COMING UP ON "CYCLE OF HEALTH."

>> TONIGHT'S TOPIC, LGBTQ HEALTHCARE.

MANY OF US ARE FRIENDS AND OUR LOVED ONES ARE PART OF THE LGBTQ COMMUNITY.

ONE OF THE UNIQUE EXPERIENCES THAT WE DO NOT DISCUSS AS OFTEN IS THE COMMUNITY'S EXPERIENCE WITH HEALTHCARE.

TONIGHT WE ARE JOINED BY FOUR PANELISTS WHO CAN HELP US UNDERSTAND THESE ISSUES AND HOW MEDICAL PROVIDERS CAN SUPPORT THE COMMUNITY TO BRIDGE THE GAP.

♪ ♪ >> HELLO AND WELCOME TO CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC: LGBTQ HEALTHCARE.

MANY OF OURSELVES, OUR FRIENDS, AND OUR LOVED ONES ARE A PART OF THE LGBTQ COMMUNITY.

ONE OF THE UNIQUE EXPERIENCES THAT WE MAY NOT DISCUSS AS OFTEN, IS THE COMMUNITY'S EXPERIENCE WITH HEALTHCARE.

THERE ARE BARRIERS TO ACCESS, HEALTH DISPARITIES, SPECIALIZED CARE REQUIREMENTS, AND MORE TO CONSIDER, ESPECIALLY FOR TRANS INDIVIDUALS.

TONIGHT WE'RE JOINED BY 4 PANELISTS WHO CAN HELP US UNDERSTAND THE ISSUES FACED IN LGBTQ HEALTHCARE, AND HOW MEDICAL PROVIDERS CAN SUPPORT THE COMMUNITY TO BRIDGE THE GAP.

LET'S MEET OUR GUESTS: MS. KAREN FULLER, FAMILY PEER ADVOCATE AT THE Q CENTER ACR HEALTH.

MS. KATHLEEN COUGHLIN, DIRECTOR OF HEALTH AT THE BARNES CENTER AT THE ARCH AT SU MS. KIM DILL, EXECUTIVE DIRECTOR AT SAGE UPSTATE AND MS. CARRIE BROWN, DIRECTOR OF COUNSELING AT THE BARNES CENTER AT THE ARCH AT SU THANK YOU ALL FOR BEING HERE.

THAT'S A MOUTHFUL.

THANK YOU ALL FOR BEING HERE.

WELL, LET'S START.

WHAT ARE THE CHALLENGES FACING THE LGBTQ COMMUNITY.

>> SO I WOULD SAY TWO OF THE BIGGEST CHALLENGES THAT FACE THE LGBTQ COMMUNITY WHEN IT COMES TO HEALTHCARE IS, NUMBER ONE, THE LACK OF PROVIDERS THAT ARE AIRM IFING AND UNDERSTANDING-- THAT ARE AFFIRMING AND UNDERSTAND THINGS LIKE GENDER IDENTITY.

ALSO THE AMOUNT OF MISINFORMATION THAT IS OUT THERE.

>> AND FOR THE PEOPLE THAT I SERVE, SAGE UPSTATE SERVES OLDER LGBTQ PEOPLE IN CENTRAL NEW YORK.

I MEAN ISOLATION IS A HUGE PROBLEM.

THESE ARE FOLKS WHO ARE MORE LIKELY TO LIVE ALONE, LESS LIKELY TO HAVE FAMILY OR CHILDREN TO RELY ON FOR SUPPORT.

AND ALSO RELUCTANT, BECAUSE OF WHAT YOU SAID, ABOUT THE PROVIDERS NOT BEING ABLE TO DEAL WITH SPECIFIC ISSUES.

THEY DON'T EVEN KNOW WHO TO TRUST OR WHETHER THEY CAN COME OUT TO THEIR PROVIDER.

SO WE TRY TO PROMOTE-- WE TRY TO OFFER PROGRAMS THAT PROMOTE HEALTH AND ALSO REDUCE ISOLATION AND HELP PEOPLE COME TOGETHER.

>> WHAT KIND OF PROGRAMS DO YOU OFFER AT SAGE UPSTATE?

>> WE OFFER HEALTH AND WELLNESS PROGRAMMING, INCLUDING PREVENTION FITNESS.

WE DO A WALKING GROUP, WE DO PROGRAMS ABOUT HEALTH.

WE ALSO HAVE A NEIGHBORHOOD ADVISER PROGRAM THAT IS FUNDED BY THE COUNTY.

AND IT CONNECTS OLDER LGBTQ PEOPLE WITH RESOURCES THAT CAN HELP THEM, WITH BENEFITS THAT THEY MIGHT BE ENTITLED TO, SO THEY CAN AGE INDEPENDENTLY IN THE COMMUNITY.

>> SO, YOU KNOW, AS YOU SAY THAT , KIM, I'M STRUCK BY THE FACT THAT YOU ARE TALKING ABOUT A NUMBER OF PROGRAMS THAT I'VE HEARD OTHER FOLKS TALK ABOUT FOR THE NON-LGBTQ COMMUNITY.

SO YOU ARE REALLY OFFERING SERVICES THAT ARE TYPICALLY AVAILABLE FOR OTHER PEOPLE, BUT REALLY FOR THE LGBTQ COMMUNITY TO HAVE A SENSE OF TOGETHERNESS.

>> RIGHT.

I MEAN THE SERVICES ARE OUT THERE.

IT'S THE ACCESS THAT IS KIND OF IN THE WAY.

AND SOMETIMES IT'S JUST A PERSON WHO HAS GROWN UP, THROUGH ALL THE ROCHESTER OF THE LGBTQ MOVEMENT, AND JUST TIMES WHEN WE WERE SEEN AS SINNERS AND SICK AND, YOU KNOW, CRIMINALS.

AND SO THEY BRING ALL THAT TO THE SITUATION.

AND THE PROGRAMS ARE OUT THERE BUT THEY'RE NOT REALLY SURE WHO THEY CAN TRUST TO GET THEM.

>> YEAH, YOU KNOW, WHEN I WAS A KID, THERE WAS NO DISCUSSION WHAT SO EVER OF PEOPLE WHO WERE NOT STRAIGHT.

THE ONLY PERSON WHO I KNEW IN MY SORT OF IN MY COMMUNITY, IN MY WORLD, WAS LIBERACI.

REALLY.

HE WAS THE ONLY PERSON THAT PEOPLE TALKED ABOUT.

WELL THIS GUY IS A LITTLE DIFFERENT.

MAYBE HE'S... AND I DON'T THINK PEOPLE EVEN SAID GAY.

BUT HE WAS THIS SORT OF SYMBOL OF A WHOLE SWATH OF HUMANITY THAT WAS DIFFERENT.

AND BACK THEN, TOTALLY UNACCEPTABLE.

>> PEOPLE WERE OLDER TODAY REALLY SAW THOSE PEOPLE AS BEACONS OF LIGHT BECAUSE IT WAS THE ONLY REPRESENTATION THEY SAW OF THEMSELVES.

>> HOW DOES THIS IMPACT S.U.?

TELL BUS YOUR SERVICES?

>> SO THE BARNES CENTER AT THE ARCH AT SYRACUSE UNIVERSITY IS REALLY BUILT AROUND AN INTEGRATED HEALTH AND WELLNESS MODEL SO YOU ARE LOOKING AT THE WHOLE PERSON.

IT'S ESPECIALLY IMPORTANT FOR LGBTQ HEALTH BECAUSE YOU ARE LOOKING AT THE SOCIAL, EMOTIONAL AND THE PHYSICAL ASPECTS OF THE PERSON.

SO FOR SOMEONE FROM THE LGBTQ COMMUNITY, WE ARE TALKING ABOUT MAKING SURE THAT WE ARE AWARE OF WHAT PRONOUNS THEY USE.

SO WE ARE ALSO TALKING TO THEM ABOUT WHAT ARE THEIR SEXUAL INTERACTIONS LIKE AND MAKING SURE THAT WE ARE COVERING THAT.

AND THAT REALLY IMPACTS YOUR SEXUAL HEALTH VISIT AND MAKING SURE YOU ARE TALKING TO SOMEONE WHO IS OPEN AND UNDERSTANDING, LISTENING TO YOU.

THE OTHER PART OF WHAT WE REALLY FOCUS ON WITH THIS POPULATION IS GENDER AFFIRMING CARE THAT YOU MENTIONED.

AND GENDER AFFIRMING CARE IS REALLY ABOUT MAKING SURE THAT WHAT THAT PERSON'S INTERNAL GENDER IDENTITY IS GOING TO HELP BETTER MATCH THEIR EXTERNAL IDENTITY.

SO, THAT MAY MEAN WORKING WITH THEM ON THINGS LIKE HORMONES.

IT MAY MEAN MAKING REFERRALS FOR SURGERY OR MAY BE NOTHING AT ALL THAT THAT PERSON WANTS TO PRESENT SOCIALLY AS A DIFFERENT GENDER.

LIKE YOU MENTIONED GENDER EXPANSIVE.

BUT WE WORK CLOSELY WITH OUR NUTRITION STAFF.

SOMEBODY MAY BE USING HORMONES, THEY HAVE TO LEARN HOW TO FUEL THAT DIFFERENT TYPE OF BODY.

OR WE REFER THEM TO THE PHARMACY WHERE WE HAVE GENDER AFFIRMING CARE LIKE CHEST BINDERS, THINGS THAT LET THE PERSON FULLY EXPERIENCE THE GENDER THEY IDENTIFY WITH.

>> SO MENTAL HEALTH CARE IS PART OF THAT ARRAY OF SERVICES THAT YOU PROVIDE.

AND Dr. CARRIE BROWN IS REPRESENTATIVE OF THAT COMMUNITY.

SO TELL US ABOUT THE MENTAL HEALTH CARE ASPECTS.

>> WAS WE HAVE BUILT AT THE BARNES CENTER IS SOMETHING SPECIAL AND UNIQUE AND I RECOGNIZE IN OUR COMMUNITY FOLKS MIGHT NOT ALWAYS HAVE ACCESS TO THE RESOURCES.

OUR STUDENTS ARE FORTUNATE TO COME TO A SPACE WHERE THEY HAVE ACCESS TO THEIR MENTAL HEALTH, THEIR PHYSICAL HEALTH, THEIR SPIRITUAL WELLNESS, ALL IN ONE SPACE.

AND SO AT THE MENTAL HEALTH LEVEL, WE ARE REALLY LOOKING AT WHAT ARE THE PRIMARY MENTAL HEALTH ISSUES THAT THE COMMUNITY IS FACING.

YOU BOTH MENTIONED ACCESS TO AFFIRMING PROVIDERS.

SO TRAINING HAS BEEN VERY IMPORTANT FOR US IN TERMS OF PROVIDING TRAINING ON OUR SAFER SPACES, SAFER PEOPLE TRAINING, PRONOUN PROFICIENCY, AS WELL AS HAVING FOLKS WHO ARE SPECIALLY TRAINED WORKING WITH THE COMMUNITY.

WE ALSO DO A LOT OF LISTENING SESSIONS WITH OUR STUDENTS AND WHAT WE CALL SATISFACTION SURVEYS.

SO EVERYONE WHO COMES INTO THE BARNES CENTER GETS AN OPPORTUNITY TO GIVE US FEEDBACK ON HOW AFFIRMING OUR SPACES ARE, WHAT ARE THEIR EXPERIENCES LIKE AND THEN WE GO BACK TO THEM AND BE ABLE TO SAY THESE ARE THE THINGS THAT WE'VE CHANGED BASED ON YOUR FEEDBACK.

>> SO IF I MAY INTERRUPT FOR A MOMENT.

SO FOR THE PROVIDERS OUT WATCHING OUR SHOW OR JUST PEOPLE IN GENERAL, HOW DO YOU CREATE A GENDER AFFIRMING ENVIRONMENT?

AN LGBTQ WELCOMING ENVIRONMENT?

WHAT DO YOU SAY TO PEOPLE?

HOW DO YOU DO THAT?

>> I THINK FIRST, GET SOME KIND OF TRAINING.

SAGE UPSTATE DOES TRAINING JUST AS WELL AS THE Q CENTER AT ACR HEALTH DOES TRAININGS FOR BUSINESSES AND AGENCIES AND MEDICAL PROVIDERS, MENTAL HEALTH PROVIDERS.

>> IN YOUR TRAINING, WHAT DO YOU TEACH PEOPLE?

>> WE GO OVER TERMINOLOGY, BEST PRACTICES, SHARE A LITTLE BIT ABOUT THE STATISTICS.

>> A TONGUE TWISTER THERE.

>> AND, YOU KNOW, BASICALLY, YOU KNOW, HOW TO AFFIRM PEOPLE FROM THE LGBTQ COMMUNITY.

>> SO GO.

>> AND I THINK ALSO ALONG WITH THOSE THINGS, LIKE HAVING VISIBLE SYMBOLS, HAVING POLICIES, USING INCLUSIVE LANGUAGE.

I THINK IT'S A CHANCE FOR PROVIDERS TO OPEN THEIR MINDS AND GET RID OF THEIR EXPECTATIONS.

EVERYBODY WHO SERVES OLDER ADULTS, IS WHAT I USUALLY SAY BECAUSE THAT'S WHAT WE SERVE, THEY'RE DEALING WITH OLDER LGBTQ ADULTS.

EVERYBODY WHO HAS SERVICES IS DEALING WITH LGBTQ ADULTS.

>> THEY MAY NOT KNOW IT.

>> WE MAY NOT LOOK LIKE YOU EXPECT US TO.

WE MAY HAVE BEEN MARRIED AND HAVE CHILDREN.

YOU KNOW, WE MAY BE EXACTLY WHAT YOU EXPECTED IN TERMS OF GENDER EXPRESSION.

WE MAY BE THE OPPOSITE.

AND REALLY HELPING PEOPLE BECOME MORE OPEN AND AFFIRMING AND USING THESE SYMBOLS AND LETTING PEOPLE KNOW THEY'RE A SAFE PERSON, THAT LETS THE PERSON COME OUT AND A BETTER CONNECTION IS BUILT.

>> SO WHEN YOU SAY GENDER EXPRESSION, WHAT EXACTLY DOES THAT MEAN?

>> THIS IS SOMETHING THAT WE TALK ABOUT IN THE BEGINNING OF OUR TRAININGS.

>> OH GOOD.

SO TRAIN ME RIGHT NOW.

>> GENDER AND PROBABLY A LOT OF YOU COULD ELABORATE ON WHAT I'M ABOUT TO SAY, BUT GENDER EXPRESSION OR GENDER IDENTITY AND SEXUAL ORIENTATION, LGBTQ IS MADE UP OF BOTH.

SEXUAL ORIENTATION IS WHO YOU ARE ATTRACTED TO, WHO YOU LOVE, WHO YOU BUILD RELATIONSHIPS WITH.

>> SEXUAL ORIENTATION.

OKAY.

>> GENDER IDENTITY IS ABOUT WHO YOU ARE INSIDE, WHO YOU FEEL, HOW YOU WANT TO PRESENT YOUR OWN GENDER, WHAT YOU FEEL LIKE REGARDLESS WHAT YOUR BODY LOOKS LIKE.

AND SO KIND OF TAKING THOSE APART IS ONE OF THE FIRST THINGS WE DO.

>> SO YOUR GENDER IDENTITY MAY BE MALE BUT YOU HAVE A FEMALE BODY.

>> CORRECT.

>> AND THEN YOU MIGHT EXPRESS YOUR GENDER IDENTITY IN A WAY THAT IS EITHER CONSISTENT WITH YOUR BODY OR DIFFERENT THAN WHAT YOUR BODY LOOKS LIKE.

>> EXACTLY.

YEAH.

>> ANYBODY WANT TO ADD ANYTHING TO THAT?

>> I THINK WHAT YOU MENTIONED ABOUT VISIBILTY IN THE SPACE, LIKE DO I SEE THINGS THAT INDICATE TO ME THAT THIS IS A WELCOMING SPACE, A SAFER SPACE.

>> WHAT KIND OF THINGS WOULD YOU SEE?

GO INTO A DOCTOR'S OFFICE, SAY, OR INTO A SHOP OR WHATEVER, WHAT KINDS OF THINGS WOULD YOU BE LOOKING FOR THAT WOULD BE WELCOMING?

>> DO YOU HAVE ARTWORK THAT REPRESENTS, DO YOU HAVE MAGAZINES?

SO WE MAKE SURE WE HAVE MAGAZINES IN OUR WAITING AREAS THAT REPRESENT THE LGBTQ COMMUNITY.

>> BATHROOMS.

>> ARE YOUR BATHROOMS GENDER INCLUSIVE.

DO YOU HAVE YOUR PRONOUNS ON YOUR NAME TAG.

WHEN I MEET WITH A PATIENT, MY PRONOUNS ARE ON MY DOOR.

DO YOU ALLOW OPPORTUNITIES TO UPDATE THEIR PRONOUNS IN THEIR ELECTRIC HEALTH RECORD.

ALL OF THESE THINGS INDICATE-- AND THE LIST CAN GO ON.

>> THOSE INDICATE AN AWARENESS OF THE ISSUES THIS MAY BE A SAFER SPACE.

>> AND ALSO SOME OF THOSE THINGS LIKE POLICIES, BATHROOMS, EVERYBODY NEEDS TO KNOW ABOUT THEM AND IT WOULD BE GREAT IF PEOPLE DIDN'T HAVE TO ASK WHERE THE BATHROOM IS OR WHERE, YOU KNOW, A PLACE FOR THEM IS IN THE INSTITUTION.

>> YOU LOOK LIKE YOU ARE ABOUT TO ADD SOMETHING.

>> WHEN YOU DON'T HAVE THOSE TYPES OF SUPPORTIVE MARKERS, I THINK THAT'S WHERE YOU GET INTO A LOT MORE OF THE MENTAL HEALTH CONCERNS THAT ARE REALLY SO WORRISOME IN THIS POPULATION.

>> YEAH, I WOULD AGREE WITH THAT, KATHLEEN.

I THINK FOR FOLKS-- AND YOU MENTIONED THIS, ABOUT LONELINESS AND ISOLATION.

AND I THINK WHAT WE ARE SEEING IN THE MENTAL HEALTH WORLD-- NOW GRANTED AT S.U.

WE WORK WITH COLLEGE STUDENTS, BUT I THINK COLLEGE STUDENTS ARE DEFINITELY A MICROCOSM OF OUR GREATER COMMUNITY AND THESE ARE GOING TO BE OUR ADULTS AND THEORY MERGING INTO THEIR LIVES AND SO WHAT WE ARE REALLY SEEING OF THESE FOLKS IS JUST GREATER AMOUNTS OF DISTRESS ACROSS THE BOARD WITH MENTAL HEALTH.

AND ACTUALLY THE AMERICAN COLLEGE HEALTH ASSOCIATION RELEASED ITS 2022 DATA RECENTLY AND IN THAT DATA, IT WAS THE FIRST TIME THAT THEY SEPARATED THEIR DATA POINTS BY GENDER IDENTITY.

SO THEY SEPARATED OUT TO BE CISGENDER WOMEN, CISGENDER MEN.

>> DEFINE CIS FOR US.

WHAT DOES THAT MEAN?

>> SURE, WHEN AN INDIVIDUAL IDENTIFIES AS CISGENDER, THAT MEANS THEIR GENDER EXPRESSION MATCHES THE GENDER YOU WOULD EXPECT FOR THE BIOLOGICAL SEX THAT THEY WERE ASSIGNED AT BIRTH.

>> SO YOU ARE BORN ON YOUR BIRTH CERTIFICATE, IT SAYS MALE AND THEN CISGENDER FOLKS LOOK LIKE THE STEREOTYPICAL MALE PERSON LOOKS.

>> CORRECT.

THEIR GENDER EXPRESSION WOULD LOOK LIKE WHAT WE WOULD EXPECT IN OUR MIND FOR THAT.

AND SO THEY SEPARATED THE DATA, CISGENDER WOMEN, CISGENDER MEN AND THEN TRANS AND GENDER EXPRESSIVE FOLKS AND WHAT THEY WERE ABLE TO SEE ACROSS MANY DATA POINTS IS THAT OUR TRANS AND GENDER EXPRESSIVE COLLEGE STUDENTS HAVE GREATER LEVELS OF DISTRESS.

ONE THING I THOUGHT WAS SHOCKING AND JUMPED RIGHT OFF THE PAGE TO ME WAS SUICIDALITY AND SELF HARM AND WHAT WE SAW FOR THE INDIVIDUALS FOR OUR TRANS AND GENDER EXPRESSIVE FOLKS, IT WAS 62% OF THE POPULATION THEY SURVEYED, WHEREAS-- >> SO LET ME JUST-- 62% OF THE TRANS AND GENDER EXPANSIVE-- AND MAYBE WE'LL DEFINE THAT IN A MOMENT.

THEY HAVE SOME KIND OF SUICIDAL IDEATION.

>> OF THE PEOPLE THEY SURVEYED.

AND THESE ARE ONLY COLLEGE STUDENTS AS WELL.

>> THAT'S AMAZING.

62%.

I INTERRUPTED YOU.

>> AND THE FOLKS THAT THEY SURVEYED, WHICH ARE ALSO COLLEGE STUDENTS FOR CIS WOMEN, IT WAS ABOUT 22% AND FOR SIS MEN, IT WAS 26%.

>> WHAT A DIFFERENCE.

SAD THAT THERE IS 22 AND 26, BUT TRAGIC THAT 62%.

>> I THINK PIGGY BACKING ON WHAT YOU SHARED, KATHLEEN, IT'S NOT THE PERSON'S IDENTITY THAT IS CAUSING THEM TO HAVE SUICIDAL IDEATION.

IT'S WHAT THEY'RE LIVING IN.

THE MARGINALIZATION THAT THEY'RE EXPERIENCING, THE SOCIAL ISOLATION, THE LACK OF PROVIDERS AND HEALTHCARE, ALL THE DIFFERENT THINGS THAT YOU ALL MENTIONED, THAT TAKES A TOLL AND THEN IF WE THINK ABOUT SOME OF THE THINGS THAT ARE HAPPENING IN OUR POLITICAL LANDSCAPE RIGHT NOW WITH DIFFERENT LAWS AND DIFFERENT ANTI-TRANS LAWS THAT ARE COMING OUT... >> ANTIGAY.

THE WHOLE COMMUNITY.

>> IT DEFINITELY IMPACTS MENTAL HEALTH AND SO I THINK THAT THAT IS SO IMPORTANT TO THINK ABOUT AND WHAT WE ARE TALKING ABOUT TODAY, WHEN I THINK ABOUT GENDER AFFIRMING CARE, WHEN I THIS I ABOUT LGBTQ AFFIRMING CARE, TO ME, THAT'S SUICIDE PREVENTION.

>> SO YOU ARE TRYING TO CREATE A COMMUNITY, A VISIBLE COMMUNITY THAT SAYS TO PEOPLE, YOU ARE OKAY.

YOU FIT IN.

YOU DON'T HAVE TO KILL YOURSELF BECAUSE YOU FIT IN.

YOU ARE JUST ONE OF US.

>> I THINK THAT'S ONE OF THE MAIN GOALS THAT THE Q CENTER AT ACR HEALTH HAS, RIGHT?

WE SERVE YOUTH AGES 5-29.

AND A LOT OF THAT IS GIVING THEM AN OPPORTUNITY TO BUILD COMMUNITY, TO BE AROUND OTHERS THAT ACCEPT THEM AND UNDERSTAND THEM FOR WHO THEY ARE.

SO THAT'S A HUGE, YOU KNOW, IT HAS A HUGE IMPACT ON THEIR MENTAL HEALTH TO KNOW THAT THEY'RE NOT ALONE.

AND THE SAME THING GOES FOR PARENTS AND CAREGIVERS OF LGBTQ YOUTH.

AS A FAMILY PEER ADVOCATE AT THE Q CENTER, THAT IS MY JOB.

I WORK WITH PARENTS AND CAREGIVERS OF LGBTQ YOUTH WITH A SPECIFIC FOCUS ON TRANS AND GENDER EXPANSIVE YOUTH.

IT CAN BE SCARY FOR A PARENT, ESPECIALLY TAKING INTO CONSIDERATION THAT SUICIDE RATE OR WHAT IS GOING ON POLITICALLY RIGHT NOW WHEN THEIR CHILD COMES OUT.

IT CAN BE VERY ISOLATING FOR THE PARENT OR CAREGIVER AS WELL.

SO I PROVIDE SUPPORT IN MANY DIFFERENT WAYS.

WHETHER IT'S LINKING THEM TO APPROPRIATE CARE PROVIDERS, WHETHER IT'S ANSWERING QUESTIONS THEY HAVE OR ADDRESSING CONCERNS THAT THEY HAVE OR, YOU KNOW, FAIMENT FACILITATING SUPPORT GROUPS FOR THEM.

BUT OVERALL, THAT'S OUR AIM AT THE Q CENTER IS TO GIVE A SPACE WHERE PEOPLE CAN BE AFFIRMED AND FIND THAT COMMUNITY.

>> I RECENTLY...

I'M SORRY, GO.

>> ON THE OTHER END OF THE AGE SPECTRUM, THAT'S WHAT WE DO.

WE PROVIDE SPACE WHERE PEOPLE CAN BE WHO THEY ARE AND FOR MANY OF OUR FOLKS, THEY WEREN'T ABLE TO DO THAT IN THEIR JOBS OR ALL THROUGH THEIR LIVES.

AND THE MESSAGE THEY GOT ABOUT GENDER WAS, YOU KNOW, YOU ARE THIS WAY OR SEXUAL ORIENTATION.

YOU ARE THIS WAY AND THERE IS NO OTHER CHOICE.

SO, YEAH, NOW WE ARE ON THE OTHER END OF IT.

AFTER WE'VE LIVED A LIFE OF OR DEALING WITH THIS STUFF, HELPING PEOPLE COME TOGETHER AND CREATE SUPPORT NETWORKS TO HELP ONE ANOTHER.

>> I RECENTLY HEARD A STORY ABOUT A YOUNG-- SOMEBODY'S SON, I BELIEVE, WHO CAME OUT TO HIS FAMILY AS A TEENAGER AND IMMEDIATELY GOT KICKED OUT OF THE FAMILY.

LITERALLY PHYSICALLY REMOVED FROM-- HOW OFTEN DOES THAT HAPPEN?

IS THAT A FREQUENT EVENT?

>> I WOULD SAY IT HAPPENS A LOT MORE THAN PEOPLE WOULD THINK.

THAT IS ANOTHER WAY THAT THE Q CENTER AT ACR HEALTH HELPS.

WE HAVE A PROGRAM, A RAPID REHOUSING PROGRAM SPECIFICALLY FOR YOUTH AGES 18-25, YOU KNOW, FOR LGBTQ YOUTH THAT HAVE BEEN KICKED OUT OF THEIR HOMES, THAT ARE COMING FROM SHELTER, WE ARE ABLE TO HELP FIND THEM HOUSING AND HELP SUBSIDIZE THE RENT AND IN A WAY, ALMOST TAKE OVER THAT PARENTING PIECE, RIGHT?

WHERE WE, YOU KNOW, PROVIDE LESSONS ON THE LIFE SKILLS THAT THEY'RE MISSING OUT.

YOU KNOW, HELP THEM FIND JOBS.

HELP THEM RETURN TO SCHOOL IF THEY, YOU KNOW, HAVEN'T BEEN AT SCHOOL.

BUT WE DO ALL THOSE THINGS BECAUSE, YEAH, IT HAPPENS MORE OFTEN THAN A LOT OF PEOPLE THINK.

>> WE ARE SEEING MORE STUDENTS COMING IN LOOKING FOR GENDER AFFIRMING CARE WHEN THEY GET TO COLLEGE BECAUSE THEY WEREN'T LIVING IN A FAMILY OR IN A COMMUNITY THAT TO WAS GOING TO ACCEPT THAT TRANSITION.

AND SUPPORT THEM FOR WHO THEY ARE AND THAT'S ONE OF THE THINGS THAT, YOU KNOW, WE TRY TO SUPPORT STUDENTS WITH, THEY STILL HAVE TO GO HOME IN THE SUMMER AND HOW DO YOU GO HOME TO A FAMILY OR A COMMUNITY WHERE YOU HAVE TO, I DON'T KNOW, GO BACK INTO THE CLOSET OR PRETEND YOU ARE NOT REALLY WHO YOU ARE.

IT'S SUCH A DELICATE BALANCE FOR PEOPLE THAT I THINK, YOU KNOW, STRAIGHT FOLKS DON'T TAKE INTO ACCOUNT THAT THIS IS JUST-- IT WEIGHS ON THEM AND THIS IS A REAL CHALLENGE.

>> SO NEVER OCCURRED TO ME, BOUGHT SO KIDS WOULD COME TO COLLEGE, AND OF COURSE THEY HAVE FREEDOM TO BE WHO THEY ARE.

AND THEN THEY HAVE TO GO HOME AND GO BACK INTO WHAT THEIR FAMILY EXPECTS THEM TO BE.

>> AND AS MULTIPLE PEOPLE HAVE POINTED OUT, THE POLITICS OF CERTAIN STATES.

YOU MAY BE GOING BACK TO A STATE THAT IS NOT WELCOMING TO FOLKS WHO APPRECIATE YOUR IDENTITY.

>> AND I THINK WE SAW ESPECIALLY DURING THE PANDEMIC, WHEN A LOT OF OUR STUDENTS HAD TO LEAVE.

THEY DIDN'T REALLY HAVE A CHOICE, TO LEAVE AND RETURN.

WE SAW FAMILY DISTRESS GO UP AMONG OUR FOLKS BECAUSE THEN THEY'RE BACK IN THAT ENVIRONMENT AND THEY'RE REALLY NOT HAVING ACCESS TO MAYBE SOME OF THE SERVICES THEY HAD ACCESS TO AT THE UNIVERSITY.

WE BRIDGED CARE AS BEST AS WE CAN WITH TELEHEALTH AND TELEMEDICINE BUT THEY'RE BACK IN THAT ENVIRONMENT THAT KATHLEEN WAS SAYING.

IN THE LAST FEW YEARS WITH THE PANDEMIC IN PARTICULAR, WE HAVE SEEN A LOT OF DISTRESS AROUND HAVING TO RETURN TO THOSE SPACES THAT ARE NOT ALWAYS SUPPORTIVE.

>> I KNOW IT HAS BEEN A SHIFT IN THE COMMUNITY WITH TRANS PEOPLE BEING MORE PUBLIC ABOUT LOOKING DIFFERENT.

THEIR GENDER EXPRESSION.

LIKE I REMEMBER ON WESTCOULD THE STREET NOT TOO LONG AGO, I WAS WALKING DOWN THE STREET AND I SAW A MAN, BIOLOGICAL MAN WITH A BEARD WEARING A SKIRT AND I THOUGHT IT WAS THE FIRST TIME I HAD EVER SEEN THAT IN SYRACUSE.

SO IT WAS LIKE ALL OF A SUDDEN I REALIZED, THERE IS A WHOLE WORLD, THE WORLD IS CHANGING.

ARE THERE SPECIAL ISSUES FOR TRANS PEOPLE COMING TO-- IN THE WORLD?

WHAT ARE THE SPECIAL ISSUES FOR TRANS FOLKS?

>> I THINK WHEN OR DEALING WITH PROVIDERS, LGB PEOPLE WORRY ABOUT CULTURAL COMPETENCIES WHETHER THEY CAN COME OUT AND TALK ABOUT THEIR CIRCLE OF SUPPORT.

BUT FOR TRANS PEOPLE, THOUGH, IT'S OFTEN MEDICAL COMPETENCY THAT THEY'RE LOOKING FOR.

CARE FOR THEIR BODIES.

KNOWING WHETHER SOMEONE NEEDS TO BE SCREENED FOR OVARIAN CANCER, FOR EXAMPLE, BECAUSE YOU NEED TO KNOW ABOUT THE ANATOMY.

YOU CAN'T MAKE ASSUMPTIONS.

SO, YEAH, THAT'S A REALLY BIG DIFFERENCE.

AND REALLY FOR TRANS PEOPLE, EVERYTHING IS HARDER.

IF WE LOOK AT POVERTY, IF WE LOOK AT VIOLENCE, IF WE LOOK AT A NUMBER OF THINGS, SUICIDE RATES OR ATTEMPTED SUICIDE.

IT'S JUST MORE DIFFICULT BECAUSE THOUGH TRANS PEOPLE ARE BECOMING MORE VISIBLE, I THINK PART OF THE BACKLASH COMES WHEN THERE IS MORE VISIBILTY AND THAT'S WHAT WE ARE GOING THROUGH NOW MUCH AND HOPEFULLY WE WILL GET THROUGH IT.

BUT IT'S REALLY SCARY RIGHT NOW.

>> YEAH, WE ARE SEEING THE BACKLASH ACROSS THE COUNTRY IN VARIOUS STATES THAT ARE TRYING TO ENACT LAWS WHERE YOU CAN'T EVEN TALK ABOUT THESE THINGS, WHICH IS JUST ABSOLUTELY AMAZING IN THE UNITED STATES FOR ME, TO THINK, YOU CAN'T EVEN TALK?

WHAT?

>> I WAS JUST GOING TO SAY, I THINK THERE ARE SO MANY CHALLENGES AND THERE ARE SO MANY HOT BUTTON ISSUES RIGHT NOW.

AND I TRY TO TELL MYSELF THAT ONE SILVER LINING IS, YOU KNOW, BEING A MOM OF YOUNGER KIDS, I SEE THAT GENERATION BEING SO MUCH MORE ACCEPTING THAN EVEN PEOPLE IN THEIR 20s.

I MEAN YOU ARE TALKING ABOUT KIDS IN HIGH SCHOOL THAT DON'T BAT AN EYE IF YOU ARE GENDER EXPANSIVE AND IF YOU WEAR DIFFERENT CLOTHES AND THEY BECOME VERY PROTECTIVE OF FOLKS AND THAT HAS MADE ME FEEL SO MUCH BETTER ABOUT THE FUTURE.

>> WHAT A LOVELY NOTE TO END ON.

THAT'S ALL THE TIME WE HAVE, I WANT TO THANK OUR GUESTS... MS. KAREN FULLER, FAMILY PEER ADVOCATE AT THE Q CENTER AT ACR HEALTH.

MS. KATHLEEN COUGHLIN, DIRECTOR OF HEALTH AT THE BARNES CENTER AT THE ARCH AT SU MS. KIM DILL, EXECUTIVE DIRECTOR AT SAGE UPSTATE AND DR. CARRIE BROWN, DIRECTOR OF COUNSELING AT THE BARNES CENTER AT THE ARCH AT SU IF YOU'D LIKE TO SEE MORE OF OUR PROGRAM AND EXTRAS, VISIT OUR WEBSITE, WCNY.ORG/CYCLEOFHEALTH.

TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM.

FOR THE CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANKS FOR CHECKING IN.

♪ ♪ NEXT WEEK ON "CYCLE OF HEALTH..." >> TONIGHT'S TOPIC, RURAL HEALTHCARE.

WITH RURAL RESIDENTS FACING BARRIERS SUCH AS LACK OF PROVIDERS, LACK OF TRANSPORTATION, HIGH COSTS FOR CARE, PROGRESS NEEDS TO BE MADE TO HELP THESE FOLKS ACCESS HEALTHCARE.

>> GEOGRAPHY IS A DETERMINANT OF HEALTH.

WE SEE HIGHER RATES OF CHRONIC HEALTH CONDITIONS AND HIGHER RATES OF MORBIDITY IN PEOPLE WHO LIVE IN RURAL AREAS.