Ariel Servadio used to dread her health care provider assuming she could only be involved with men or asking uncomfortable and medically irrelevant questions.

Servadio, a Syracuse resident, identifies as a bisexual woman. Doctors never knew what to do once they found out about her sexual orientation, she said.

“Well, do you gravitate towards one or the other?” she recalled a past doctor asking.

Servadio had her first appointment with a primary care provider at Upstate Medical University’s newly renamed Inclusive Health Services department in July. Her experience at the department was the most comfortable she’s had with a doctor, she said.

This May, IHS began providing general health care to any patient who identifies as a member of the LGBTQ community with the help of an annual state grant. The department aims to provide a well-rounded and positive health care experience for LGBTQ patients of any income and age, said Mattie Cerio, a social worker for IHS who co-manages the state grant.

IHS was previously named Immune Health Services. The clinic served patients with HIV and people taking pre-exposure prophylaxis, or PrEP, a preventative drug for people with a high risk for HIV. The renamed department is sharing the $130,000 state grant with two of Upstate’s pediatric clinics.

The LGBTQ specialty care program has taken in more than 70 new patients in addition to its about 1,200 existing patients, Cerio said. The program’s patients range from 18 to over 80 years in age, she said.

Cerio worked on between 35 and 40 of the new patient intakes last month alone after Facebook posts about the specialty care program received over 300 likes, she said. CNY Pride, Inc., a Syracuse nonprofit, and Wunderbar, a theatre and queer bar, made the posts.

Jennifer Schumacher, a physician assistant serving as one of the program’s four primary care providers, has trained over the past few years to specialize in transgender care. Breaking down barriers with transgender patients who have built walls up due to traumatic health care experiences is the biggest challenge, she said.

Transgender patients are often misgendered and treated with hostility from either health care providers or clinic staffs. A specialty program is needed to ensure that transgender patients feel comfortable discussing their health care needs with a doctor, Schumacher said.

“They get glossed over a lot, not get all of those pieces introduced, or get it done in a way that’s uncomfortable,” Schumacher said.

Schumacher also focuses on getting patient feedback on ways to improve the program. The program responds positively to patient feedback, even suggestions as simple as labeling condoms as “internal” and “external” as opposed to “traditional female condoms” and “traditional male condoms,” she said.

Her goal is to foster transparency with patients while also making sure they feel comfortable. She has recently encouraged nurses to schedule follow-up appointments while patients are in the examination room, so they don’t have to schedule sensitive sex- and gender-related appointments at the front desk.

“(The transgender population) is a population that’s very underserved, and to be able to provide them good quality care, including all of the services they need, and not have to send them elsewhere is really important,” Schumacher said.

Instead of calling patients by name, the IHS has also implemented a pager system in its waiting room to avoid issues of misnaming and misgendering patients. The pager system also gives all patients more privacy, regardless of whether they identify as transgender, Cerio said.

Upstate’s electronic medical record system now provides spaces for a patient’s gender identity, sexual orientation, pronouns, preferred name and legal name, in addition to the sex assigned to them at birth, Cerio said.

The university has also updated its portal software to use a patient’s preferred name even if it has not been legally changed. Cerio said she was told at previous jobs that these changes to electronic systems weren’t an option.

A key to IHS’s success will be its ability to not only provide affirming medical care to patients but to also connect them to a comprehensive network of support services, such as mental health care, Cerio said.

Meg Lyttle, another member of the IHS social work staff, said a handful of the clinic’s patients have requested assistance in changing their name. The Volunteer Lawyers Project, a nonprofit, offers free legal assistance with changes to name and gender markers to all clients, Lyttle said.

“I feel optimistic,” Lyttle said. “We are moving in the correct direction. We are making the correct changes. There are hurdles, but we’re not the only one’s doing it.”

Published on October 22, 2019 at 9:11 pm

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