In The Hospital, There's No Such Thing As A Lesbian Knee

November 30, 2014 8:24 AM

"When my partner Cheryl was dying from respiratory complications related to treatment for Hodgkin's lymphoma, she was in so much physical distress she couldn't bear to be touched. The only contact she could stand — one of the few ways I could share my love with her — was for me to rub her feet. As I stood at the foot of her hospital bed doing just that, a scrub-clad figure we had never seen before poked her head in the door, curled her lip and demanded: 'What is your relationship?' The question was clearly directed at me, but my girlfriend reached through her drug-induced, hypoxic haze to respond with her New Yorker tough-girl attitude: 'Really? Whose feet do you rub like this? What the hell are you, the relationship police?' "

"But LGBT people have been so systematically discriminated against, misunderstood, and (at best) ignored within the health system that when we walk into a practitioner's office or a hospital room we don't assume that we're starting at neutral in the interaction, because we know better. "

posted by Librarypt (31 comments total)

Thanks for posting this. The suggestions for specific changes are so so easy.
posted by janell at 9:08 AM on November 30, 2014 [2 favorites]

This is a great article, thanks. One of the worst stories (aside from Janice Langbehn, the whose partner, Lisa, died alone in a Florida hospital while Janice and her three small children were kept out of the room, after a social worker told Janice there cause was nothing they could do be she was in an “anti-gay city and state”) is that of Nakoa Nelson. Nakoa was in a car and had an allergic reaction. His partner drove him to a fire station for EMS help, but the EMS, upon seeing that he had breasts, "opened his shirt to check his heart and then said there was nothing they could do to help him."

I am glad that we have the hospital visitation policies in place now where if your hospital receives federal funding, you MUST allow LGBT people to choose their own visitors, but there is so much still to be done.
posted by roomthreeseventeen at 9:16 AM on November 30, 2014 [5 favorites]

I always think of Sharon Kowalski and Karen Thompson, who were all over the news for years when I was first coming out.
posted by bile and syntax at 9:36 AM on November 30, 2014 [6 favorites]

This is a great article, thanks. One of the worst stories ... is that of Nakoa Nelson. Nakoa was in a car and had an allergic reaction. His partner drove him to a fire station for EMS help, but the EMS, upon seeing that he had breasts, "opened his shirt to check his heart and then said there was nothing they could do to help him."

While this is something of a derail (and it's hard to write this comment without seeming, I don't know, churlish), as far as trans people being refused treatment by paramedics goes, that's not a particularly horrific story because Nelson survived. Tyra Hunter didn't.
posted by hoyland at 9:47 AM on November 30, 2014 [7 favorites]

hoyland, that's a good point. However, all of the stories are terrible.
posted by roomthreeseventeen at 9:52 AM on November 30, 2014 [5 favorites]

Years ago now I was living with a roommate who was seriously allergic to at least one thing. Every once and a while she'd consume some by accident and end up in the emergency room. On one such trip she was brought in by her girlfriend who shared her sense of style. The nurse, walking in the room said, "So... Are you two brothers?"
posted by ODiV at 10:17 AM on November 30, 2014 [10 favorites]

I am glad that we have the hospital visitation policies in place now where if your hospital receives federal funding, you MUST allow LGBT people to choose their own visitors, but there is so much still to be done.

The policies can always be reversed -- they were created by presidential memorandum in April 2010, and as the memorandum states, "This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person." In addition, hospital employees can always plead ignorance or find some other pretext to get around the policies, as in this Kansas City case, in which the partner was taken out in cuffs because he allegedly posed a security threat by staying at his partner's side when the hospital demanded that he vacate the room.

Don't get me wrong. I'm glad that some policy is currently in place that deals with this issue in a positive way. But that's not the same as something more permanent that can't be overturned by, for example, an all-GOP Congress. In October 2012, GOP presidential candidate Mitt Romney said that hospital visitation was a "privilege," not a "right," and said that he believed each state should be able to decide whether hospital visitation could be allowed for same-sex couples.

Point being, never assume that an LGBT-favorable federal policy that Obama put in place (especially by executive order or similar) won't be upended after he leaves office.
posted by blucevalo at 10:18 AM on November 30, 2014 [13 favorites]

I always think of Sharon Kowalski and Karen Thompson.

I was in college around that time. I'm glad to hear it eventually ended up with a victory. There's been a few Ask questions along the lines of "why should we get married?" This is why. Of course people should be able to get in to see their family members in the hospital (no matter how "family" is defined) but until that's set in stone, don't risk being turned away.

It's so stupid that this is still going on. There are such bigger issues in the world.
posted by Beti at 10:44 AM on November 30, 2014 [7 favorites]

I had a friend who was told by her doctor that he would not put her on the liver transplant list because, after all, she was an "old dyke, and there are young women with children waiting for a liver."
posted by vitabellosi at 10:48 AM on November 30, 2014 [2 favorites]

These are great, humanizing recommendations even from my perspective as a straight white male. Decency sometimes gets thrown to the wayside in medical care and all efforts should be made to make those hardest of times as bearable as possible.
posted by furtive at 11:25 AM on November 30, 2014 [2 favorites]

My partner and I always get mistaken for relatives (mom, daughter, sisters, cousins). We do look alike. I always refer to her as my wife but sometimes people will put it on the file wrong. One hospital here had our relationship down as my sister and got the life of us we cannot get it changed.

But for me I've seen more discrimination due to my mental illness than to my sexuality. But like I said most people assume we're 'naturally' related to each other which really really cuts out a lot of discrimination. I try very very hard not to end up in a hospital alone, I need someone with me to validate any symptoms and concerns unless it is obvious what is wrong with me. (Note: I only go to the ER for serious things and not little things. I have a good GP who is open 6 days a week and an urgent care for issues on Sundays. My health just sucks.)

I like the questions she poses. They are simple. I hope they get used by health care providers.
posted by AlexiaSky at 11:41 AM on November 30, 2014 [2 favorites]

I just don't even understand the rationale for this: what is the pretext by which someone is being ejected out of a hospital room to visit someone? Evidently, someone above pointed out a security risk or somesuch but I'm struggling to understand or find documentation of why you would do this...
posted by koavf at 12:02 PM on November 30, 2014

koavf: Evidently, someone above pointed out a security risk or somesuch but I'm struggling to understand or find documentation of why you would do this...

You can't let random people wander the hospital freely partly because you have to protect unconscious or otherwise defenseless people, and partly because drug-seeking individuals would steal or tamper with medication.
posted by Mitrovarr at 12:05 PM on November 30, 2014 [7 favorites]

On the other hand, my experience as a middle class white guy in suburban hospitals is that you can wander as much as you want and nobody says anything.
posted by ryanrs at 12:39 PM on November 30, 2014 [58 favorites]

One hospital here had our relationship down as my sister and got the life of us we cannot get it changed.

I wonder--don't know where you live--if this could be an end-run by staff around discriminatory policies? As in some jerkface might try to deny visitation as a couple, but can't really say your/her sister can't visit. Maybe it's a reach, I dunno.
posted by feckless fecal fear mongering at 12:53 PM on November 30, 2014 [2 favorites]

Everyone initially thinks that my wife is my sister. I just shake my head and say "Nope. That'd be the missus." Reaction usually hilarious.
posted by triage_lazarus at 1:02 PM on November 30, 2014 [2 favorites]

I'm a straight white middle class woman. I went into the hospital about 15 years ago with horrible pain and symptoms consistent with the presentation of my chronic illness. My then live-in boyfriend brought me to the hospital. They wouldn't allow him to go into the ER rooms with me and insisted he had to stay in the waiting area. It was only after I'd been there about 12 hours and the shift had changed that he was allowed to see me. My pain and stress dropped a lot when I had someone by my side. When I asked why he couldn't stay with me, they said it was policy that non-family members had to stay out. I knew it was BS because I'd been in the ER a month earlier with *my boss* and they'd let her stay with me. To this day, I wonder if they thought it was a domestic violence situation they were trying to rule out or if I'd just run into a nurse who really thought were were living in sin and needed a lesson or what.
posted by Chaussette and the Pussy Cats at 1:19 PM on November 30, 2014 [2 favorites]

What's wrong with treating people with basic human dignity? How does their lesbian foot rub affect the sanctity of your marriage? I'm glad we're making progress, but does it always have to be this damn hard?
posted by arcticseal at 1:20 PM on November 30, 2014 [2 favorites]

Got to the end of this and saw the author's bio and realized I've met her, which is to say I flirted with her at her table in the vending area at TransHealth last year. And then, having flirted with her, I bought her book Freak of Nature. It was kind of hit-or-miss, like a lot of collections of short pieces, but the good stuff was really good, and she does tragicomic really well.

And then I had a little panic attack about having flirted with her when she was in a customer service role trying to sell something and perhaps constrained from telling me to fuck off, and my partner had to talk me down. I did feel kind of bad about it, though.

Last summer at a big Quaker conference I gave one of the plenary speeches, and in it I mentioned that I have a trans son. I was waiting for a shuttle later in the week with my girlfriend, a butch lesbian 21 years younger than me, and someone came up to chat with me about my speech. The new person mentioned that she was glad I'd mentioned my trans son, and I said, "Oh, yeah, have you seen the sample copies of Friends Journal that are around? My article about him is in it. That's him on the cover." (It was this picture.) And the person said, "Oh...yes! I did see that," seeming a bit flustered.

Apparently she'd been giving my girlfriend some significant looks. We'd always wondered if anyone took us for mother and daughter, but we were a bit taken aback to have someone apparently take her for my transgendered son.

I've had the same experience as ryanrs. Nobody has ever challenged my partners and me in medical settings, or my friends and me, when we've taken each other in or been each other's hospital support person, even if some of us are very dykey. But that's exactly why, I think, this stuff needs to start getting disseminated as standards of care, because it falls disproportionately on people with less social capital to begin with.
posted by not that girl at 1:24 PM on November 30, 2014 [7 favorites]

What I got from the article is that she knows the foot question itself probably wasn't meant to be specifically a call out saying "wtf lesbians???" but the abrupt nature of the question from someone they hadn't seen before naturally came off as offensive. The author is aware of the general reasoning (some basic amount of security and seemingly random people doing a CYA round) but also is hyper aware of the history of LGBT discrimination in these settings

As a white male I find I can wander hospitals freely until I enter or try to enter a room. Typically I might run into some nurses along the way or they pop in but if there's a shift change or one nurse covers another during a smoke break you might run into this more often. I have had a boss with me in the ER as well.
posted by aydeejones at 1:26 PM on November 30, 2014 [1 favorite]

Wow, all the stories in this thread are making me super raged out. I've seen or heard of some, but WOW.

On the other hand, my experience as a middle class white guy in suburban hospitals is that you can wander as much as you want and nobody says anything.

I hadn't thought about this in a long time... But you're right.

The last time I remember being stopped or questioned at all was when I was a teenager, and going into a psych ward. Other than that every interaction since I grew a beard in high school has been of the "excuse me, how do I get to XYZ?" variety. And i'm always just told "oh yea, take a left and go over there". Never even asked who I am. Never asked to leave more than super passively in a "hey visitation is over you need to leave soon ok bye I'm not going to enforce that" kind of way.

God damn, fuck the system.
posted by emptythought at 2:54 PM on November 30, 2014 [2 favorites]

Since getting married, I've called and made doctor's appointments for my wife, sat in on her advising appointment (I wasn't going to, but she leaned out and asked me a question and the advisor told me to come on in), been taken more seriously by CSRs and other folks we were doing business with... it's been amazing how much easier the legitimacy brought by being married has made things.

But you'd best be sure I'm bringing a copy of the license with us the next time someone has to go to the hospital.
posted by joycehealy at 3:44 PM on November 30, 2014 [2 favorites]

How widespread is the practice strictly limiting of visitors to couples/family? How do people show proof? Is it more common outside of major cities?
posted by the jam at 6:44 PM on November 30, 2014

I don't know about other hospitals, but the VA system seems to be pretty decent about that. If the patient says you're allowed to be there, you're allowed to be there. If they have chronic conditions where they know they're going to be in the hospital a lot, they can even set up a whitelist in advance.

Also, there are some family members who shouldn't be allowed within fifty miles of a hospitalized relative.
posted by clarknova at 6:52 PM on November 30, 2014 [3 favorites]

Once, when my friend was asked how she was related to the patient, she answered "She's my partner." The nurse came back with "Are you lawyers?"
posted by artychoke at 7:35 PM on November 30, 2014 [9 favorites]

I'm a certified nursing assistant, getting ready to get my RN next year. Here is what my CNA textbook has to say about trans people, in the one entire paragraph given over to the topic:

Some people have a personal feeling that their gender does not match the physical body they were born with. They may be males who feel themselves to be female, females who feel themselves to be male, or people who do not strongly identify themselves as either male or female. Such people are called transgender. Transgender individuals may or may not become transsexuals, people who alter their physical appearanceto more closely match the gender they most strongly identify with. A person who is transsexual may take hormones, have surgical procedures or both to alter his or her body to better match his or her inner sense of gender identity.

The idea implicit here that trans people generally go down a linear path from one gender to another is problematic. I know few, if any, actual trans* people who use the term transsexual at all, let alone use it in the manner the textbook describes. Plenty of people who might otherwise want to be "transsexual" by the textbook definition are shut out from accessing the medical procedures of transition by cost, lack of insurance, not living and/or working in an environment where it would be safe to be openly trans.These are definitions that are going to trip up students at best and deny a lot of vulnerable people care at worst.

And this doesn't even start to address the basic points of dignity Kelli Dunham touches on, the things that really matter in your day-to-day dealings with trans people as a medical professional. Ask about preferred names and gender pronouns. Take trans* people's reproductive health claims seriously. Don't fucking gawk and point at people's genitals if they don't match your expectations. (That Tyra Hunter case linked above is still making me shake with rage.)

It's not that I think I'm so much more enlightened and empathetic than anybody else, or that I want special cookies for being an ally. I'm just a vaguely queer lady who fell into communities where this stuff mattered, who had friends who came out as trans comparatively early on, thought "I wonder how that feels for them" and proceeded to read everything I could find. (Some of which was pretty awful!) It shouldn't have to take that kind of personal connection to treat people with basic dignity, at least not if you're in a field where you interact with a diverse range of people every day. We should be listening to community ideas of what constitutes said basic dignity.

I was recently in a class full of pre-allied-health students where my professor repeatedly mis-gendered a trans child in a video clip we watched, wouldn't believe me when I tried to explain that the term 'gender identity disorder' is being phased out of the current DSM. Coming out of that class, livid and venting along with my other queer, pre-nursing classmate I sighed and said 'and this is why I want to be a nurse.' More specifically, I want to be a nurse educator down the line. Because the attitudes we treat patients with trickle down a long ways, society, to teacher, to practitioner, to patient, and I want to do my part in cutting the most egregiously awful crap out of the pathway.

PS-Kelli Dunham is a national treasure, and if you get the chance to either see her do stand-up or facilitate a more serious workshop, jump on that.
posted by ActionPopulated at 7:51 PM on November 30, 2014 [12 favorites]

Oh man, the stories in that article make my skin crawl. Overt discrimination is horrific, but even small failures in LGBTI-inclusive practice can make a huge difference in whether queer people get the healthcare they need. I'm several months overdue for a Pap smear, for example, and it occurred to me the other day that part of the reason I've been putting it off is that last time I visited my GP for a lady-bits related matter, I was quizzed about contraception and asked when I last had "intercourse". I'm not usually that afraid of outing myself, but there's an extra degree of vulnerability in saying I'm queer while half-naked and awaiting a speculum. I don't just want to hope that the person poking around in my nether regions will be on my side, I want to feel unconditionally safe. I'm not entirely sure that I do, and that uncertainty is a significant stressor on its own, independent of any substantive discrimination I might face. It's a small thing, this one overdue test of mine, but across the population of LGBTI people, the little things and the big things add up to demonstrably worse health outcomes than those of straight people. Some of us are going to die sooner because of this crap. It's really scary.

There's an organisation in Australia, GLHV, that accredits healthcare providers for LGBT inclusive practice, and they make a poster that says,"You don't have to tell us if you're gay or lesbian. But you can." It's a small thing, again, but I really wish there were one in my doctor's waiting room.
posted by embrangled at 8:46 PM on November 30, 2014 [7 favorites]

Is anyone else clicking on the link and finding it brings them to a different article, one about sugar? I had to copy and paste the link, stripping out the args at the end, to get it to work.
posted by dubitable at 10:58 PM on November 30, 2014

"Some people have a personal feeling that their gender does not match the physical body they were born with. They may be males who feel themselves to be female, females who feel themselves to be male, or people who do not strongly identify themselves as either male or female. Such people are called transgender. Transgender individuals may or may not become transsexuals, people who alter their physical appearanceto more closely match the gender they most strongly identify with. A person who is transsexual may take hormones, have surgical procedures or both to alter his or her body to better match his or her inner sense of gender identity."

Oh wow there is so much wrong with this. I mean, best of intentions I'm sure, but acknowledging non-binary people and then using "his or her"? Ugh. Aside from the fact that the second sentence effectively identifies trans women as inherently male and trans men as inherently female. It's also a completely bizarre distinction between trans gender and transsexual, and an at best awkward definition of transsexual.

And this is quite possibly the only real comment on trans people student nurses will receive? It's downright misleading, and will not set them up to have interactions with trans people that are positive for anyone involved. It's so disappointing, but it does rather effectively point to the root of the hurtful and hateful attitudes that are so widespread in healthcare in general - poor understanding of queer (and particularly trans) identities by those devising the education and curricula.

At least it's good to know that there are people like ActionPopulated challenging that and trying to change things. Hopefully we'll one day look back at conversations like this and marvel and the cruel, backwards world and systems that made it necessary.
posted by Dysk at 2:27 AM on December 1, 2014 [1 favorite]

Kelli wrote another great piece about the death by assisted suicide of her first partner, activist Heather MacAllister.
posted by ottereroticist at 11:48 AM on December 1, 2014

Turns out Kelli Dunham has some great advice on pap smears, too: I Promise You Can Successfully Get A Pap Exam Even If You Are Traumatized, Grossed Out Or Really Really Not Into Those Parts. Oh my goodness, she is the best.
posted by embrangled at 9:22 PM on December 2, 2014 [1 favorite]