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2016 Conference: Opening Plenary Session

Posted By Matthew P. Martin, Friday, October 14, 2016



Welcome to the 2016 CFHA Annual Conference! The opening plenary session included remarks by current president Natalie Levkovich and incoming president Tina Runyan. The Don Bloch award was presented by John Rolland and given to Barry Jacobs, a worthy recipient. Check here for a video of the presentation.


The actual plenary session was an incredible, multimodal presentation of video, music, and live speakers. Directed by Randall Reitz and moderated by Jodi Polaha, the theme was "LGBT at CFHA” and included a panel with Beth Evelyn Barber, Michelle Evers, Steven Migalski, and Stacey Williams.


The first video introduced the audience to several LGBT advocates: a University of Chicago student, a state department worker in Brazil, and a Mormon couple in Seattle. Jodi started with a question: what does an organization do when they’re locked into a conference site in a state that passed controversial legislation affecting the LGBT community? Here is our response: we will hold up the LGBT community!


During the first video, the Seattle couple shared their experience of raising a 10 year old transgendered boy. When he was younger, he hated his hair and insisted on wearing hats to hide his hair. One day, when the boy was three years old, the mother found him in bed crying and asked him what was wrong. He said, "Why would Heavenly Father make me a girl when I’m a boy”. The mother responded, "I love you no matter what”. Years later, the boy was teased at a Sam’s Club store which upset the entire family. The mother pleaded with the father "Get us out of this state. We can’t raise our child here”.


Stacey Williams then took the stage to explain the terrible health disparities that LGBT patients face. She attributes these disparities to minority stress at the individual and structural levels. "Even if they don’t experience it firsthand” Stacey says, "they can experience it through anticipation, constantly monitoring the environment to see if it’s safe”. She quoted one study that demonstrated the higher rates of mortality that LGBT face compared to the general population.


Beth Barber then identified the barriers to affirmative healthcare. "One of the easiest ways to demonstrate your acceptance of LGBT as a clinic” Beth says, "is to place a rainbow sticker or sign on your building”. Other strategies include developing non-discrimination policy, labeling bathrooms as gender neutral, placing LGBT-friendly reading materials in the waiting room, and being willing to open the conversation about LGBT health-related issues. She cited the Fenway Institute Guidelines as an excellent resource for talking to patients about gender, assigned sex, and preferred names.


The panel then discussed together the need for addressing LGBT health in every health setting and how clinicians can assess if minority stress is contributing to the presenting problem at a medical visit.


Steven Migalski continued the plenary by recounting his story of coming out as a gay man. After growing up in Chicago, he completed graduate studies at Auburn University where he came out and then became involved in LGBT advocacy efforts. At one point he was interviewed on CNN which is how his family learned about his orientation. "We have come a long way since I started at Auburn” Steven says. "The fact that I can speak to you this openly is a sign of that. Please, let’s keep it moving forward.”


The next video included the student, the state department worker, and the couple all suggesting ways in which clinicians be person-centered and address LGBT health issues.


Steven then took the stage again to deliver ten guiding principles for compassionate care:

1. Use sex and gender accurately

2. A binary for gender and sex does not reflect reality

3. Differentiate between gender role, expression, and identity

4. Know and use gender queer appropriately

5. Use transgender and cisgender

6. Appropriately use transman and transwoman

7. Distinguish between social, emotional, and medical transitioning

8. Understand intersectionality of sexual and gender identity

9. Mange pronouns sensitively

10. Don’t assume homogeneity of identity and experience


Steven also identified several common missteps to avoid: education burdening, gender inflation, gender narrowing, gender avoidance, gender generalizing, gender repairing, gender pathologizing, and rigid gate-keeping. He encouraged clinicians to show their humanity to patients because then that gives permission to patients to do so as well.


The final story was given by Michelle Evers who shared her experience of growing up in a loving family in Ohio and then slowly discovering her identity as a lesbian woman over time. This discovery included periods of uneasiness, recognizing she did not fit in with the normative. She considers herself to be on a continuum of sexual orientation rather than a concrete binary. She then shares how her story has affected her work as a nurse practitioner with LGBT patients.


The audience left feeling inspired and informed. The presentation ended with a quote by Mia Kirshner: "I think one’s sexuality can be the center of life, and coming out and discovering your sexuality is something that really can define your existence”.

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CFHA is a member-based, 501(c)(3) non-profit organization dedicated to making integrated behavioral and physical health the standard of care nationally. CFHA achieves this by organizing the integrated care community, providing expert technical assistance and producing educational content.