CBST Community Care Survey Findings

Demographics

Gender Identity: 49% identified as women, 42% as men, 8% as gender queer or trans.

Sexual Identity: 42% gay, 36% lesbian, 9% queer, 6% bisexual, 5% straight, 2% other.
Age: 41% were over 55, 37% were between 36 and 55, 22% were 35 or younger.
Relationship Status: 46% of all respondents were living alone, and 54% of those over 55 were living alone.

Living Will / Health Care Proxy
60% of all respondents had a health care proxy, and 54% had a living will. These numbers were higher for those who were partnered (71% living will, 65% health care proxy). In contrast, only 11% of those under 26 had these documents.

Out to Medical Providers
77% of all respondents were out to their medical providers. These numbers were somewhat higher for who were partnered (82%), those who identified as queer (83%), and those who were between 36 and 55 (81%).

Improving Health Care Access
When asked about what most needed improvement to allow for equitable and comfortable health care for LGBTQ:
Visitation Rights:  90% felt that visitation rights were most or very important.
Medical Providers’ Knowledge/Attitudes: 93% felt that health care providers’ knowledge of and attitude toward LGBTQ issues were most/very important. 87% felt providers’ general knowledge of gender and sexual diversity was most/very important.

Discrimination
There was little fear of LGBTQ discrimination among the total group (6% feared discrimination from a specific provider or facility), but that number was much higher among those identifying as queer (29%). These findings were consistent with those who reported actually having been a victim of discrimination (3% for the total group, 17% for the queer group). Similarly, nearly half (47%) of those identifying as queer reported that they felt they had received sub‐par medical care because of their gender/sexual identity, while only 6% of the total group felt this way. About half (49%) of the total group reported seeking out LGBTQ‐friendly providers; but almost all people identifying as queer (94%) reported seeking out these providers, as did 73% of those under 36.

Medical Intake Forms

Only about half of the total group was comfortable with the adequacy of medical intake forms for reporting gender identity (66%), relationship status (56%), and sexual identity (45%). These figures were much lower for the queer group, where only about one quarter of respondents were comfortable with the adequacy of current medical forms for recording gender identity (26%), relationship status (33%), and sexual identity (25%).
77% of the total group felt that revisions of medical intake forms were most/very important, but only 39% were comfortable having sexual/gender identity recorded on these forms; 46% were unsure about it. For those who identified as queer, 39% were unsure and 22% did not want to record this information on a form.

Suggestions for Future Action:
(1) Koleinu sponsorship of programs/workshops on the importance of Health Care Proxies and Living Wills , with an opportunity for preparing these forms. This is important for the whole community, and programs may need to target different age and orientation groups.
(2) Regarding improvement of health care access : Develop or sponsor educational programs focusing on
a. Legal rights, including enforcement of visitation rights
b. Special LGBTQ health issues
(3) Advocacy for sensitivity training for health care staff/providers at all levels and in various settings (e.g. medical schools, health care settings for all ages, medical provider offices, and recovery centers).
a. Providers must elicit information they need to provide appropriate health care.
b. Providers and community must work together to achieve an atmosphere of open communication.
(4) Both the LGBTQ community and medical providers need education regarding the importance of ascertaining accurate information on medical intake forms . This would allow for the LGBTQ community to be counted as a group with health care access needs. We also need to explore issues related to reluctance to identify as LGBTQ in medical records, particularly with the young, queer, and trans communities.
(5) Explore the issues regarding LGBTQ comfort with professional providers and other staff .
(6) Compile / distribute a listing of LGBTQ‐friendly providers and facilities  based on anecdotal evidence from the community and from known LGBTQ providers such as Callen‐Lourde and GMHC.