“Where can I find a primary care provider who understands LGBTQ+ health?”

“Can you recommend an LGBTQ+ competent therapist?”

These are two questions that I encounter daily by people in Maine. It is a daunting task for individuals to navigate referral lists and insurance requirements, only to find out that a lack of culturally competent care can prevent their health care questions from being answered. All too often, patients report that they spend more time educating their providers than they do getting their questions answered.

They often hear “that isn’t really my specialty” – as though a conversation about sexuality or gender requires specialization, rather than sharing an understanding that areas of identity are part of the continuum of who we all are.

I have been advocating for comprehensive LGBTQ+ health care for many years. Through my work at The Gender Clinic, a Program of the Barbara Bush Children’s Hospital, and with the National Association of Social Workers, I am able to hear stories and experiences from Mainers of all ages. Recently, I have been hearing more stories about the experiences of LGBTQ+ elders.

Particularly, LGBTQ+ people over 65 have asked for help navigating situations that are complicated by the years of discrimination and stigma they have experienced. The long-term lack of legal protections and experiences of discrimination have resulted in hesitancy around institutions like hospitals and aging services. LGBTQ+ older adults just want to know how they can navigate health care, what their rights are, and find providers who are willing to help them. This is especially difficult for those who need specialized services, or who have limited options based on insurance. They want help with coming out at work, talking with their family members and long-term care facilities, and to know they will be safe wherever they go.

Health care providers are also reaching out to me to learn how to support their patients. Recently, I was asked to provide training to providers who work exclusively in geriatrics, to help them identify ways to help their patients feel comfortable with them. A social worker at a rural hospital asked for my help with getting a transgender patient discharged from the hospital. Although this patient was medically stable when a facility had an available bed, they reviewed and declined the patient, denying them an appropriate level of care. This happened multiple times with the same patient.

I moved to Maine in 2007 from the south, because I felt that Maine would be a safe place for me, as an LGBTQ+ person, to live and raise a family. Prior to living in Maine, I experienced discrimination in health care, education, my children’s education/daycare, employment settings, and other general stigma on a daily basis. Some of these were small events, such as a new primary care provider cancelling my prescription for prenatal vitamins when she found out I was with a woman. Other situations had more difficult consequences, such as when my partner was fired after our picture was in the newspaper, when we advocated for marriage equality. Coming to Maine significantly improved my feeling of safety, but with LGBTQ+ elders living in the 29 states without anti-discrimination protections under the law, relocation cannot and should not be the only option.

As an LGBTQ+ person in Maine, living and working in this community, providing health care and advocating, it really matters to me that our elected officials stand behind the people they serve. Being an LGBTQ+ person is not a partisan identity. Everyone across the country should feel protected from discrimination, regardless of which state they live in. Not everyone has the option to relocate to a state with more protections. We need federal protections for the LGBTQ+ community so that ALL Americans can have the same protected rights, regardless of what state they are in.