The Center’s Women’s Resource Center hosted Thrive!, its first women’s wellness panel, on Tuesday, April 20. The panel featured community healthcare providers discussing lesbian, bisexual and transgender women’s health concerns and the health resources available to them, and provided an opportunity for attendees to ask anonymous questions. The panel will be held quarterly, with the next one scheduled for June.

Topics of major concern included access to healthcare, how to locate female- and GLBT-friendly providers and how to be assertive with doctors in requesting important exams, tests, medications and procedures.

Sandra Perez, M.D., acupuncturist Andrea Beth Damsky, Elizabeth Pendragon, M.D., Priority Pharmacy pharmacist Sherril Davidow, therapist Debra Stern-Ellis and Diana Schmid, also of Priority Pharmacy, comprised the panel.

Schmid remarked that more LBT women – particularly LBT women of color – need to volunteer for studies, or important medical research targeting their needs will not get done.

“Women are overlooked in medical research in general,” Perez agreed.

For many GLBTs, the fear of coming out to their healthcare provider is palpable enough to inhibit them from getting regular checkups. Rates of cancer, heart disease, drug and alcohol abuse and obesity among LBT women can be attributed to this fear, Pendragon said. Avoidance of doctors can also stem from previous negative experiences or uncomfortable situations.

“That is the whole lack of cultural competency training,” Perez said. “The climate [in the medical community] is changing now – they want medical students to be more culturally competent.”

“Specifically, we need them to know that gay and lesbian issues are something that they need to be culturally competent in,” Pendragon said. “We need to stand up politically for ourselves and say ‘We are a minority, we want to be treated that way – we want all the benefits that come from that; whatever we can get in terms of funding it.’”

A recent survey of the overall health of Kansas’ GLBT community found higher rates of depression and drug and alcohol abuse in the GLBT community at large, and higher incidences of obesity and breast cancer among LBT women specifically. The survey is one of few such surveys in the nation on GLBT health, and is looked to as one of the first indicators for the national GLBT population.

“There is this whole other issue of who comes out in the study,” Pendragon said about the lack of GLBT health surveys conducted thus far, noting that few surveys target GLBTs directly. She cited a Kaiser study conducted by anonymous phone calls where participants were asked to place themselves in straight, lesbian and decline-to-state categories. “Between that group of women who self-identified as lesbian and the group that said ‘I won’t tell you’, they were almost the same in their lack of seeking healthcare; in their smoking; in their drinking; in their obesity. They were very similar, and I think they probably should have been added to the lesbian group, but they weren’t because they said ‘I won’t tell you’ on the phone.”

Several agencies in California, including Planned Parenthood, provide free access to Pap smears, pelvic exams, mammograms and even cancer treatment. “At some of them, the women are required to be of reproductive age, [though] they’re not required to be reproductive,” Pendragon said. “Some people have kind of excluded lesbians and thought they don’t count, but you don’t have to walk out with a pack of birth control to qualify. But women have done that. Plenty of lesbian women have gone to Planned Parenthood and walked out with three months’ worth in a bag because it was easier to just go with it. … Just because you are a lesbian, you are still supposed to be able to go into one of these agencies and receive their services without having to walk out with a pack of birth control.”

“One of the things that I see in my practice is a lot of people coming to me because I am not a doctor – they think I either won’t ask them the hard questions or I won’t tell them the hard, cold facts that a doctor would,” Damsky said, adding that she does address these concerns, and occasionally refers them to physicians for further treatment. “Many people feel more comfortable with alternative practitioners.”

Each panelist described statistical and anecdotal data about LBT clients they have gathered over the years in their respective professions.

Damsky has observed a high incidence of breast cancer, cervical cancer and liver disease related to drug and alcohol abuse, as well as HIV and other STDs, including hepatitis C.

Schmid said that there are few, if any, HIV/AIDS support groups for lesbian and bisexual women besides Christie’s Place, a local nonprofit that assists HIV-positive lesbians with medical resources and other services such as childcare.

All panelists agreed that HIV infection and hepatitis C are under-addressed in women’s health.

As a pharmacist, Davidow noted that lesbian women tend to ask fewer questions than gay men do about the specific impact of certain medications. “It’s a real pill-popping society, and that tends to be on both gay and lesbian sides,” she added. “But maybe that’s society as a whole, too.”

Damsky referred to a World Health Organization statistic that said depression is quickly replacing back pain as the number-one cause of work-related illness worldwide.

“The main issues I come across are chemical dependency and depression [and] especially in youth – attempted suicide,” Stern-Ellis said. “Also, lesbian seniors have issues, particularly with access to healthcare. I would also say that domestic violence is an issue. Coming out is an issue, which creates situational depression, anxiety and other struggles.”

Panelists agreed that being “closeted” promotes poor mental and physical health.

“When you’re closeted, you’re less apt to seek professional intervention which would cause you to not seek regular checkups, and would cause you not to feel comfortable going to a medical health professional,” Stern-Ellis said. “It certainly can create health risk and any other issues that haven’t been addressed, which may in the long term create more issues.”

“Any withholding of the truth creates internal turmoil, which can create problems,” Damsky added. “Particularly where emotions are concerned… [it] can cause tremendous strain on the physical body.”

“The more honest you can be with your doctor, typically, the better healthcare you’ll get; the more personalized the healthcare you’ll get,” Pendragon said. “Because if I know that you are in a special category – whatever that category is – if I know that you’re in that group, I know I need to watch out for A, B and C, and I make sure that we address A, B and C. Then you’re getting the healthcare you need. But if I don’t ever know that you’re in that special group, whatever it is, then I’m not going to [be able to] personalize your healthcare.”

A San Diego LBT women’s needs assessment study, funded by the California Endowment, is underway, and is open to all interested LBT women. To participate in the needs assessment, to obtain resource listings or receive a full listing of the programs and events hosted by the Women’s Resource Center, contact Claudia Lucero at (619) 692-2077 ext. 206 or clucero@thecentersd.org.