For Patients of All Stripes

we support celebration

Jay and Miguel were apprehensive about their first visit to a UCLA Health provider, and understandably so. For both Jay, 34 years old and gender-assigned female at birth who now identifies as nonbinary, and their partner, Miguel, a 32-year-old transgender male, previous interactions with health-care providers had been characterized by insensitivity and ignorance.

Jay (who prefers the pronouns they/them/their) recalls a particularly upsetting experience with a gynecologist who counseled, “If you want to get a husband, you have to shave and do something about your eyebrows.” Jay says, “I hadn’t asked for any life advice. It was such a [terrible] conversation to be having while I was half-naked.” After that encounter, they avoided going back to a doctor for a long time. Miguel, despite being diabetic, has mostly confined his visits to clinics that specialize in providing hormone treatments to trans patients. “It gets tiring having to explain what ‘trans’ and ‘queer’ mean to your doctor,” he says.

Health-care experiences for people like Jay and Miguel often are “suboptimal,” says Amy K. Weimer, an internal medicine specialist who directs the UCLA Gender Health Program. “They have stories about providers or institutions that are ignorant, in part because there hasn’t been a lot of attention paid to issues of care specific to gender transition, or to general health care delivered through the lens of a person’s gender experience,” she says.

Doctor meeting with patient

UCLA Health is working to change that. In 2016, the UCLA Gender Health Program was established to provide a knowledgeable staff in a compassionate environment for transgender or gender-diverse people of all ages to receive primary care and chronic-disease management, as well as care that is specific to their gender or gender-transition issues.

Jay and Miguel saw Valentina M. Rodriguez, an obstetrician/gynecologist at the UCLA Gender Health Program, when Jay became pregnant. From the outset, they knew the experience would be different from their past health-care interactions.

“Dr. Rodriguez was adamant about making sure all of the nurses and staff used my correct pronouns and name,” says Jay. Other requests also were respected, including Jay’s desire not to be called “Mom” and the couple’s decision not to have a gender assignment for their newborn.

The program is part of a focused effort by UCLA Health to ensure equitable, affirming and supportive environments for lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) patients and their families. In its 2018 Healthcare Equality Index, the Human Rights Campaign Foundation awarded each of UCLA Health’s four hospitals — Ronald Reagan UCLA Medical Center, UCLA Mattel Children’s Hospital, Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA and UCLA Medical Center, Santa Monica — the distinction of “LGBTQ Healthcare Equality Leader.”

At the UCLA Center for Clinical AIDS Research and Education (CARE), which provides state-of-the-art care to patients with HIV and AIDS, the vast majority of patients are gay and bisexual men, says Emery H. Chang, an internal medicine physician and HIV specialist. Chang notes that even in a city as diverse as Los Angeles, many of his patients complain about experiences with other health-care settings. “There still is a stigma, around both HIV and LGBTQ issues, that results in patients not feeling comfortable disclosing information that would be important to their care,” Chang says. At CARE and elsewhere, he adds, the UCLA Health system is taking extra measures to ensure that interactions with LGBTQ patients at both the staff and provider levels are inclusive and welcoming.

Numerous studies have found that sexual minority and gender-diverse youth are at elevated risk for poor outcomes such as depression, suicidality, substance use and trauma, notes Natalia Ramos, a UCLA Health child, adolescent and adult psychiatrist. “Often, this is a cumulative effect of various stressors — discrimination, harassment, microaggressions, family rejection, issues with peers and not having supportive environments,” Ramos says.

UCLA recently launched the EMPWR (“empower”) program, directed by Ramos, to provide a safe, open environment for LGBTQ youth with mental health concerns. The program delivers a range of evidence-based services through the lens of understanding minority stress and following an affirmative model — the belief that any expression of gender identity or sexual orientation is normal. A teen resilience group teaches cognitive behavioral therapy skills that have been shown to help teens improve mood and emotional regulation and establish supportive networks.

Jay and Miguel’s experience with UCLA culminated with the birth of their child, Azul, on June 30. “During the birth, Miguel was able to be with me without having to worry about correcting people who were saying insensitive things,” Jay says. “That made the experience really nice.”

Stay Informed

Sign up to receive engaging, educational and inspirational content in your inbox.