RAINBOW ACCESS INITIATIVE

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MODULE ONE
Barriers to Quality Health Care Services
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• Lesbian, Gay, Bisexual, and Transgendered
  people have the same health needs as all other
  people, but they also have additional unique
  health care concerns.
• Barriers like bias, ignorance, and fear
  create homo/hetero/bi, and trans phobia, which
  make it difficult for people in the LGBT
  community to access quality health

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What Creates the Barriers to Quality Health Care?

• LGBT Often Do Not Seek Health Care
• This places them at increased risk of physical
  and mental heath problems.
• Intake and assessment forms routinely say
  "husband" and "wife."
• Transgender health care is simply not taught in
  medical or clinical programs.
• Stereotypical Assumptions About LGBT People
• Many populations of people invisible as LGBT
  people, including people of color, those who
  are poor, the elderly, those living with
  disabilities, religion, or parents.

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What Creates the Barriers to Quality Health Care?

• Inadequate Training in Couple Issues
• Lesbian or gay males couples have greater
  difficulty finding therapists with proper LG
  training
• And therapists often receive even less
  information on bisexual and transgendered
  people.

• LGBT are rarely able to have their families
  covered on their health insurance.
• LGBT youth are often silenced or told that they
  are too young to know if they are gay.

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What Creates the Barriers to Quality Health Care?

• Many physicians do not routinely ask about
  same-sex relationships, and make assumptions that
  married people do not engage in same-sex or
  non-monogamous sex, so they do not routinely
  screen for STDs.

• LGBTs who choose parenthood do not receive
  assistance in making decisions about alternative
  reproductive, surrogacy, or adoption, or advice
  on the legal implications of family-building
  within a homophobic culture.

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LGBTQQI?
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• Coming Out The process, often lifelong, where
  LGBT people become aware of, acknowledge, accept,
  appreciate, and let others know about their
  sexual identity. Coming out can involve
  self-knowledge, or sharing this information with
  friends, family and employers. Developmental
  models of sexual and gender identity are
  descriptive of western cultural processes they
  may not be universal human experiences and should
  be used cautiously across cultural differences.
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• An LGB person must "come-out" of other people's
  assumptions that they are heterosexual 
• There is a continuum of coming out (to oneself,
  to others, to employers) and coming out is a
  lifelong process.
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•  

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  Stages of Coming-Out Stage One Identity
ConfusionThe fear that the person may be gay or
lesbian. Oh my God, what if I am gay?.
 Stage Two ComparisonBeing able to accept
that the person may actually BE gay comparing
oneself to other gay people.Stage Three
Identity ToleranceExploration of gay identity
and the gay community. Often feels bad about
being gay, but cant help oneself.
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Stage Four Identity AcceptanceAcceptance and
comfort with self as a gay person. Often feels
different from heterosexuals and hostile towards
straight culture. Stage Five Identity
PrideOccurs when the person immerse themselves
in lesbian and gay community and culture to live
out the identity totally.Arrogant pride and
rejection of straight culture as the norm Stage
Six Identity SynthesisOccurs when a person
develop a fully internalized and integrated
lesbian or gay identity and experiences
themselves as whole when interacting with
everyone across all environments.
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Bisexual Identity DevelopmentInitial
confusion Finding and applying the
label Settling into an identity Continued
uncertainty 
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Exercises

• Reactions to Coming Out
• Myths and Stereotypes

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• Internalizedhatred of self because of gender
  identity or sexual orientation. May not seek
  medical or mental health care because of being
  afraid to come out.
• Externalizedothers hatred of persons who are
  LGBT. Client may feel nervous to be treated
  differently by the practitioner or support staff.
• Institutionalizedbarriers in societys
  institutions i.e. churches, government (marriage
  law). Partner or significant other may not be
  permitted or feel comfortable to be present in
  exam room. Exclusion of gay and lesbian partners
  from health insurance benefits, inability to
  legally adopt children or receive reproductive
  technology.

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Exercises to Combat Homophobia

• Buy a magazine that visibly addresses LGBT
  issues and carry it around with you so others
  will see it. Read it on the train, in a doctors
  waiting room, carry it with you under your arm
• Purchase and display a button or bumper sticker
  that might identify you as a supporter of LGBT
  issues, i.e., a pink triangle, a rainbow flag
• Walk down the street holding hands with someone
  of the same sex
• Attend an event sponsored by the LGBT community
  and attend it with a friend of the same sex or
  attend a heterosexual event with a friend of the
  same sex and sit with the person and/or dance
  with them.
• For one week, do not identify the sex of your
  partner/spouse. Talk about him or her without
  using pronouns.