical clinic from July 1 2014 to June 30, 2015.
For more information about Fan Free Clinic, see fanfreeclinic.org or call 358-8538.