Clinicians from the future practice the medicine of inclusion – Kaiser Permanente LGBT Health Symposium

I got what I expected at the first ever Kaiser Permanente Lesbian, Gay, Bisexual, and Transgender Health Symposium this past weekend – interaction with the most courageous nurses, doctors, allied health practitioners, patients, and staff in health care today.

There was a heavy focus on the care of trans people, which is also what I came for. There were sessions covering everything from endocrinology care to surgery, to the stories of patients. The sessions were filled with people interested in learning and providing more and better service to trans people. One of the Kaiser Permanente members present even remarked on this:

#2013LGBT #KP member Ashley – “wouldn’t have seen this 10 years ago” -room filled w professionals interested in #transgender #health

— Ted Eytan, MD (@tedeytan) April 12, 2013

There was honest recognition throughout that health care still has major hurdles to overcome in the nonjudgmental, safe care of trans individuals,

• People who are not covered for services may obtain them illegally, with potentially devastating results. Fortunately, hormones and behavioral health services are now base benefits for all Kaiser Permanente members.
• Modern electronic health record systems cannot cope with the difference between “sex” and “gender” – resulting in inaccurate testing and confusion throughout the care process. This is also being worked on.
• Some health care workers make mistakes in addressing or working with this population, and some are insensitive or hurtful, leaving lasting impressions. Here, again, training is occurring throughout the system.

Toby Meltzer, MD was present with us, which was a great treat. He is the surgeon who is now contracted through Kaiser Permanente to perform trans surgeries for our members – he is nationally recognized and has over 20 years of experience in this field. When you hear him speak, you can tell he’s not just interested in excellent surgical care, he’s passionate about promoting someone’s healthy life.

Judy Lively, MD, a surgeon at Kaiser Permanente, also told us about her journey, which was written about in the San Francisco Chronicle.

Watching people talk about the care as if it is just “health care” was the best part. Because that’s what it is. 

#2013LGBT #KP “eventually transgender health care will be just ‘health care’”

— Ted Eytan, MD (@tedeytan) April 13, 2013

There were many more issues discussed than trans health at this conference, including youth suicide prevention (from advocate and colleague @DrRonHolt), to intimate partner violence prevention to LGBT aging.

Toni Atkins (@ToniAtkins), the California Assembly’s Majority Leader, remarked that she was surprised that this conference was the first of its kind, given how far ahead she perceives Kaiser Permanente is in supporting culturally humble care. In actuality, Kaiser Permanente has hosted a Diversity Conference for many years, so these topics have been discussed for a really long time in our system. 

The special thing for me about this event was that a group of people so invisible in society and health care, trans individuals, were visible in a meaningful way throughout. There was not enough space and too much content when the topic was transforming care and supporting the health of trans people. Conferences like this did not used to be mainstream. Now, at Kaiser Permanente, they are.

Both of the Kaiser Permanente members present did not want to be quoted using their real names or with photographs. They came anyway, to teach us.

One of the members told us about a nurse who embarrassed him in the waiting room of the breast center when he presented for a medically necessary mammogram. He said she immediately apologized when she realized what she had done. He told us what this meant – “the apology made it okay.”

In the spirit of what our members desire, the ability to achieve their life goals, I think we can make it okay. All of it. Together. You can either help us, or you can watch us :).

Ready to make health the norm, not the exception View LGBT Health Symposium 21750 on Flickr.com

Thank you, Southern California Permanente Medical Group, course co-chairs Maria Carrasco, MD and Mateo Ledezma, MD, and all of the faculty, medical, nursing, staff colleagues (and members!) for coming to Los Angeles from the future. The present is listening. Inclusion equals health.

Cultural humility – the expert on you is YOU. Ronald Copeland MD, Diversity & Inclusion Officer #2013LGBT #KP flic.kr/p/eaTWZJ

— Ted Eytan, MD (@tedeytan) April 13, 2013