Formulating Healthcare Clinics for the Gay Community

Thanks for the very appropriate eye roll face btw! LOL.

Kevan

:icon_roll

Hey...I was just stating my opinion...very tactfully at that. I just think everyone should be treated equally...and think it's ironic that people will quickly rise up and protest about being singled out negatively..but not if it benefits them. How would you promote this clinic? Advertise "Gay clinic"? Will straight people be allowed? Would it be discrimination if they were not?

:icon_roll

Hey...I was just stating my opinion...very tactfully at that. I just think everyone should be treated equally...and think it's ironic that people will quickly rise up and protest about being singled out negatively..but not if it benefits them. How would you promote this clinic? Advertise "Gay clinic"? Will straight people be allowed? Would it be discrimination if they were not?

This is a subject you and many others know very little about. You say "treated equally" -- for your information, the GLBT community is not treated equally and absolutely discriminated upon on a daily basis.

And "gay clinics" as you call them are typically strategically placed in ares of the city where there is a large GLBT population and they use a marketing strategy aimed at the GLBT population. Of course these clinics accept hetersexual clients, but the majority of the clients at these type of clinics are typically the GLBT clients, because they are welcomed with opened arms, know they can talk about issues that concern them and not feel as if they being discriminated against.

Back to your treated equal statement -- we don't live in a perfect socieity. Racism, classism, homophobia, "gender-ism", and every other type of discrimination still exists. Thus, there is absolutely nothing wrong with someone choosing to open a clinic that markets to a specific group of people that face discrimination when walking into many other health care clinics around the city.

I find it offensive that homosexuality be so closely related to STDs. If you want gay patients, be a good NP that asks and appreciated your gay patients. They will tell their friends, you can get your name on the GLMA lists/websites start asking for referals from local glbt physicians etc. Acting like the thing gay people need most is treatment for STDs will not get you very far with this population. Good luck.

I'm not sure if you are offended by a clinic focusing on gay people, or that you think the OP is stereotyping.

It seems like a good idea to me. For example, in Chicago they Howard Brown Clinic focuses on the health needs of gay people.

http://www.howardbrown.org/

One of their services is the walk in clinic featuring free HIV tests. THis concept is not a new one, and is present in several urban areas.

Oldiebutgoodie

I don't think the intention was a gay ONLY clinic. I think of it this way and by no means is this an absolute. There are times when we feel more comfortable talking to people that understand our problems and so forth. Women can relate when they're talking about menstrual problems and so forth. Men feel more comfortable talking about penile problems, erectile dysfunction with other men.

Think about gay guys/gals. If you're having medical issues that relates to gay people in particular, would you feel more comfortable talking to someone that at least understands what you're going through? A good friend of mine is gay and when he tried to ask his doctor about a gay related issue his doctor got very uncomfortable.

Point is, we all have people and providers that we're comfortable going to. Why not have the same available for gay people?

Washington DC has the Whitman Walker Clinics that have GLBT programs and so forth. They do hire NPs that have experience in STD treatment and HIV.

http://www.wwc.org/

Hope this helps!

There is not only Howard Brown in Chicago, but in San Francisco there is the entire SF Dept. of Public Health, and UCSF and SF General Hospital, which carry on a huge amount of research aimed at health issues affecting the LGBTI community (including HIV/AIDs), and their clinics have a strong focus and practitioners knowledgeable about health issues unique to the community. SF also has the Lyon-Martin health center for lesbian and bisexual women; and UCSF has a Lesbian Health research group.

I'm not sure if you are offended by a clinic focusing on gay people, or that you think the OP is stereotyping.

It seems like a good idea to me. For example, in Chicago they Howard Brown Clinic focuses on the health needs of gay people.

http://www.howardbrown.org/

One of their services is the walk in clinic featuring free HIV tests. THis concept is not a new one, and is present in several urban areas.

Oldiebutgoodie

There are gay friendly clinics across the US in small towns and large cities alike. Some are staffed with straight providers and some with gay providers. Their focus is on creating a welcoming environment at which the patient will not feel judged. It should not be to provide STD treatment and testing. Gay people have hypertension, dm, etc. and their total health should be the focus. The fact that what we think of first in our minds is STD testing/treatment is a consequence of the social environment in our country and not based on facts reguarding the many, many gays and lesbians in long term, commited relationships, some of them married and all of them monogamous and disease free! They need good care for their FAMILY in a place that will not judge them for adopting, getting married, etc. and request to test them for random STDs that they have absolutely no chance of having and had they been straight would have never been tested for.

My concern is public perception of the glbt comunity, the whole reason this clinic needs to exist in the first place. By making the focus of the clinic STDs in the gay population you only worsten the current homophobia in society.

To the OP.. If you are gay, or straight but still active in the gay community. You will get gay patients. There is little need to make it the focus. If your interest is in infectious disease, stds, and HIV (also an honorable pursuit but a seperate from gay and lesbian health) I suggest you look into getting certified by the AAHIVM as a midlevel. That will get you far in landing a job taking care of folks who have developed those conditions. Best of luck to you. Whichever you choose will be a great service to your community.

There are NPs who practice in community health centers that cater to mostly the gay, lesbian, and transgender popluation. I think it was driven by gay patients who wanted a comfortable tolerant healthcare environement. However..its mostly in urban areas. I think that even today..some GLBT patients would want to have a provider sensitive or aware of his or her needs re healthcare.

In Boston..where I live..there's the Fenway Community Health Ctr (where I happen to go for healhtcare) that caters to mostly GLBT patients. And they're growing..so there's obviously a niche for this type of healthcare.

So funny, I was thinking of Fenway also. Wonderful place.

For the OP (and anyone else interested), I'm posting their site

http://www.fenwayhealth.org/site/PageServer

This is where I have gone in the past. I'm straight, married, monogomous. However, I preferred the care and treatment I received in an environment that advertises its acceptance. GLBT/poly is historically a high risk population--providing a health care environment where no topic is left undiscussed and where the staff and the patients do not fear to say ANYTHING about health/psych issues is utterly invaluable.

Not every GLBT person carries the same risks--just like not every African American does, or every woman, or every recent immigrant. However, there are some topics that un-specialized HCPs will be unfamiliar with (risks of syphillis in a population of gay men who use crystal meth, risk of violence toward transgender persons, risk of depression or SI in youth who are afraid of coming out to their families, etc). To the OP--there is definitely a niche for you out there. Good luck!

:)

Kan

Let me give two examples.

Patient #1 Comes in and says they have been using crystal meth and having unprotected sex. He is male, white, and heterosexual.

Patient #2 comes in and says they have been using crystal met and having unprotected sex. He is male, white, and homosexual.

Now, are you telling me that they will need different expertise on the part of the provider? Are you telling me they need different testing?

I don't think so. I would like to make the point again. There ARE special considerations for the gay population that involve being accepting and welcoming and understanding the process of coming out and the unique social injustice faced by this population.

However, a high risk individual is a high risk individual whether they are straight or gay. Both should have the same cautious and thorough approach to testing for the various diseases that they could have been exposed to. Yes, there is a place for clinics that are open to gay and lesbian clients. Other than that, the medicie that is practiced should be identical. The new CDC guidelines for HIV testing and their rationale for changing them are a perfect and validated (in case you want proof) example of the error in the ways of thinking being gay or straight puts someone at any specific risk that the other would not have.

Other than that.........

For many homosexuals it's the "other than that" that matters the most. It's the "other than that....." that's lacking for many of us.

It's a no brainer that human begins and medical treatment are the same.

Let me give two examples.

Patient #1 Comes in and says they have been using crystal meth and having unprotected sex. He is male, white, and heterosexual.

Patient #2 comes in and says they have been using crystal met and having unprotected sex. He is male, white, and homosexual.

Now, are you telling me that they will need different expertise on the part of the provider? Are you telling me they need different testing?

I don't think so. I would like to make the point again. There ARE special considerations for the gay population that involve being accepting and welcoming and understanding the process of coming out and the unique social injustice faced by this population.

However, a high risk individual is a high risk individual whether they are straight or gay. Both should have the same cautious and thorough approach to testing for the various diseases that they could have been exposed to. Yes, there is a place for clinics that are open to gay and lesbian clients. Other than that, the medicie that is practiced should be identical. The new CDC guidelines for HIV testing and their rationale for changing them are a perfect and validated (in case you want proof) example of the error in the ways of thinking being gay or straight puts someone at any specific risk that the other would not have.

I am not sure if you are a nurse, nursing student, pre-nursing, or something else... but nursing care is not only about medical care. As Tweety pointed out, it is a no-brainer that every individual, regardless of sex, race, creed, sexual orientation, income, education, etc... should receive the same type of medical care. No one is debating this.

But different groups of people (I am not just talking about the GLBT community) sometimes require specialized care. For example, I used to work at a local clinic (as a program coordinator) that provided care to the hispanic female population. The clinic accepted any race, but marketed it toward the hispanic population. 99% of our clientele were hispanics/Mexican. We provided an environment that promoted safety and comfort to that specific population -- provided a Spanish speaking environment if they so chose -- provided activities that were culturally appropriate. Thus, that specific population were more apt to choose our clinic because we provided these amenities. The reason the clinic did this was because statistics and research have shown that this population were not comfortable going to a random clinic, did not feel as if their needs were met, were not educated according to their language and beliefs...

The same is true for GLBT clinics. It is not only the medical care they are seeking. They are seeking the environment, the open-minded staff, the programs put on by the medical professionals, etc. A gay couple has a hard time finding acceptance walking into a clinic holding hands -- they are given glares and people proably snicker around them. In a GLBT friendly clinic, this is accepted and the staff warmly welcomes them.

And finally, I am not sure why you are putting up a crusade against a GLBT clinic. Nursing is about providing culturally competent and sensitive care, and this is what the OP is intending to do. He is looking to pursue something he is passionate in and ultimately do good by providing health care and education to the community. Where is the harm in that?