LGBTQ people face lack of health care in Routt County
STEAMBOAT SPRINGS — This week marks the nationwide LGBTQ Health Awareness Week, highlighting an effort to ensure that everyone receives the health care they need.
One Colorado, the state’s leading advocacy group for lesbian, gay, bisexual, transgender and queer citizens, has been one of the largest promoters of the week.
The group’s leaders say that while the state has made progress in LGBTQ health care in recent years, challenges remain. That is especially true in more rural areas like Routt County, where people from the LGBTQ community face obstacles in finding quality care and treatment options.
Daniel Ramos, executive director for One Colorado, said the Affordable Care Act of 2010 was a big step in reducing discrimination against this community. It explicitly protects LGBTQ people against discrimination in health care on the basis of gender identity and sex stereotypes.
Still, some health centers in Routt County lack more specialized treatments that such people often require to lead healthy, happy lives.
“Rural folks have to travel much further to find healthcare providers that meets their needs,” Ramos said.
Lack of treatments
For example, transgender people seeking hormone therapies to transition genders need to travel all the way to Denver to see a specialist and begin their treatments.
B Torres, a community liaison and translator for the Steamboat Springs School District, has heard concerns from transgender students, especially at the high school. Many cannot drive themselves to Denver or have otherwise struggled to start on gender transition therapies, which she considers a basic human right.
“The fact that we don’t have that here is sort of mind boggling,” she said. “Anything involving trans health care is terrible here.”
Torres, who identifies as a lesbian, has been pleased with the way her own primary care doctors have treated her in Steamboat. Still, she worries about the lack of resources for people who do not adhere to the gender binary.
“I’m not trans, but if I was, I don’t think I’d able to live here and get the medical care that I would require,” she said.
The LGBTQ community also disproportionately suffers from sexually transmitted infections as compared to heterosexuals, which require additional treatments that can be difficult to find in rural towns.
The Centers for Disease Control and Prevention report that gay and bisexual men accounted for more than two-thirds of all new HIV infections in 2016.
Treatments exist that can stop HIV infections, even after someone has been exposed through sexual contact. It is called post-exposure prophylaxis, often coined the “HIV morning-after pill.” The treatment must be started within 72 hours after exposure to HIV, which necessitates a rapid response among health care providers.
But, most health care centers in Routt County do not offer post-exposure treatment for this type of infection.
Only two centers in town explicitly said they provide the prophylaxis: Northwest Colorado Health and UCHealth Yampa Valley Medical Center’s emergency room.
The latter option, which provides faster care, can cost twice as much as a regular doctor visit. Without insurance, a full course of treatment can cost between $600 and $1,000 at a hospital emergency room. That does not include emergency room expenses, which can add hundreds of dollars to the bill.
Northwest Colorado Health does offer prophylaxis prescriptions and was able to schedule an appointment within 24 hours on Wednesday.
Training for better care
The Rocky Mountain branch of Planned Parenthood, a nonprofit sexual health care provider, has an office in Steamboat. Maia Arthur, the health care manager there, said the center offers a preventative prophylaxis, but that does not protect someone who has already been exposed to HIV.
Arthur recounted trying to help a patient Tuesday who needed a post-exposure prophylaxis. When she called the hospital’s emergency room, she experienced a struggle in getting answers about the treatment.
“It took a minute for us to be on the same page of what was going on,” she said.
Arthur explained it can be daunting for anyone to talk about and seek help for sexually-related concerns.
“When you add the stigma that LGBTQ folks often face, it can be even worse,” she said.
For that reason, all of the staff at Planned Parenthood undergo specialized training on how to address a diverse group of patients. They ask patients their appropriate pronouns, who their sexual partners are — without assuming their gender — and give referrals when they cannot provide an on-site treatment.
For now, a lack of quality and inclusive health care is simply a reality for LGBTQ people, Ramos said. That is why One Colorado will be touring the state this summer, including a stop in Steamboat, to discuss both the progress that has been made and the issues that remain.
Torres acknowledged that Steamboat does not have as robust a community of LGBTQ people as a more urban city, like Denver. Regardless, she believes that everyone, no matter where they live, should have access to the health care they need.
“Just because we are in the middle of nowhere doesn’t mean that the LGBTQ community isn’t here,” she said.
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