It's a pleasure to be here, and thank you all for your time.
I would like to introduce myself. I'm a family physician who has spent most of my career devoting my time to delivering health care to the LGBTQ community as well as people living with HIV. This is a very important topic to me.
I'm also here as a gay married man. I'm here as a doctor, but I've also been in the health care system as a patient, so I'd like to tell my story and get some points across on what I think is important on this topic.
I'm sure that in this committee you've heard a lot of the salient points regarding LGBTQ health care, so I thought I would just tell you stories. Hopefully, these stories will get some points across and maybe offer some solutions to what I think are the issues. I'm going to tell you patient stories. There's no personal identification in these stories, so it's all confidential. I'm going to see how much time I have to see how many stories I can tell you.
The first story I want to tell you is about a patient of mine who was distressed because his friend, a female patient, was really struggling in the health care system. She really needed a doctor. I agreed to take her on as a patient and in comes this lovely, let's say, mid-fifties, female patient, and she is a female-male transgender woman. She comes in with a bit of trepidation. I can see she's a little bit anxious and we start to talk, do a bit of introduction, and then I tell her about what we do at my clinic—what we've done for 20 years—and that we call it a medical home for patients, but a medical home specifically tailored for LGBTQ patients.
We have low barrier access. We're very respectful, staffed from top to bottom, and very aware of what this group of patients needs and how to communicate with them. We're a multidisciplinary group, doctors, nurses, pharmacists and other staff.
I started to talk to her. I said, “This is your new medical home. You will always be safe here. You will always be heard. You will always be respected.” In those few seconds that we spoke, I saw a ton of bricks falling off of her, that relief. I suspect she experienced a lifetime of prejudice, and in the medical system, not always having optimal communication and being asked uncomfortable questions.
That's my first point. What's important is that this population needs a medical home that's tailored to them. We can talk during question period about what that means, because in today's day and age, medical home doesn't necessarily need to be a specific physical place.
I have one more point to make about her. She's a happy patient, happy in her new medical home where her needs are met. She has to go for a routine colonoscopy. She goes to our local hospital and I get the report back, and my heart sank, because the report said that a 56-year-old male patient was seen and he was told this and that. My heart just sank, because I actually knew the people, those physicians, and they're great people, but there's a systemic problem in how medical professionals get educated around LGBTQ health issues, and how they communicate. If you ever met this woman, you would never refer to her as a male, and that was an atrocity.
So often, and I don't know if this is across the whole country, medical education for health care professionals around this issue is either an opt in or non-existent. My second point is that I really think that “mandatory” sounds like a prison sentence, so I don't want to say that word, but I think we really need to have it in medical education for health care professionals on all levels as a really important issue that's strongly encouraged, but I don't want to say “mandatory”. That's my first story.
My second story is about doing scoping for anal cancer. Although I'm a family physician, I trained in that. I see a 46-year-old gay man. He came in and said, “I've had complaints for a long time, a few years. I've seen a few doctors, and they told me I have a hemorrhoid.” I looked with a scope, and sure enough, unfortunately, he has anal cancer, which is quite a devastating cancer diagnosis. It's treatable, but the treatment is harsh.
Why I bring this up is that in the gay population, anal cancer is a much more prevalent cancer than in the general population. There is screening available. There are clinics like mine also available in Vancouver, but they are minimal. I think, if I would make a recommendation, I would say that gay men need to be screened for anal cancer and need to have access to clinics like mine, where I work, to be assessed and to make sure that, even if they have cancer, it's early cancer that can be treated.
Women are the same. Cervical cancer rates, actually, are the same as anal cancer rates for men who have sex with men, so it's the same thing. All women have universal access to screening in colposcopy clinics province-wide, probably country-wide, but gay men don't have this. I think that's a very, very important point, as I said, in looking at gay men's health.
This is my next patient's story. I got called by a health care nurse. A 24-year-old guy just got diagnosed with HIV. It was very distressing. It was in the past year or two. He came in. He was in school and was devastated by this diagnosis. Of course we had a conversation, and I put him at ease by telling him that we can treat HIV today, but it would have huge health impacts on his life for the rest of his life and on many levels, not just health but social and economic. In B.C. we got universal access to PrEP just two weeks prior to this appointment with this patient. My heart sank, because I felt like he had just missed the bus.
I don't know if this committee has heard about PrEP. It's a treatment you can take every day that's more effective than condoms to prevent HIV acquisition. I just think that today in Canada we should not have any new HIV infections. I really think we should have universal access for people at risk of getting HIV. That's another point.
I have one minute, so I'll to go to my next patient. My next patient was a lovely guy. He's in his mid-eighties. I've known him since he's been in his sixties. He has HIV, well controlled, and some other health issues. You get health issues after 70, as I always tell my patients. But he's doing well and he's working every day. The last time I saw him I had a bit more time, so I asked him, “Why are you working every day? You're in your mid-eighties. It's not for financial reasons.” He told me, “ I wouldn't know what else to do. All my friends have died, and all my family have died, so this is what I can do.”
Why I bring up this point is that, for the LGBTQ community in the future, as they age, we're going to see more social isolation. We know that loneliness is a disease in itself. You can read up on the health impacts of loneliness. That's why I bring up this point. It's really a concern for us, because we know our patient population is aging. How are we going to deal with loneliness? You can ask me in the question and answer period if you think I have any suggestions.
That was my last story.