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What is the first thing that comes to mind when you hear that it is LGBTQ+ Health Awareness Week? Maybe you think about the recent political climate and how basic healthcare rights have been under attack, maybe you think about the great strides being made from medical providers who offer gender-affirming care for trans and gender non-conforming individuals, maybe you think about the strong presence of hookup culture within the community and the importance of proper sexual health through testing and preventative measures, maybe you consider the high prevalence of mental health issues, substance use issues, and suicide rates within this community. There is a lot to consider when it comes to LGBTQ+ health awareness, so any and all of the answers above could be correct.

HISTORY

This year marks the 23rd year of LGBTQ+ Health Awareness Week established by the National Coalition for LGBTQ+ Health. LGBTQ+ Health Awareness Week was established by this organization to call attention to the diverse and expansive healthcare needs within the LGBTQ+ community and the coalition is not just made of LGBTQ+ individuals, but also advocates, allies, and healthcare professionals. Healthcare is a vast subject that encompasses not only physical needs, but mental, emotional, and even spiritual needs. Treating the person as a whole ensures that their needs are being met and each component of healthcare can have a drastic impact on the other parts if left unmanaged.

WHY DO WE NEED LGBTQ+ HEALTH AWARENESS WEEK?

Health care is of course important for everyone, but unfortunately it is true that both physical and mental health issues are seen at higher rates in queer people than in cisgender and heterosexual people. 4.5% of the United States identifies as LGBTQ+ and 39% of these people have reported suffering from mental illness within the past year, but how many people does this come out to be? 4.5% doesn’t seem like a huge number, but to have a little over one third of this percentage suffering from a mental illness within the past year means that 5.8 million LGBTQ+ Americans are dealing with mental health struggles. Queer people are also six times as likely to experience depression at some point in their lives compared to cisgender and heterosexual people. For substance use too, 20-30% of the LGBTQ+ community is affected by harmful substance use compared to 9% of cisgender and heterosexual people.

In discussing physical health issues for people in the LGBTQ+ community, it is important to note that stress is a factor that can increase the risk for many chronic health conditions. This is because we are not meant to have increased levels of stress hormones, they are only meant to assist during times of distress. Having excess stress hormones can cause what’s called allostatic overload which is the point at which the cumulative wear and tear on the body, mind, and emotions caused by chronic stress exceeds an individual's capacity to cope, leading to health problems and disease. What diseases and health problems are exaggerated by being in allostatic overload? Aside from an increase in mental health issues as seen above, cardiovascular diseases, diabetes, cognitive decline, migraines, and sleep disturbances are just some of the other issues that can arise from the increased and prolonged biological stress response.

WHY INCREASED STRESS?

It’s no shock to anyone that LGBTQ+ people do in fact have more stressors than the average cisgender/heterosexual person. They have to worry about being accepted by loved ones, employers, teachers, neighbors, landlords, friends, coworkers, service providers, doctors, nurses, therapists, psychiatrists, and really by everyone in society who they may come into contact with, because if they aren’t being accepted the best case is a neutral response and the worst case would be experiencing discrimination, microaggressions, and persecution for their gender identity and/or sexual orientation. It can be exhausting to switch between feeling like you have to hide important pieces of yourself or share these important pieces of yourself with others and risk being judged or not accepted for who you are. This constant fear and exhaustion puts so much pressure on queer individuals and the numerous discriminatory laws being passed on both state and federal levels are not helping to ease these stressors either. With gender affirming healthcare being under attack, queer and gender non-conforming individuals are consistently feeling like they have no place to go to be understood by their medical providers. Queer people are also more likely to experience higher poverty rates than their cisgender/heterosexual counterparts which directly impacts healthcare accessibility and the ability to purchase health insurance or pay for procedures/routine checkups out of pocket. And, of course, the higher poverty rates, higher discrimination rates, being attacked by legislature, the fear of being accepted, and all the other struggles faced by the LGBTQ+ community compile and make it so that the statistics listed above are not only correct, they also tend to rise as more research becomes available, making this a systematic problem.

WHAT CAN BE DONE TO HELP?

There are so many negatives associated with LGBTQ+ access to healthcare, and while it’s not necessarily wrong, it’s not right that it seems to take over the positive aspects either. Great strides have been made in gender affirming care that shouldn’t be ignored. Trans surgical procedures and hormone replacement therapy continue to be improved upon to be made safer and more affirming for trans individuals. Even though queer individuals have higher rates of mental health concerns, they’re also much more likely to utilize any available resources to be able to pursue therapy and then utilize the therapeutic skills they’ve learned to help manage their mental health. Queer joy is also something that gets overlooked in all the negativity. Queer joy is beautiful and can be fostered by building community through sharing resources, knowledge, and quality time together with people in the community… but also with allies of the community to help impose systematic change, a few people at a time.

It’s horribly daunting to try and fix a systematic problem, but what we are all capable of is sharing resources to help each other and ultimately, better education is what the most powerful tool is. Ideally, physical and mental health service providers would be able to attend more training on working with LGBTQ+ clients and patients in order to fight against the great levels of discrimination people of this community face in a healthcare setting. It would also be helpful for medical professionals to be allowed to take a more active role in treating their patients instead of most of the treatment being at the will of insurance companies run by people without medical training. Finally, having educational events for all members of society to attend to learn more about LGBTQ+ health because this just isn’t a topic that many people know about. The more we’re able to spread awareness, the better this issue can be helped and hopefully resolved.

New to Therapy?

Sun, 31 Mar 2024 01:50:59 GMT

What to know if you are new to therapy!

New to Therapy? Not a Problem

What does "being ready" for or "needing" therapy even mean? Clinicians hear people talk about this concept all the time, and often, what we see is that people trend toward avoiding seeking counsel until they feel like they really need it, until they are in crisis. This is often because being vulnerable is scary... that is what makes it such a courageous thing to do. But this is your permission slip to start earlier, before another crisis or tragedy. You do not have to wait until you feel like you are falling apart to justify coming. Therapy before these moments can be preventative care!

Now, unconsciously, we do have to ramp up to facing ourselves. There are stages of readiness for change :

1) Precontemplation- There is not a big intention to change and the depth of the issue is not quite conscious yet.

2) Contemplation- The person is aware of the issues but does not feel completely confident in being able to make changes.

3) Preparation- The person intends to take some action, make some changes and is taking the steps to do so.

4) Action- The person has engaged in work and made some changes for a short period of time.

5) Maintenance- The person has maintained changes and is working to prevent from returning to old patterns.

This is more of a cycle, all of us move back and forth in these stages as we are healing. This can also help us identify barriers to change.

The secret here is that people start therapy at ALL stages. People have come to therapy in Precontemplation, feeling "off" but attached to their behaviors, unsure of what is wrong, showing up weekly to session but resistant to being completely open or following through outside of the safety of the therapy container. But eventually, they start to identify things they want to be different, situations in life that have hurt them and what feelings stand in their way. Then they take some action and we move through the entire cycle many times.

You can come to therapy at any time, you are always welcome in the doors. You can come with goals or you can come open to the experience, or even just a little curious if not completely open. Your therapy, your pace. It is all ok!

Once you are in the space of starting therapy, there are a few things to know. Therapists are people too, they are here to help but they are not mind readers despite being perceptive folks. You are allowed to ask for what you need. Need a "tough love" therapist? Tell them! Need a break during session? Tell them! In healthcare, there is a power dynamic we all tend to fall into and so we do not always ask our healthcare providers for what we need or wait until we find the right provider for us. You are in power!

How to find the right provider : Finding the right fit for you can take time. Allow yourself time to identify how you are best communicated with. Personally, I requested a "no bullshit" therapist that would call me out when necessary. I had too many experiences of being placated or therapists not challenging me when I needed it because I could talk a good talk. Now, I have a therapist who calls things out, who pauses and explores, who rewinds, who can completely tell when I'm full of it and is also compassionate, encouraging and healing.

While you are searching, really trust your gut with how you respond to profiles and take advantage of the consultation calls! Hear their voice and connect with them.

If you do start with someone, typically give it at least three sessions, allow relationship and rapport to build.

But therapy is expensive! Insurance vs OOP: Therapy cost money! That is an unfortunate reality of the systems we are in. And since it is an expense, we often put ourselves on the back burner because "we will survive". But you are worth it, you are worth prioritizing, and it is preventative care that could save money in the long run! With that said, let's get practical. Two ways to access treatment are through insurance or out of pocket. If you have insurance, every plan is different, but there is mental health coverage. You'll potentially have a deductible to meet (a certain amount of money you have to spend first) or you have an immediate co-pay. Lots of options in the middle! Check your plan and then utilize tools like Zoc Doc to find clinicians that accept your insurance. Therapy offices will confirm and offer you estimates for all costs.

Out of pocket: Therapists have an out of pocket fee- this typically matches the full fee paid from insurances. Access with out of pocket is simple (in terms of not needing to deal with any third party). Many clinicians offer a sliding scale fee, this is the range they can afford to offer so that treatment is accessible. If you are financially privileged and can afford the full out of pocket fee, be honest, that full fee is often how the sliding scale and lower fees are sustainable to offer to other clients in need. No shame in needing the lower fee! Truly, talk with your provider about what you can make happen and how often. If you have insurance but the clinician you would like to see is out of network, check your benefits to see if you can still see them and talk with your provider about super-billing. Upfront, you will pay they full fee and then submit the claim to insurance who will refund part of the fee; it may be less coverage than your co-pay but could still be very sustainable and worth it if you found someone you really connect with.

EAP : Employee Assistance Program- some employers utilize EAP programs to provide mental health care for their employees. Check with what provider your company purchased this care and then use it! This therapy is already paid for! They bought you sessions. It is typical for a package to range from 3 sessions to 8 sessions. After that, you can continue with your therapist at their fee until your EAP renews.

Lionheart, specifically, offers therapy packages! These are discounted sessions (lower than sliding scale) purchased upfront and scheduled out. You can get 4 sessions or 8 sessions. Save money, save time.

The work outside of session: Eventually, you will start to take the work, reflections, explorations and challenges that happen in the therapy office into your daily life. How powerful the experience of therapy can be depends on your willingness to move it into your life. Try the new communication tactic, use the breathing technique, allow yourself to feel the full feeling, ask for what you need; this all allows new experiences to happen that help our healing and growth. The more you understand yourself, the more you will know how to show up for yourself in the here and now. You'll create a feedback loop of change!

So... if you're new to this idea, no problem! We can guide you through. If it is scary... then you probably care and that is a great sign.

Queer Resources

Sun, 31 Mar 2024 00:58:03 GMT

Resources for LGBTQIA+ Community

Resources, Local Support and Groups

Trevor Project: text 678-678 or call 1-866-488-7386

https://www.thetrevorproject.org/

YPA (Youth Pride Association): https://www.ypapride.org/

GLAAD: https://glaad.org/resourcelist/

Human Rights Campaign: https://www.hrc.org/resources

Stonewall Foundation: https://www.stonewallfoundation.org/

NYS Office Resources: https://omh.ny.gov/omhweb/lgbtqia/

In Our Own Voices: https://ioov.org/programs-services/

The Center: https://gaycenter.org/support/

National Center for Transgender Equality: https://transequality.org/

Resources for Trans Youth: https://www.transyouthequality.org/ and https://www.samdevorah.org/resources

Legal Support

https://transgenderlawcenter.org/

https://lshv.org/program/lgbtq-rights-unit/

https://nylag.org/

https://www.lgbtbarny.org/legal-services

Adoption Support

https://ocfs.ny.gov/programs/youth/lgbtq/resources-household.php

https://www.nyc.gov/assets/acs/pdf/lgbtq/ACS_AffirmingFamiliesBrochure.pdf

https://www.lifelongadoptions.com/lgbt-adoption-resources/lgbt-adoption-laws/new-york

https://spence-chapin.org/lgbtq-adoption/

Fertility Support

https://www.chelseafertilitynyc.com/fertility-care/lesbian-gay-fertility

https://www.gayparentstobe.com/gay-parenting-blog/is-ivf-covered-for-lgbtq-families-in-new-york

https://www.rmany.com/lgbtqia/lesbian-couples/ivf

https://www.kofinasfertility.com/fertility-therapies/lgbtq-fertility

https://www.conceptualoptions.com/

Crisis Resources

looka_production_149439946 — Sat, 23 Mar 2024 19:30:38 GMT

Below are some resources if you are experiencing thoughts or urges to hurt yourself or someone else, feeling down or hopeless, are in a dangerous situation or could use a life raft:

Suicide and Crisis Hotline: 988

You can call for yourself or if you are worried about a loved one

Crisis Text Line: 741741

24/7 support via messages

Sherif Office and Mobile Crisis by County

https://www.cobleskill.edu/campus-life/wellness-center/TelecounselingCrisisResourcesbyCounty.pdf

NYC Crisis Support

Text "WELL" to 65173 or call 1-800-NYC-WELL

Domestic Violence

If you, or someone you know, are being controlled by another individual through verbal, physical or sexual, or other tactics, please contact: 1-800-942-6906

Click below to download ways to support and speak to a loved one that may need support