We don’t know nearly enough about the health outcomes of the LGBT community. In fact we know nearly nothing at all. Recently the National Institutes for Health (NIH) put out a request to the Institute of Medicine (IoM) to find out exactly how much is known about LGBT health. The answer? Not a whole lot. I believe there are two big reasons behind this gap in medical knowledge; Lack of access to (competent) healthcare and inadequate tracking of data. This post is about how I worked to tip the scales just a little.
Lack of access to (competent) healthcare
During my senior year in college I wrote my thesis on health disparities in Gay and Bisexual men of color. I knew that I didn’t go to the doctor regularly, didn’t have a physician I could trust, and didn’t have the resources to find a good doctor. As a black, immigrant, queer male, I didn’t think that I was alone. I could only imagine how much harder health access would be for men who lived outside of a city’s core, men affected by HIV, and men who were not college educated. Thousands of pages worth of academic writing led to believe that I was not alone and that my thoughts about unequal access to healthcare were correct. These articles only offered ‘what if’ conclusions without much work on the ground. It was time for me to put my awesomeness to work.
Through my fieldwork I found out that the men I worked with only trusted each other and that there was inherent distrust in the medical profession. We had to make a change. How could I help these men talk to their doctors? How would I find doctors worth talking to? Was it possible to create a Professional Learning Community where ‘good’ doctors could exchange best practices with doctors seeking change? Theatre of the Oppressed (TO) came to mind.
Theatre of the Oppressed was born in 1971, in Brazil…with the specific goal of dealing with local problems – soon, it was used all over the country.
The main idea behind TO is about problem-solving through the medium of theater. The specific part of TO that we decided to use (Forum Theatre) looks a little something like this; performers (I use this term loosely) present problem X in a very short (1-2) minute scene. After the scene, a ‘joker’ allows audience members to assume the role of any person engaged in the conflict and contribute some sort of character change, offer new information, or insert their own knowledge. After many rounds of these ‘guest appearances’ the hope is that the entire audience gains some new perspective about the presented problem.
My colleague Tom Bardwell and I thought really critically about how we could bring Gay & Bisexual Black men to take part in something so new, awkward, and just plain weird. We knew that if we could get these men to engage creating the scene of a typical doctor’s visit and insert themselves into various roles, we would find some interesting data. How do these men perceive their doctors? How were they reacting to the doctors in the scene? Who was playing the doctor? How did the men change the role of the doctor? These were the juicy bits of information that we knew would be useful. But who would find it useful? Surely the men we were working with would be the immediate beneficiaries of the exercises but we needed to engage the people who had a lot of power in these interactions; the doctors.
Tom and I launched into Metro-Boston area and asked men about the nitty-gritty of their experiences with healthcare. Who were their doctors? Were they good doctors? Why or why not? The questions were endless and with just cause. We needed to bring these people together. After we interviewed these men we compiled a list of doctors they’d mentioned and began asking these doctors about their perceptions of themselves as medical professionals. What have you done to improve your practice? Do you consider yourself a good doctor? What are some ways you think you could improve your healthcare delivery? These weren’t easy questions to answer. They weren’t meant to be.
With the doctor’s responses recorded we brought our findings back to the participants in our project and their responses were eye-opening. Many of them had never considered the possibility that doctors had these thoughts, that doctors wanted to become better at their profession, and doctors cared about their patients.We later brought the providers and consumers together for events that would help start the conversations that needed to happen. We started to mend a broken relationship.
This is the kind of work that our community needs to do if we are truly serious about closing the healthcare gap. We cannot afford to let our current situations doom us to a state of anger or paralysis. Instead we must find our creativity, innovation, and tenacity toward our search for understanding and equality. Tap into your own awesome. We must create new ways (and revitalize old practices) to tell our stories to each other and engage the people who can affect the change we seek. The new story starts with you.
- Doctors need more data to help gays, lesbians: U.S. report (theprovince.com)
- Doctors lack data on LGBT community: report (reuters.com)
- Fenway Institute Applauds Institute of Medicine’s Release of Historic Report on LGBT Health (prweb.com)
- More Federal Funding for LGBT Research (abcnews.go.com)
- Gay Community ‘Largely Ignored’ By Health Research (huffingtonpost.com)