Navigating the complex U.S. health care system can be a challenge. For the transgender and nonbinary communities, trying to find providers who offer both gender affirmation and holistic inclusivity complicates matters further.
Bloomington-Normal has multiple resources for helping people in the LGBT+ community find adequate care, but some say the process could be smoother, and providers say there are some things their colleagues can do to help.
Beth and Wesley Howard moved to Bloomington-Normal last year so their daughter could get treatment she could not get in Texas. They said they’ve found gender-affirming care, a new pediatrician and a therapist for their daughter, who is trans, but not without effort.
“You got to be ready to put in the footwork, put in the paperwork, do the work to get there,” Beth Howard said.
And it goes beyond checking databases for doctors, they added, though they did find some options, such as the LGBTQ+ Healthcare Directory, helpful.
“There's plenty of safe spaces, but you do have to call around, and you do have to go down the list and find them,” Wesley Howard said. “It would be nice if more practices would put their flags out.”
Illinois State University student Court Reid, who is nonbinary, finds themselves in a similar situation. They are still trying to find a primary care provider after some of the recommendations from friends, the Prairie Pride Coalition and a Reddit thread they started didn’t pan out. Reid said several told them the doctors weren’t taking new patients, but Reid is not deterred.
They say getting in to see a doctor who will acknowledge their needs is essential — and it would be a first.
“I want someone who's gonna take what I'm telling them seriously,” Reid said. “In my past, with small town health clinics, I felt like a lot of times they would ask questions like, ‘Oh, what's your gender identity? What's your sexuality?’ But… it was never something that they seemed to really care about.”
Past doctors were also invalidating about mental health, Reid said.
“I felt like I was never really taken seriously, and they were really quick to just like, prescribe you with something that may or may not help, which ultimately kind of led to me feeling defeated with seeking out help in general,” they said.
Part of the reason Reid said they feel so invigorated to find a new doctor is being in Bloomington-Normal. They know it’s an inclusive community and there’s a good chance they will find what they’re looking for.
However, they anticipate it may still take several more months and lots more outreach. They added that they think it would help if ISU put in a bit more effort to collect and distribute resources for students like Reid. They also said ISU does have some helpful tools, including the Multicultural Center and student organizations, but it never hurts to have more information.
“I went to Reddit because… in the past, my mom set up my appointments,” they said. “But now that I’m on my own and living a bit more independently, it definitely would be a little more helpful for there to just it be well known who's queer friendly in the area.”
Provider perspective
On the provider side, counselor Bryan Hinman said there is also a decent amount he and his colleagues can do to become more accessible. He said a lot of being an inclusive provider is about educating oneself on best practices.
“There's a lot of constantly shifting things and priorities,” he pointed out, adding that he has seen an increasing need for mental health care from the transgender and nonbinary communities since Donald Trump was reelected.
Adam Houghton, a doctor at Bloomington Primary Care, said he is putting more personal emphasis on making himself known as an inclusive provider in the area given recent politics and looming policy changes. He added that online directories are not always “all-encompassing,” and providers have to put themselves on those lists.
“I think that's a really important thing to be visible and to provide awareness that this is a service that is needed and the service that is lacking,” he said.”
Hinman, who is gay, said he also looks for inclusive care and keeps several things in mind when trying to find providers who cater to different parts of the queer community — “Whether it's the gay community, transgender gender or non binary community, it's not a monolith,” he added.
Language on a provider's profile can be very telling, he said. For example, he said he sees remarks about treating everyone equally as somewhat of a red flag.
“Because that really dismisses some very key things to be aware of and how to help those populations,” he said.
Truly inclusive care, he said, is about more than just checking the box that says LGBT+ friendly. It’s also about what certificates someone might have.
“We're not asking for just baseline tolerance, but are you aware of the existing systems and how that's impacting people in certain communities?” he said. “Like even in the transgender community, sometimes people can focus solely on physical transition, but there’s also social transition.”
Houghton said gender affirmation misconceptions often lead to inaccuracy surrounding proper care. He said mainstream definitions tend to focus on the physical transition — medications and surgery — but that is not an accurate picture.
“There's a huge impact on mental health services and other social services and just basic health care access that is really difficult,” he said.
In that sense, he said affirmative care is really synonymous with inclusive care, and it all circles back to the provider. Houghton said every staff member in an office needs to be trained on proper practices for a patient to feel comfortable receiving care.
“In one office visit, they could come into contact with six or seven different people. And so I think it's really important for offices to be aware and be making sure we're on the top of our game across the board,” he said.
While Houghton’s office is considered closed and his staff will tell callers he is not taking new patients when they inquire, Houghton stressed that it is a standard line they give out.
“There's always availability for anyone calling to specifically say why they want to see me, and I would say as a blanket statement, that I'm always accepting new patients who need to see me for any kind of gender-affirming care,” he said.
So even when doors may seem closed, he said, they may be open.
