WVPA Sharing

When All Are Counted: Members of West Virginia LGBTQIA+ community struggle to find healthcare providers

By Autumn Shelton, West Virginia Press Association and “When All Are Counted” Project

CHARLESTON, W.Va. — Finding a healthcare provider that one feels comfortable with can be difficult, but for some in West Virginia’s LGBTQIA+ community, it can be almost impossible. 

In addition to limited resources and insurance barriers, those who are LGBTQIA+ also face added stigma, fear of disclosure, and a lack of providers who have received specialty training for LGBTQIA+ specific issues. 

Editor’s Note: The “When All Are Counted” project, directed by the Charleston-based nonprofit advocacy group Think Kids and funded by a grant from the Robert Wood Johnson Foundation, have two goals—to advocate for those who have historically been considered “statistically insignificant,” especially in the Black, Disability and LGBTQIA+ populations, and to create a statewide healthcare data surveillance system that includes everyone, not just those in the majority population. 

A recent article published by the National Library of Medicine, states that “health disparities experienced by LGBTQ+ individuals have been partially attributed to health professionals’ lack of cultural competence to work with them.” 

The article continues, “Despite multiple published LGBTQ + cultural competency trainings, there has been no quantitative appraisal and synthesis of them.”

Without measurable data on how effective training for medical professionals is, or even what resources are available to the state’s LGBTQIA+ residents, many may not be receiving quality healthcare. 

Erica Parrish, a Monongalia County resident, has experienced this first hand – as both a member of the LGBTQIA+ community, and through her prior work in healthcare. 

She explained that LGBTQIA+ specific education for all healthcare providers is imperative, and it may be something they are overlooking. 

“Education, just the basics of what it means to be LGBTQ, specifically for older physicians whose first big exposure to gay, lesbian and transgender patients was in the ‘90s, is important,” Parrish said. “That was a scary time for that whole community with the HIV epidemic, and a lot of practices in healthcare really haven’t updated from that time. . . . There is still a lot of that bias that runs around, and in West Virginia I think that is pretty true especially with mid-level practitioners who may have not received their education outside of the state.”

Parrish continued that in many of West Virginia’s rural areas, the bias against those in the LGBTQIA+ community can be prevalent. 

“A lot of people boil down being gay or lesbian or trans as a sexual practice, not a facet of who they are, and there’s a lot of judgment that comes with that,” Parrish stated. “There’s a lot of assumptions that come with that about the lives people live, their characters, their moral values, and I think that bias is something that prevents, or at least causes some members of the LGBTQ community to hesitate in seeking care, because nobody wants to be judged when they are already vulnerable.” 

Parrish recalled her own experiences when seeking medical care. 

“I have encountered some bias on my own part when I revealed to providers that I am queer. While I have been more fortunate than some, I have definitely encountered some roadblocks along the way.” 

While in her 20’s, Parrish was living in a low-income situation, and was uninsured. 

“That was when I experienced most of my difficulties,” she stated. “No one ever really talked to me about Medicaid. I thought that was something for older people. I wasn’t educated on the differences between Medicaid and Medicare at the time, but it just seemed like that was something that was inaccessible to me . . . anytime I had an issue, I had to find my own way around, like trying home remedies.” This also included needing to purchase antibiotics once from a friend. 

Parrish said she lived in fear of visiting a healthcare provider primarily due to a concern about financial ruin, but when she finally received employment that provided healthcare, she developed another concern after visiting a local provider. 

“I hadn’t seen a doctor in quite some time, so they wanted an updated medical history, and they went over sexual health and personal practices,” Parrish remembered. “I replied that I was queer, and had previous relationships with women . . . the practitioner, her whole demeanor changed. It was like a light switch. She became very cold where previously we had been talking, and she just kind of clammed up.” 

Parrish said she remembered feeling like she had made a mistake by revealing her history. 

“It worried me because, now, what if that information is passed along to someone taking care of me, or involved in my care, that might create some sort of bias. I wondered if next time, I should lie out of self-preservation.” 

Parrish stated that many in the LGBTQIA+ community have told her that they are also worried about finding a healthcare provider who understands their needs. 

“A friend of mine is a transgender woman who has difficulty getting consistent healthcare in general,” Parrish said, adding that the constant misgendering, use of the wrong name and being “grilled” by providers about sexual history has resulted in her friend no longer seeking healthcare. 

“They stopped going to a doctor because the overall situation was very traumatic for them,” Parrish said. “Another friend, who is non-binary, received some pushback because they were taking testosterone – even in Morgantown, there is a lot of bias and issues with gender-affirming care.” 

Through Parrish’s time working as a nursing assistant in a critical care unit, she recalled feeling that transgender individuals “were met with confusion and a lack of respect for who they were as a person by physicians, specifically older physicians, who didn’t really know how to address them or how to talk to them.” 

Parrish said that today she is in a heterosexual relationship, and therefore she can “blend in and not worry” as much about healthcare. However, she knows that is not the case for others. 

“A lot of people are concerned that they will be dismissed or outright discriminated against by seeking care in general in West Virginia. The state is not exactly known for being the most tolerant. . . . Acceptance and welcoming care is not visible. Even something such as a rainbow sticker on the receptionist’s window, I think, would go a long way in some places to say, ‘You are welcome here’ and won’t be discriminated against for something that you are entitled to.” 

Dottie Sayre, a Kanawha County resident, feels that much needs to be done to decrease the stigma for those in the LGBTQIA+ community – to not only ensure they receive adequate healthcare, but to have fundamental human rights. 

Sayre has become an activist in an attempt to make a change. 

Back in February, Sayre made the news when they stood before members of the West Virginia Legislature during a public hearing to voice opposition to House Bill 3042, a religious freedom bill that many fear will allow for additional discrimination of the LGBTQIA+ community. 

Sometimes referred to as the “License to Discriminate” bill, Sayre stated during that public hearing, “This bill is a mockery of what my kind already knows, whether you pass it or not, the damage is done. It’s proof, further proof, that you are willing to create turmoil rather than stop and fix something. I want to address my fellow pagans and my fellow queers. Those who would do us harm, cannot tell the difference between us, and neither can I.” 

Sayre stated that they attended the public hearing due to the frustration of new laws being passed, like HB 3042 which went into effect in May. 

“I’m 37 years old,” Sayre said. “I’ve watched this go on my whole life, and I don’t know that I’m going to be able to fix anything, but I will hold the line, so to speak.”

Sayre explained that anti-transgender laws, religious freedom bills, and the overturning of Roe v. Wade has directly affected those in the community. 

“We have a freedom of religion, and we are watching that get chipped away. Then, of course, Roe fell. It’s a whole lot of existential dread that’s just been building up over my lifetime, and I finally have the guts to stand up.”

While a child, Sayre said they were diagnosed with ADHD, and came out as bisexual at the age of 16. 

“I spent most of my life in my own head,” Sayre explained. “I felt more comfortable in my own head than I did out in the world, and Hurricane (located in Putnam County, and where Sayre attended school) is not really a great place to be different. I know a lot of people had it a lot worse.” 

Sayre is now aware that some data shows that having ADHD can lead to a shorter lifespan, but along with depression and anxiety, it can be difficult to keep up with medical appointments. 

“I try to be a mental health advocate,” Sayre explained, adding that it can be difficult to find a counselor who is a “good fit” for both those in the LGBTQIA+ community, and for those who practice paganism.

A study published by the National Institutes of Health in 2012 concluded that “clinicians working with [those in the LGBTQIA+ community] need to be attuned to their clients’ religious backgrounds and current religious commitments.” 

But without current data, it is hard to determine what effect this is having on those who are not considered to be in the majority population. 

In addition to finding a provider who is a good fit, Sayre stated that they have also experienced issues with paying for those services due to a middle class health insurance gap. 

“If you make less than so much a year, then you are not expected to pay anything. If you make more than that, you’re expected to have $10,000 on deck ready to go for any emergency at any time.” 

Sayre expressed, “I am not a victim of the system, because I have been able to find healthcare, but I have to be careful of which counselor I visit.” 

To help those who feel left out, Sayre, and others, have started Metro Valley Pagan Pride. 

“I’m trying to gather people now that already want to change, and we build it inside,” Sayre said. “We create our own community, and we do it with the sense that this community could eventually be everybody – they just need to put down their pitchforks and they could be a part of the party too.” 

Sayre continued that change will not happen overnight. 

“It’s going to take generations to fix this,” Sayre noted. “I do think we are making progress, but I’m just trying to fight the backslide at this point . . . I share my story, and I try to make people feel better. . . . I have been alone so long that I don’t care who doesn’t follow me, but I really, really care about the people who do.” 

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