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Perspective | How the way we talk and listen to each other can prevent discrimination

Carey Candrian is an associate professor of internal medicine at the University of Colorado School of Medicine. In her research, she investigates how health care can be compromised if an open discussion with patients about what and who matters most to them is avoided.

In 2021, 56% of LGBTQ+ adults reported experiencing some form of discrimination from a health care provider. For those who are transgender or gender non-conforming, the rate of discrimination from health care providers vaults to 70%.

This type of discrimination is happening all over the health care ecosystem. It is also happening outside health care: in 2022, 155 bills were introduced to limit the participation of transgender people in public life. In many of these bills, lawmakers have targeted some of the most vulnerable members of our community: kids. 

I work on the other side of the spectrum with older LGBTQ+ adults — many who have not come out until their 60s, 70s, even 80s. And some who have come out and gone back into the closet to stay safe. One woman, Shirley, did not come out until she was 81, when she was writing the obituary for her wife. She wrote “friend” instead of wife. The worker at the mortuary caught it and asked her if she wanted to change it to reflect her true relationship. Estelle lived with her wife for 40 years. But after a fall, surgery, and a divorce, she moved into assisted living and went back into the closet. She is 82. Janelle told me her biggest fear if she enters hospice is that no one will help her shave her face and she will die as a man with a man’s name. She transitioned in her late 60s. 

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