Access to health care is a concern for many Peorians. However, finding health care is an even bigger struggle for members of the LGBTQ+ community, who often can't find medical providers willing to serve them, offer the services they need, or make them feel comfortable in a vulnerable setting.
Positive Health Solutions (PHS), a clinical site within the University of Illinois College of Medicine Peoria (UI-COMP), recognized that Peoria had a large gap in LGBTQ health care services, including mental health. That's why the organization recently expanded its operations to include specialized comprehensive medical and case management services specifically for members of the LGBTQ community.
Lisa Roeder is the director of PHS, and explains how the clinic will impact various groups.
“We’re pleased that our LGBTQ primary care clinic will be able to address the needs of LGBT youth, who are two to three times more likely to face depression, struggle with their identity, and can’t find providers willing to serve them. We’re pleased we can meet the needs of lesbians who are less likely to get preventive services for screenings and cancer.
"Our LGBTQ primary care clinic can address the medical needs of our gay men population who are at higher risk of HIV and STI’s, especially among communities of colors. And transgender individuals, who have a high prevalence of STI’s, HIV, mental health issues, and suicide attempts,” explained Roeder.
She said offering these sorts of services in central Illinois will help people who were previously driving to areas like Chicago or Springfield to receive the care they need.
The clinic also will be offering gender affirming care, and is so far the only facility in central Illinois to do so. Dr. Teresa Lynch is the chair of internal medicine at UI-COMP.
“There's not a lot of expertise, and you know, the need has increased faster than the expertise,” said Lynch.
Offering gender-affirming services doesn’t just have physical benefits, according to Amy Gregory, a nurse practitioner with PHS.
“Most studies have shown that rates of depression and anxiety…they get better once someone starts hormone therapy, and not everybody does gender affirming surgery either. But even you know, just affirming someone's gender and letting them express how they identify as helps a lot of mental health issues,” said Gregory.
According to the American Psychiatric Association, people who identify as part of the LGBTQ community are more than twice as likely as heterosexual men and women to have a mental health disorder in their lifetime. When it comes to seeking treatment for mental or physical health, it’s important that the provider understands who the patient is, including how they identify. However, providers often never ask those questions to begin with, according to Roeder.
“I think a lot of our patients have struggled. They're actually kind of surprised when we ask them when they come in, what are their preferred names? What are their preferred pronouns? We're not used to being asked those questions. So, being able to ask those questions and being able to identify with whatever name and gender you identify with actually helps them put them at ease right from the beginning,” Roeder said.
Having an environment that people can feel safe and comfortable being vulnerable in is a large barrier that often keeps people from seeking treatment in the first place. Gregory mentioned that even as a patient herself, she has had negative experiences with providers.
“A lot of primary care doctors don't even ask the gender of your partners, and there's different risk screenings that you have to do based on your activities and who your partners are. You know, a lot of lesbians don't get pap smears. Gay men are more at risk of HIV and STIs,” Gregory said.
Dr. Lynch added that having a comfortable patient and provider relationship is not just beneficial for those in-the-moment health concerns, but opens to doors to conversations about preventative care in the future.
“I think sometimes being able to relate to someone and talk to someone about gender affirming care also opens up conversations for other care. So, it may then allow that person to be connected to mental health resources that they need, or connect to just a counselor…it just opens up the ability to treat underlying issues… you would be surprised the number of people who have mental health issues,” said Lynch.
Mental health has proven to be a large problem within the Tri-County area it’s getting worse. According to the 2022 Community Needs Health Assessment survey, the percentage of people describing their overall mental health status as “good” fell 73% in the past six years, while the percentage of people reporting “poor” mental health doubled in the past three years to 16%.
Roeder said it’s a problem PHS is working to address.
“We do have mental health counselors at PHS, and we do offer those services. We have psychiatry that comes in also and monitors medications for patients that we have. We definitely have addressed the idea and the thought that we have a greater need for mental health services, and we'll be working to address those needs as they become more apparent to us with the population of LGBTQ patients that we see,” said Roeder.
According to research led by Harvard T.H Chan School of Public Health this past year, gender-affirming surgeries were associated with a 42% reduction in psychological distress and a 44% reduction in suicidal thoughts compared with other gender diverse people who wanted gender affirming surgery, but did not have it.
With outcomes like these, it’s a surprise that more medical providers in central Illinois aren't providing gender-affirming care. Peoria generally isn’t considered a medical desert. As the regional medical center of central Illinois, Peoria boasts three major hospitals. While lack of expertise is one limitation, Lynch thinks Peoria eventually will move to offer expanded LGBTQ care in the future.
“I honestly think the community and the health care providers in the community are trying to address this patient population," said Lynch. "It's hard to carve it out and make a specialized space for a specific population and make that population of people feel comfortable … in an existing clinic. We're kind of fortunate that the HIV population already has some of those patients or is connected to those patients, and so it might make it a little bit easier for us and that we already have some specialized connections…I think you're gonna see this expanding, and other people are trying to build it up. We're just a little bit ahead.”
She added that PHS hopes to partner with other organizations to engage more people in the process. For now, PHS director Roeder said she’s just happy to get people in the door who didn’t feel comfortable accessing services until now.
“That's pretty much a huge leap for the majority of our patients, just recognizing that there's a place where they can come, be who they are, get the services that you need, and not feel quite so isolated, that there's somebody in central Illinois who can provide your care, and doesn't make them feel ashamed of what their needs or identity are.”
To find more information about Positive Health Solutions and their LGBTQ primary care, visit their website.
