Transcription:
Supporting LGBTQIA+ Community on National Coming Out Day

Melanie Cole (Host):  Today's episode of Kids Health Cast for National Coming Out Day comes from our Back to Health series. Back to Health features conversations about trending health topics, and medical breakthroughs from our team of world-renowned physicians at Weill Cornell Medicine. I am Melanie Cole and this conversation features Constance Zhou, Candidate and Co-Executive Director of the Wellness Clinic. We discuss the recent impacts from the pandemic on the LGBTQ community and how friends & loved ones can continue to be supportive allies. Connie, I’m so glad to have you with us today. Such an important topic. Tell us a little bit about yourself and the Wellness Clinic At Weill Cornell Medicine. How did that come about?

Constance Zhou, MD-PhD Candidate (Guest):  So, I am 4^th year MD-PhD student at Weill Cornell Medicine currently working on my PhD at Rockefeller University. And I am one of the Co-Executive Directors of the Wellness Clinic. The Wellness Clinic came about in the summer of 2017 as initiative between a board of eight medical students and after laying the groundwork for 18 months we finally were able to open our clinic doors last year in March and we’ve been doing our best to offer culturally competent patient care ever since.

Host:  That’s amazing. So, tell us about the importance of World Pride Day and the March for the LGBTQ+ Community. We’ve seen virtual Pride celebrations in other boroughs but how difficult is this year as the community is unable to celebrate and express themselves as publicly as they normally do this time of year and why is it so important Connie, to come together as a community and support each other at this time?

Connie:  Well I think that the World Pride Day and the Pride March are incredibly important for the community. For me, personally, growing up in a conservative family, there was always this narrative of why do these people have to be so flamboyant, why do they have to be so loud and in your face. But for a lot of us, we don’t live our lives feeling celebrated. And I remember the first time I walked the street in new York during Pride Month and feeling so overwhelmed with visual reminders that who I was, was okay. I once had a mentor who said that for queer and trans people, self-care and joy are radical. I remember just having that environment of seeing all these flags and seeing all these signs and even being in the parade and seeing people cheering, you know families, parents. I think that was really, really important for me.

In terms of this year with COVID-19, there are a lot of virtual Pride Events and you’re right that they are not as public as they otherwise would be. However, I don’t really see the virtual Pride events as being a bad thing. I think that in person Pride events historically have not been very accessible to people who are disabled, and I think that hopefully this year sets a precedent for a range of more inclusive Pride events in the future.

Host:  I couldn’t agree more, and they can actually be global in a way now that they couldn’t and reach other countries and as you say, people with disabilities or people who couldn’t attend those rallies. So, how can one provide encouragement? If they know someone who is having a difficult time with not being able to celebrate as they normally would or really at all; how important is it for this community to have access to good mental health services?

Connie:  Well I think that the primary way to provide support in terms of family members and friends is to let them know that you are there for them and I think that that goes not just for Pride Month but just year round. I think that this community, the LGBTQ community does have a complicated history with medical professionals and there are a lot of reasons why LGBTQ patients are often mistrustful of the medical profession. This definitely goes back as far as historical pathologizing of LGBTQ identities, but it is still perpetuated today by microaggressions such as misgendering patients, making assumptions about their identities and their behaviors as well as just meeting and interacting with physicians who seem uncomfortable working with queer and trans patients. Which I understand because our medical school curriculums have not historically prepared us to do this.

Host:  That’s so interesting and we do see the tide turning quite a bit. So, the community is sometimes hesitant. You just briefly touched on that, to receive care and medical services, to visit physicians. Tell us a little bit more about the Wellness Clinic as a resource and how it can help. What services do you offer?

Connie:  So, the concept behind the Wellness Clinic is that in order to provide a safe and accessible space for LGBTQ patients, we need a clinic that is intentionally geared towards addressing these gaps in our knowledge. LGBTQ patients experience disproportionately high rates of mental health disorders but have limited access to culturally competent care as I have mentioned. It’s not to mention financial hurdles such as insurance. So, the types of services that we provide, we provide free mental health care. We do initial screenings as well as medication management, individual therapy and group therapy which is exclusively student led. All of our volunteers go through a specialized 8-week training that we designed that they attend concurrent with their medical school education. And that covers culturally competent practices, trauma informed care, health disparities in LGBTQ communities, the biopsychosocial model as well as transgender health and psychiatry interview basics.

So, the hope is that this curriculum combined with the clinical experience that our volunteers will gain informs them in their careers going forward whether or not they decide to do psychiatry. It is also important to note that health screenings and preventative care are very important for the LGBTQ community. I think that we do live in an age where there are a lot more resources than there used to be, such as PREP and postexposure prophylaxis. And we do have a lot of physicians who are dedicated to providing good services to people who are LGBTQ. And despite the historical mistrust of the medical profession, I think that by changing the culture of medicine as a whole and kind of changing our reputation in the community; that’s a great way to reengage folks with preventative services.

Host:  How proud you must be of what you’ve helped to create. Tell us about the continuity of care from the Wellness Clinic. Who are some of the other partners that work with the clinic?

Connie:  We are very fortunate to be situated in New York, a place where there are a lot of additional resources. In terms of the continuity of care, we do try to provide internal continuity of care. So, when a patient first comes to the Wellness Clinic, we will conduct an interview over the phone initially to see if they are a good fit and then from there, we will do an in person intake but once we find patients a medical student and a provider, we do our best to make sure that they have the same providers throughout their course of treatment with us. And the reason for this is because for a lot of our patients who have traumatic or complicated stories, the stress of repeating their narrative over and over to new providers is something that is kind of intrinsic to a lot of these free clinic models but something that we want to minimize.

And actually, that is a great rule for medical students to play in the care team with the fluctuating schedules of doctors and residents who would be part of the care team. The medical students always stay with this one patient. However, because we are a free, volunteer led clinic, we do only offer short term therapy and so we will eventually refer outwards to either the long term treatment programs within Weill Cornell or centers such as the LGBT Center, Columbia also has a student run clinic that covers more primary care and STI needs that we partner with as well as multiple other institutions.

Host:  Well thank you for that. So, can we jump back for just a minute to the mental health component. We briefly touched on Connie, and it’s so interesting to me that the community shares similarities right now with the Black Lives Matter movement and rallying together. Why is rallying together so important?

Connie:  I think that rallying together is extremely important. The first Pride started as a riot with Stonewall. And I think it’s a powerful reminder of the battles that every community has fought against police brutality, nonetheless. The first punch and the first brick at Stonewall were thrown by a black transwoman and a black butch lesbian drag king which is something that is little known. And I think that that Gay Pride Movement has kind of advanced very quickly in the past few decades and we’ve had a lot of victories however, we need to rally for intersectional social change and stand in solidarity with movements such as Black Lives Matter. I don’t really believe that you can have queer liberation without having black liberation and having true equality for people of color and within the Black Lives Matter Movement which is centered disproportionate violence against people of color; there is something to be said about the fact that trans people of color are often the most disproportionately affected and these cases are often the least publicized. Black trans women in particular, are very at risk. They don’t have access to a lot of basic services and at the same time, do experience disproportionate violence, sexual assault and also police violence.

So, I think that it’s sad that we won’t get our one allotted month of celebration and as a queer person, that is something that I will miss this year. But I think that actually this is a great time to take a step back from kind of the parade and the celebration to really reflect and refocus on the fights that we have left to fight.

Host:  Connie, this is such an important topic. Before we wrap up, do you have any resources for those within the community to deal with every day stressors? Please give us your final thoughts on how the emotional triggers that Pride Month and COVID and everything going on, all converge to make this a very stressful time for the people in the LGBTQ+ Community and for those that love and support them and how tough this can be at this time? What words of advice can you give us?

Connie:  Well in terms of resources for the community which I can touch on first. There are especially in New York, a couple of institutions that are very excellent that offer a variety of services and also a lot of them are sliding scale or accept patients who don’t have insurance such as and the LGBT Center, Gay Men’s Health Crisis. In terms of resources in a crisis, the Trevor Project has a lot of resources as well as an LGBTQ Crisis Hotline and there’s also a new trans lifeline which a suicide hotline specifically for trans folks.

In terms of family GOSEN, GLLADD, PFLAG. These are all really great resources for both community members and their families and loved ones to really learn more about the issues in our community as well as the best ways to be supportive.

Host:  It’s so important and how lovely you are. Thank you so much Connie for coming on with us today and giving us some great resources and telling us about the Wellness Clinic at Weill Cornell Medicine. Thank you again. And Weill Cornell Medicine continues to see our patients in person as well as through video visits and you can be confident of the safety of your appointments at Weill Cornell Medicine. Thank you for listening to today's special episode of Kids Health Cast that comes from our Back to Health series.  We'd like to invite our audience to download, subscribe, rate, and review Back to Health and Kids Health Cast on Apple podcast, Spotify and Google Podcast. For more health tips, go to WeillCornell.org and search podcasts. I am Melanie Cole

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