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Caitlin Whyte (Host): Welcome to Hally HealthCast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic, important to your health and wellbeing; bringing in expert doctors, specialists, and community leaders who offer advice and answer your most pressing questions.

June is Pride Month, a time to celebrate and advocate for the LGBTQ+ community. So on our episode today, we take a look at how to create truly equitable and inclusive healthcare environments, services and experiences for LGBTQ+ patients and their families. Here with us are two expert voices, Dr. Tabatha Wells is a Family Medicine Physician and the Program Director of the Family Medicine Residency Program at Carle Foundation Hospital in Urbana, Illinois. And Nicole Frydman is the Director of Operations at Uniting Pride of Champagne County, an organization that advocates for the equity, wellness, advocacy, and visibility of the LGBTQ+ communities in Champagne County, Illinois.

Welcome to you both. And thanks for being with us today to discuss such an important topic. So let's begin. Nicole, your organization's mission is to create a world where all who identify as sexual and gender minorities can live full, healthy and vibrant lives. It's easy to forget, but no person can live a truly full and vibrant life, if they don't have the equal access to safe, welcoming, and appropriate healthcare. Can you give us a little history of the barriers of LGBTQ+ individuals have faced in our country when it comes to healthcare? Big question on the top.

Nicole Frydman (Guest): Yeah. I can do a whole podcast just on that alone. In the interest of time, I'll say of course there has been barriers throughout time, but I'll stay focused on where we are right now. Barriers that LGBTQ folks face today largely fall in three main categories, lack of access, negative experiences and lack of knowledge of providers. So, lack of access is just what it sounds like. Overall, we're an under-insured group of folks when compared to other demographics, young people are sometimes kicked out of homes early. Don't have access to schooling. Therefore don't have access to good jobs, which of course is where a lot of people get their health insurance. Even if folks are able to navigate a system and get through to Obamacare, often that is baseline insurance, and then there's a lot of cost prohibitive stuff that comes along with it.

So we're talking about just being able to afford care and get insurance coverage, but we're also talking about where the access even is. You know, if you live in a smaller part of the state or, you know, somewhere in the country where there's, there's less care that is focused on LGBTQ issues, you may have to add in transportation costs in order to go get the care that you need.

That's another huge barrier. And we talk about negative experiences and negative experiences are a range of things, obviously but is generally about non affirming experiences, people being mispgendered, dead named, doctors or nurses or other staff in facilities who aren't open-minded and don't consider that people have different lives. And that means their healthcare needs to be different as well. The last one is a little bit more specific, especially in our community. We get this complaint a decent amount of times, sometimes, especially trans folks feel like they have to do train their providers in how to give them the kind of care they need.

And that's really not ideal for lay people to be having to go and reach into their communities and networks, find people who've gone through some of the same stuff before and find information about the kind of care they should be giving them. Getting an and bringing it to their providers. And then of course, unfortunately, providers don't always listen to their patients because they aren't experts of course.

But then you've got this double thing happening where the providers aren't going to look for it and then they're not listening to their patients when their patients bring them information. As you can see, this can create a really difficult scenario for LGBTQ folks to get the kind of healthcare that they need.

Host: No, absolutely. I completely hear you. And thank you for that explanation, Nicole. Now, Dr. Wells, apart from creating a just, welcoming and safe environment, what are the specific services and types of care that a truly inclusive healthcare organization should offer to members of the LGBTQ+ community?

Tabatha Wells, MD (Guest): Well, the care offered for the LGBTQ+ community should really be exactly the same as the care offered to all patients. So I'm talking about primary care services, counseling services, OB GYN care, including pregnancy management, contraception management, preventive health management, like cervical cancer screenings, mammograms, diabetes screenings, STI prevention, and testing, but additional offerings that are specific to the community would be things like gender affirming care, including hormone therapy, referrals for different types of surgeries like top surgery, bottom surgery, hysterectomies, orchiectomies, facial feminization, or masculinization surgeries, pre-exposure prophylaxis for HIV. But there is a really important thing to note as with all health care services, insurance coverage varies for different health care services and procedures, and that can vary greatly from state to state.

So patients need to check with their plan to see what is covered and what out of pocket costs might be. And patients need to work closely with their providers to use the appropriate insurance determined diagnosis, to try to get as much coverage as possible. Some examples that I've run into are gender affirming hormone therapy may not be covered under some plans. Sometimes using certain diagnoses can help get it covered. Gender affirming surgeries might not be covered, but again, using certain diagnoses, we can sometimes get them covered. Specific issue that I had in the past, but I've not run into in the last few years since the ACA was enacted was when the gender identity on legal documents or on the insurance information for the patient didn't match the preventative health care needs of the patient, that preventative health care coverage was denied. So for instance, when a male patient still needed cervical cancer screenings or mammograms, that coverage would be denied.

Host: Okay. Well, thank you so much for that. And Nicole, is there anything else you'd like.

Nicole: Yeah, obviously everything Dr. Wells said, I want to make sure that we also think about the way patients are treated, spoken to and engaged with, not just by their providers, but also from non-provider employees as well. You know, if patients could expect an affirming experience from the moment they park their car and walk in the door to check in maybe even multiple check-ins to whoever they ask for directions to when they finally get in the room with a provider. I mean, if they could expect an affirming experience across the board, that would be life-changing. Right now, the standard scenario is that most LGBTQ folks expect a non affirming experience and are happy and surprised if they get one. Wouldn't it be amazing if we could invert that and have the expectations be that their experience is going to be an affirming one and the times that it isn't are the exceptions.

Host: Gotcha. Yeah. It's so surprising. We, we have come so far, but we have so far to still to go. Thank you for your response, Nicole and Dr. Wells, I know this is an issue near and dear to your heart. I know that we're continuing to look for more and more ways to make healthcare more welcoming, safe, available, and equitable for the LGBTQ+ community. But what are some of the strides that have already been made? Like we were just talking about in the past few years to improve the situation, talking about hospitals, clinics, talk to us about that progress.

Dr. Wells: So a big one, like I said, was when the ACA was passed, that provided insurance coverage for many patients countrywide, but specifically many patients in the LGBTQ+ community that didnt prior have insurance like Nicole was talking about earlier. So now patients have coverage for all aspects of healthcare, but especially to mental health, this is really important because we know that people in the LGBTQ+ community face higher rates of multiple forms of violence, higher rates of substance use disorder, higher rates of self-harm and suicide than their non LGBTQ counterparts. Other examples by insurance companies are coverage for PREP, HIV care, coverage for gender affirming care. Like I was talking about earlier, some things that clinics and hospitals have done are like being open about providing LGBTQ+ care. So advertising on their websites, inclusive advertising, advertising featuring same-sex couples, listing their providers on LGBTQ+ provider directories so that patients can specifically seek them out. Posting LGBTQ friendly symbols and stickers like a rainbow flag or other symbols or stickers, visibly posting a non-discrimination policy on the clinic walls or hospital walls, having brochures and advertisements, that feature educational materials specific to the LGBTQ community and their healthcare concerns.

Signing up to participate in the human rights campaign, healthcare equality index would be a huge one. Displaying posters like educational posters from nonprofit organizations that are specific to LGBTQ organizations or HIV, or even from the CDC about health concerns to the LGBTQ community, customizing patient intake forms. De-stigmatizing HIV, having pronouns on all employees' name badges, employers that offer same-sex partner benefits, employers mandating implicit bias training, inclusivity training, cultural sensitivity, and competency training, education about how language matters and using proper language and patient preferred language, utilizing and teaching trauma informed care. I can go on.

Host: I know, I don't think we'll be able to fit everything we can do into this 30 minutes. But it's encouraging to hear that there are so many options and ways to make people feel comfortable. Dr. Wells, and, you know, I understand that you, yourself and your colleagues at Carle Foundation Hospital have put into place a large number of these important changes. Can you discuss what you've done and the changes you've made at Carle and the positive results that you've seen from them so far?

So I think the most recent thing we've done is a gender health, or gender equity. I can't remember what it's called, monthly webinars series. I actually did the first talk in the series that was just kind of an intro to LGBTQ healthcare that really just gave very basic like definitions, things like that. And just the first steps of what you can do to make patients comfortable and things like that. And it, it's once a month through June, it'll be covering a multitude of LGBTQ related topics, including trans health. And then in June, we will end with a panel just for Q and A, but it's open to all Carle's staff and it's online and we've had 300 or more participants at some of them. So it's been very successful and it is available online because it's been recorded. So, it's on the Carle Simi website. If anybody wants to watch it. We also have an Carle wide equity, diversity and inclusion committee that covers everything related to those topics, but they're working on many issues related to the LGBTQ community.

And they're the ones that with the CME committee has put on those webinars. But some specific things that they've been working on is related to our electronic health record. So through the patient portal, or when they check in or during visits, patients can now change their gender, they can list their preferred name, instead of just having their legal name, they can change their pronouns. Our EHR now has an anatomical inventory. Patient's preferred names will print on their patients stickers instead of just their legal name, so that when we call them back, we know that the name to call instead of calling the wrong name and the preferred name will print on hospital bracelets as well. Specifically in the clinic I work in, I've created a few rules or concepts that apply to how we treat all people and how we interact with everyone, not just the LGBTQ population.

I kind of created it because of my work with LGBTQ patients, 10 rules that I got from the Transgender Law Center. But I'm only going to go over a few of them because again, we're limited on time. The first one is treat all people as you would want to be treated. The second is refer to all people by the name and pronoun that they use, even when, not in their presence. The third is if you are unsure about a person's gender identity or how they wish to be addressed, ask politely for clarification, a simple, what may I call you goes a long way versus assuming that they want to be called whatever is listed. The fourth is establish a policy for how to address discriminatory comments and behaviors, which we have not done yet. We are working on it. The fifth is keep the focus on care and not curiosity. So, that one usually needs a little explanation. So, this one is more usually specific to transgender patients. It means only ask what's relevant to care. Don't ask about someone's genitals if it's not relevant to what they're there for today, don't bring learners into just so they can meet a transgender patient because they've never met one. If they are not already participating in the care, don't bring them in. Don't ask things not relevant to today's visit. So some of the positive results that we've already seen are better relationships amongst staff, better connections with patients, more inclusivity, people actually feeling like they can be themselves.

Patients being more open and honest with their providers, attempts between providers to collaborate. A lot of us didn't even know each other existed that provide LGBTQ care in Champagne. So we've had a couple of meetings and we're creating a list so that we all know each other and can collaborate and refer to each other.

And I think the biggest one is just more people interested in LGBTQ care at Carle. A specific example that I have is one of my residents. He talks all the time about he couldn't be happier here because he can finally be himself. He did a drag show for the first time in his life because I told him I would support him and that it would in no way negatively impact his career. And, you know, he always tells this amazing story about how being a black gay man has been difficult because of the typical discriminations that he's always being both black and gay. And before he moved here to little old Champagne, Illinois to start residency, he had never met a black gay physician other than knowing himself.

And the first weekend he moved into his house. He met one of his neighbors who happened to be a black gay physician here at Carle. And now he has a great relationship with this physician who is now one of his mentors and has been a huge, positive influence for him, both in his career and in his life as a black gay man.

So even with all these changes and positive things, we're not nearly done. We have a long way to go. You know, I would love to eventually be on the list of the Human Rights Campaign Centers of Excellence for LGBTQ+ health care. But again, we have a long way to go. The there's a lot of things on their list that needs to happen, but a couple of the things on my list of things that need to happen are more providers doing full spectrum, LGBTQ+ care, inclusive advertising. You know, we need some advertising that includes same-sex couples. We need improvements in sexual health care overall, including HIV prevention, STI education, things like that. And you know, many of the things I discussed earlier that other hospitals and clinics are doing are things that we're not doing yet. So, you know, we need to do everything on that list that I was already talking about.

Well, some incredible work that you're doing Dr. Wells, and that was such a good point to bring up about visibility and being able to see providers and caretakers that look like you. I think that's so important as well. And now, Nicole, how have you and your colleagues at Uniting Pride of Champagne County worked to address healthcare issues and inequities over there? What are some of the actions you've taken and also those you plan to take in the months and years to come?

Nicole: So, this is a moment when I let people in on information that we, we find out people don't always know, people tend to think we are a larger and older organization than we are. We actually have only been around about 12 years and we have one and a half employees. So we are a teeny, tiny little nonprofit organization finding our way and building things up and we're doing really well and we're on a, a big growth plan. So, we're excited about all of that, but I understand that people think we're bigger than we are, maybe because we have such an imprint in the community, especially with Pride Fest and that sort of thing, but there are limits to what we've been able to do and what we're going to be doing, but we sincerely hope that we have less and less limits as we go.

But what we have done, is training Dr. Wells talked about those seminars that have been happening monthly. We did one of those and we do cultural competency trainings all over the county. And we are grateful to have been invited into a number of healthcare organizations and institutions. There's also an Illinois Department of Public Health, LGBTQ+ Round Table Taskforce Group they started up this year. We're thrilled to be involved with that. And that is the goal of eliminating health disparities throughout all of Illinois and particularly hyper-focusing on communities that have been underserved. We also have a directory of providers that we know to be affirming on our website and something we started a couple of years back, mostly just with providers we know through, you know, our own personal and social networks. And then we've since reached out and tried to expand that list. It is by no means comprehensive. So, if there are providers out there listening to this who believe you're affirming, and arent on that list yet, get in touch. We have a set of standards and questions we ask. But something to note is that if we get complaints from the community, we will also post them up along with directories because that's part of that transparency, but we would love to have a full and comprehensive understanding of providers in our community who really can be trusted to provide fully affirming care. That would be amazing. So that's something we're in the process of doing, and then I'm glad Dr. Wells brought up mental health care. You know, what Dr. Wells was talking about is so true. It's really difficult in our community. We have higher rates across the board, but also even folks who have insurance often have no coverage or very little coverage for mental health care.

And the cost is so prohibitive that it's just, it's really difficult. So one of the, we are not mental health providers, but one of the things we can do and we do do is have support groups, for all ages from our littlest of little, to younger kids to older kids and teens, up to a bunch for adults, including an aging group for our elders, we held over 180 meetings last year.

And, we're excited to do even more of that this year. You know, we, we can't necessarily get everybody mental health with experts, but we can certainly create groups of peers who maybe have been there before, who can help each other out and support each other and try to make up some of the gap that's missing there, but in a dream scenario, we'd love to provide everybody real mental health care from experts.

And we'd love to be doing training all over the place and, and, you know, really helping to expand access. So if there's anybody out there who wants to help us do our work, who wants to help us on this growth plan, please do through donations, through volunteering, through finding resources for us, through helping us expand these programs.We want it. We need it, we're desperate for it, please, please, please.

Host: Well it is just so inspiring to hear everything you're doing Nicole, thank you so much for sharing. And Dr. Wells, as someone who's began the important work to create more inclusive and equitable healthcare for LGBTQ patients and families, what advice do you have for other doctors, hospitals, and clinics. Another huge question here, but we'll break it into two parts. What could they be doing right now or tomorrow in the short term? And then how about some tips for long-term planning to create those lasting permanent and holistic changes in offices?

Dr. Wells: I mean, really, it's just all the things I've already been talking about. Everything that I listed earlier, it really just starts with one person deciding to make the change and taking the first steps to do that. When I came here to Carle, there really wasn't much social justice stuff going on in the residency program here. So I just passed out rainbow stickers to put on our name badges and passed out pronouns pins.

And that was what started everything. So, you know, my advice for the first thing would be, if you want to do it, just start it and pick something that is easy and needed, whether it's displaying pronouns and buying bulk pronoun pins like I did on Amazon and buying bulk rainbow stickers and cutting them up into small pieces for badges, doing a sit down and educating staff about language use, ordering free education materials from CDC or other organizations to stick up in bathrooms or wherever you can get away with sticking them up. For the longer term planning, you know, the, obviously you're going to do the harder ones, like changing the intake forms or creating inclusive advertising, training providers in LGBTQ care. You know, that that's obviously going to take longer, but there's a lot of CME courses out there, both in-person yes, they're back or virtual and even some free webinars that providers can do that are free. You know, anybody that's interested can, can learn this. I, I'm completely self-taught with my LGBTQ care. You know, it was, it was needed. I had a patient walk into the office that wanted care. I didn't know any specifics. So I went and looked them up and kept looking things up and kept teaching myself, you know, no one taught me how to do any of this. It was a need that I felt. So anybody, anybody can do it.

Host: Well, that's actually a great segue into my next question. It's for Nicole, but in your opinion, what types of resources, training and education do doctors and hospitals and clinics need to create this lasting change and how can community organizations like yours help them out?

Nicole: Well, I just want to say that there's been a huge uptick in healthcare organizations and folks asking us to come and do our cultural competency trainings. And we are thrilled that that's happening. We love doing it. We will happily come and camp out at your facility for a month if we need to get everyone trained. And that's the number one thing, because so far it's been this team here, or this group there, or this particular set of leaders at this one organization. What we'd love is if literally every single person who is involved with health care in our community, could get this training. And I'm just going to reiterate what I said earlier, which is it needs to not just be providers, but the other staff, as well. It is anybody that somebody might touch from the moment they walk in the door to the moment they leave.

All the feedback tells us when we do these trainings, that folks learn a ton, they understand the impact better, and they get useful tools to walk out the door with about how they can make shifts right away. So, we really wish that we could get in front of everybody. And if that was something healthcare organizations would give us the time to do, we'd be there in a heartbeat.

Also, it's not something you just do one and done as new folks get hired, of course they need this training, but you know, just like with medical science, best practices grow and change, data grows and changes, you know? And so we need to keep coming back and touching on these every so often. I'm so thrilled to see the way that providers are always going back for continuing education, but they're not necessarily doing it around LGBTQ care.

So, you know, we'd love to have that looped into what we're doing. And we'd also like to see some deeper training that goes on because sometimes we're invited in for a very short period of time. And there's only so much you can get into on that. If we're invited in for a longer period of time, we can do some training on interventions and what we call gentle corrections for when folks make mistakes, right.

Or when affirming care isn't being delivered, how do you address that? How do you fix it and change it and make sure that everybody's on board in the same way to be delivering the same kind of care. So more time is important too. And then a dream goal for us, which is a bit of a longer term, maybe a larger issue.

We've heard some medical students that they get one hour of training on LGBTQ care, not one hour a month, not one hour a semester, not one hour a year. One hour total in all of their training. Now, obviously we don't think that's enough. And the evidence shows it's not enough because the care is not being delivered when they get out into the world.

And there are health outcome disparities. Right. So we would love it if we could shift it, such that we put ourselves out of business, right. We train people in school, such that we have to do far less training once they're out there in the world. I don't see this. People who disagree with increasing the amount of time spent on training around LGBTQ care, often cite low percentage of population.

So polls vary, but generally there's a five to 7% ish range for adults who identify as LGBTQ in this country. However, when you start breaking it down by generation, it gets real interesting, real fast, because about 20% of millenials are identifying as LGBTQ+. And now there's the new polls coming out around gen Z. They're staying at somewhere between 30 and 40% of gen Z are identifying as LGBTQ+. Obviously there are not more queer people in the world. People are feeling safe to identify as queer, younger generations are feeling safer than older generations to do that but I really hope that shifts the conversation because when you're talking about the right amount of time to allot to 5% of the population, that's a very different conversation than if you're talking about allotting time to 40% of the population.

So I sincerely hope we can shift the mindset around the kind of time that's needed to get us to a place of affirming care for all patients.

Host: Beautiful, Nicole, thank you so much for that. I'll turn to Dr. Wells now. So far, we've mostly talked about, you know, the importance of creating equitable and inclusive healthcare for patients and their families. But another key change is the hiring of more doctors and nurses and staff who identify as queer, LGBTQ+, you know, we talked about earlier, your resident who moved to Champagne is now a drag queen. I love that. Can you let our listeners know just again, why it's so important that hospitals and clinics hire individuals who identify as LGBTQ+, and also on that topic since you're the Program Director of the Carle Family Medicine Residency Program, why is it key to make college, med school and grad school more welcoming, safe, and inclusive for LGBTQ+ individuals?

Dr. Wells: I hate that these even have to be questioned. So someone's sexuality, ethnicity, or any other personal traits should not matter when it comes to the care they provide or the job they perform or whether they're going to get a job or not. Right. But with what is going on in Texas right now with some of these laws that are being passed and Texas trying to make it legal to discriminate, we have to talk about these things. A couple of key points is, you know, like I talked about earlier, it's very important for everyone to have representation.

It's vital to have a physician work force that reflects the population it serves. We know that those from marginalized communities might feel more comfortable with a care provider with a similar background. We know people in the LGBT community have higher rates of health disparities in part, because of seeking health care less often due to prior biases and discrimination they faced when seeking medical care or fear of, of that same bias or discrimination or because of actual denial of healthcare services. Many patients are fearful or have levels of distrust about disclosing sexual orientation or gender identity or otherwise advocating for their own health journeys to their providers because of their prior experiences. But we also know when a provider shows knowledge and sensitivity about LGBTQ community and concerns; patients are more likely to establish effective therapeutic relationships. There's a lot of reasons it's important to hire more physicians that are LGBTQ+. As for the students and residents, they deserve to see someone like themselves in leadership positions to serve as a mentor and role model. Like my resident that I was talking about earlier. An interesting thing is that the Association of American Medical Colleges, the AAMC started collecting data on sexual orientation in 2017, which is fantastic. It's way late, but it's fantastic. And where we are actually seeing the numbers of graduating medical students identifying as part of the LGBTQ+ community rising, which goes along with what Nicole was just saying. But overall, we don't know how many LGBTQ+ physicians there are. We don't know where they practice and we don't know what specialties they're in. Because so far the WMC is the only one collecting any data. So about being welcoming, inclusive, and safe, really, no one should ever go anywhere and not feel welcome or safe. Right. I mean, does anyone ever say, I want to not feel safe right now, right? I mean, this whole movement would never have happened if people felt safe and included to begin with.

So I'll talk about some of the things that we've specifically done in our residency since I came. I mentioned a few earlier, but I really tried to create an inclusive and welcoming environment for our staff, our residents, the physicians, our patients. Like I said, I walked around with rainbow stickers for anybody that wanted to put them on their badges. I walked around with pronoun pins that everybody could pick from. I've done quite a few LGBTQ+ patient care education sessions for the residents. I am the first person here to provide gender affirming care. I really stress wellness and mental health for ourselves, especially for the residents, make my residents use their vacation time.

When I found out that some of them don't use all their vacation time, I scolded them and told them I expected them to use their vacation time. And if they didn't use one or two days fine, but if they rolled over like a week, well, they can't roll over. If they didn't use like a week or something, I was, I was not happy. And then we also created a diversity equity inclusion and anti-racism committee for graduate medical education that's outside of the overall committee so that the residents and faculty have their own committee to work on issues that relate specifically to resident training.

Host: Oh my gosh. You two are just doing so much. It's incredible to hear. Thank you so much for sharing Dr. Wells and Nicole, of course, I'll open to you. Anything else you'd like to add on this topic?

Nicole: Yeah. So, I would say, look, I'm not, I'm not young. I'm 46. I very much remember the first time when a doctor was asking me about my sexual activity and added the question with men, women, or both. I'll remember his face. I'll remember what ha what the room looked like. It was a, I don't have words for the way in which it was life-changing to suddenly have a moment where I knew I wasn't going to have to have an awkward conversation with a doctor. And I wasn't sure whether I was safe to have that awkward conversation with a doctor.

And this was a doctor who had, you know, photos in his office with his husband, you know, and I can't speak enough to how much it matters to have this kind of representation and then to feel it in the way the care is being delivered to someone. Now, obviously that question needs to be updated because we know gender isn't a binary.

And just asking men, women, or both, you could get the answer, no, because someone's partner could be non-binary. So we need to update that question. When it happened 20 or so years ago to me, for the first time in my life, it was huge progress and it changed the way I interacted with healthcare. But I'd also just like to say that in relation to trying to make this kind of progress, I want to make sure we don't skip over the idea that we need people in positions of power to advocate on behalf of our LGBTQ community.

We can't just put it all on the shoulders of LGBTQ folks who work in healthcare. We need folks who want to be allies, because let's be honest. There are biases that may mean that LGBTQ voices aren't listened to in the same way. Minority voices need majority voices in the conversation. We need people with power to not just be allies but be accomplices. To utilize a phrase from an incredible civil rights leader, we need you all to make good trouble on our behalf because you will inevitably suffer far fewer consequences for that trouble due to your position of power. So yes, we need representation and yes, we need allies, but I want those allies to think about how they can be advocates or even accomplices in the work that needs to get done, because that's the only way we're really going to get there.

Host: Well, thank you. Y'all are so passionate. It is so wonderful to hear the work you're doing and the work you continue to do. And just thank you so much from. I moved, as just the host here. But my final question, and I'd love to hear both of your thoughts in your opinion what would a perfectly fair, equitable and inclusive future look like in terms of health care for LGBTQ+ individuals and their families?

Dr. Wells, we'll start with you.

Dr. Wells: I mean, I just really think it would look no different than it does for everyone else. You know, LGBTQ+ individuals would have the same respect from everyone. You know, be seen as equals instead of as other, same legal benefits, same health insurance benefits, same tax benefits, just same everything. And you know, like Nicole was talking about earlier, feel affirmed from the moment they get out of their car and not have any fear when they go to their healthcare provider that they're not going to be accepted.

Host: Thank you, Dr. Wells and Nicole, same question to you.

Nicole: Yeah, bottom line is outcome disparities, right? We, we can't necessarily know exactly all the little things that go into why, but we absolutely can measure outcomes and our community's outcomes are not good. And so whatever it takes to get those outcomes up to other people who get health care, I mean, you know, whether that's changing the behavior, whether that's changing and challenging insurance, whether that's challenging state law and legalities, or whether that's education, you know, I mean, there's a whole host of areas in which we have to do work to get there.

But I think we all know this isn't the kind of thing you can slap a bandaid on. It's not something you're going to be able to get done in one training or, you know, by putting a rainbow sticker on it. As much as we love our rainbow stickers and believe me do but this is deep dive work and it's going to be years and it's going to be long-term.

And I just say, you know, we are incredibly grateful for doctors like Dr. Wells and, and for other folks that we've worked with who are really, truly committed to what it takes to change the outcome disparities.

Host: Well, like I said, you both have truly been such wonderful guests with such important and inspiring messages. Thank you so much for joining us today. And for all you do every day at Uniting Pride of Champagne County and Carle Foundation Hospital, you help so many individuals and families throughout our communities. That concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and wellbeing.

And remember Hally Health is your partner in helping you live your healthiest life. Visit hally.com. That's H A L L Y.com for resources, information, tips, and much more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in again.