Imagine this: Chris, a 57-year-old with severe chest pain is taken by car to Johns Hopkins Bayview Medical Center’s Emergency Department; Pat, aged about 46 years, drives and waits in the Emergency Department. Chris is in severe pain, and Pat is palpably terrified. And Chris is thinking:
- “Will this doctor believe my life isn’t worth saving because of whom I love?”
- “Will I receive substandard care because I am who I am?”
- “Can I trust these people to treat Pat and I with dignity and respect?”
- “Will these strangers in white coats listen to my life partner of 21 years, whose judgement I trust over my estranged family’s, if I become incapable?”
Sadly, the fears in this hypothetical scenario are all too real for most LGBTQ+ older adults. According to the AARP’s report, Maintaining Dignity, a sizeable sum of LGBTQ+ people do not trust medical professionals out of fear of prejudice, leaving them increasingly vulnerable for adverse health outcomes. They can’t tell at a glance if a doctor or nurse has prejudice against them.
By the same token, even culturally competent clinicians can’t tell if a person is LGBTQ+ just by looking at them. Frankly, clinicians don’t know if this particular patient had lost their job or housing due to their sexual orientation, or was forced to go through conversion therapy by another physician many years before, or experienced other appalling insults and harmful practices by past doctors. Many LGBTQ+ elders have experienced such trauma, producing minority stress that erodes their health quality over time, and that has led to a large number of them avoiding healthcare when they need it.
You may be interested to know that LGBTQ+ people in the greater Baltimore metropolitan area on average live to be around 59 years old according to Chase Brexton Health Services. Per Trust Choice, the average life expectancy in Baltimore is 84 years, and the national average is 78.5 years. That is a 20 to 25 year difference.
To address this glaring disparity, Geriatricians Engaged and Ready (GEARed) for LGBTQ+ Aging, Health & Wellness is a new initiative resulting from a Johns Hopkins Diversity Innovation Grant aimed at improving the quality of compassionate, culturally aware care to Baltimore’s LGBTQIA+ community. GEARed’s leadership includes: Dr. Matthew McNabney, Chair, Mosaic Initiative Workgroup to Promote Diversity and Inclusion, Division of Geriatric Medicine and Gerontology; Dr. Panagis Galiatsatos, Co-Director, Medicine for the Greater Good, Division of Pulmonary and Critical Care Medicine; and me, Tony Teano—I work with several different teams as a Communications Specialist, and I serve on the Johns Hopkins University Diversity Leadership Council. Additionally, we are fortunate that Dr. Cynthia Boyd, Director of the Division of Geriatric Medicine and Gerontology, fully supported the idea to create GEARed and helped shape the winning grant proposal.
At this time, the Division of Geriatric Medicine and Gerontology invites Johns Hopkins Medicine clinicians—including MDs, RNs, PAs—who serve older people to participate in GEARed’s training program. GEARed’s curriculum is currently being finalized; it will be a carefully curated selection from the National LGBTQIA+ Health Education Center, a program of Fenway Institute that offers free online training modules. A limited number of those who acquire the most CMEs in LGBTQ+ older adult care by the end of April will be eligible to receive a subsidized “Health Professional” membership with GLMA, an association of Health Professionals Advancing LGBTQ+ Equality. To express an interest in GEARed, please email me at firstname.lastname@example.org by the end of the day on Friday, March 18th for next steps.
I believe that GEARed for LGBTQ+ Aging, Health & Wellness will make a valuable contribution to meeting the healthcare needs of older adults in our communities. I hope that GEARed may serve as a pilot program, in a way—inspiring other areas of medicine to do something similar. Ultimately, my dream is that GEARed will build trust between LGBTQ+ elders and their care team, and bring parity in outcomes for healthy aging. I am grateful to work with such an amazing team of visionary people who make GEARed possible:
“I have been interested in the care of LGBTQ+ older adults for several years. This has been inspired by an opening dialogue on the national scene as well as participation in the Mosaic Initiative in the Division of Geriatric Medicine and Gerontology since 2010. The Mosaic Initiative explores all issues of diversity and inclusion including LGBTQ persons. There are many things that our Division can learn and grow as people and professionals. We are grateful for this grant and the opportunities that will follow!”
—Dr. Matthew McNabney, Chair, Mosaic Initiative for Diversity & Inclusion
“We aim to assure the promise of medicine reaches all and every person. This initiative, this collaboration, reaffirms that promise. I’m thrilled to see this executed, and the great projects and engagements this will bring on in the future!”
—Dr. Panagis Galiatsatos, Co-Director, Medicine for the Greater Good
“Congratulations to the team that has kicked off this exciting initiative!”
—Dr. Cynthia Boyd, Director, Division of Geriatric Medicine and Gerontology
By Anthony L. Teano, MLA