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Has marriage equality made health care more accessible for LGBTIQ people?

"Having medical staff add to your feelings of safety by affirming your relationship without question really does make the experience better."

Hands of a lesbian couple during their wedding

Source: Digital Vision / Getty Images

During the postal survey and surrounding debates about marriage equality, LGBTIQ+ people expressed many different views on marriage and what it would mean for the queer community. People of different cultural backgrounds, age groups, gender identities and sexualities had varied stakes in the issue; some expressing the view that they weren’t stakeholders at all. However, one constant came from all quarters; LGBTIQ+ people needed equal treatment at the most vulnerable times in our lives. In our worst crises, being able to unequivocally assert ourselves as life partners is necessary.

Even though de facto couples in Australia enjoyed roughly the same rights as married couples, the pre-marriage-equality reality was that any officials in a hospital or coroner’s office who wanted to play hardball could put the onus on us to prove the validity of our relationship. Ben Jago of Tasmania made after he was unjustly treated when his beloved partner, Nathan, died in 2015. Even though Ben and Nathan lived together, police wouldn’t accept that their relationship had the status of marriage, and this resulted in Ben being excluded from funeral arrangements by Nathan’s homophobic family.

It seems that everyone in the queer community knows one of these stories; countless devoted lovers were locked out of hospital rooms or funeral arrangements during the AIDS epidemic in the 80s and 90s, and since then, progress has been slower in some institutions than others. I have a gay friend whose deceased partner’s lawyer tried to disinherit him out of homophobia, even though there were no relatives who contested the will. Some homophobia and transphobia persists in the medical profession,, and even accepting doctors sometimes that leave queer patients with sub-standard treatment.
Post marriage equality, there are signs that things may finally be improving.

Last month I valiantly volunteered to experience a trip to hospital so that my wife and I could check out the difference. (Okay, so my badly broken ankle which ended up requiring an ambulance trip and subsequent surgery was more of an accident than a deliberate experiment, but I’ve decided to make the best of it anyway!) Unlike other interactions we’d had with medical staff, this event came without the added stress of having to explain ourselves. When I was in the emergency room crying for my wife, they all knew who I meant. When I was able to see her again, one of the doctors instructed a nurse to ‘find [her] wife in the waiting room’ without batting an eyelid. As anyone who’s been in a large amount of pain and distress would know, having your loved one close to you is paramount to being able to cope with the trauma. And having medical staff add to your feelings of safety by affirming your relationship without question really does make the experience better.

Now that we’re legally married, my wife and I enjoy a modicum of increased security. If the worst were to happen, we wouldn’t have to dodge legal landmines to have the rights afforded to the next of kin.

Still, I’m under no illusion that a wedding ring opens all doors or smooths over all problems. LGBTIQ friends tell me that they’ve long had positive experiences at hospital, where staff are used to encountering and accepting people from all walks of life. Some maternity hospitals, for instance, have implemented policies to ensure that same-sex couples are treated appropriately in the birthing suite, and these initiatives preceded marriage equality. Still most primary care is not provided in major city hospitals, but in GP and allied health clinics all over the country, and even with equal marriage, the health system still has a long way to go to ensure that all people have equal access.
Recently, a queer friend who’d moved into a new inner-city neighbourhood called her local GP clinic for an appointment, asking for a doctor who was good with LGBTIQ healthcare. After a long pause, the receptionist icily suggested that she find a different clinic. Clearly, even in metropolitan centres, there is still an assumption that LGBTIQ healthcare should be separated from general family clinics. This has a dual impact: doctors in regular clinics often have no experience of treating LGBTIQ people and lack the up-to-date knowledge and experience that could help them treat and diagnose relevant health concerns for these populations. Even worse, doctors who are uncomfortable with diverse sexualities and genders may fail to treat the presenting issue seriously because of the assumptions they make about the patient’s lifestyle.  Thus, LGBTIQ people, especially in rural and outer-metropolitan areas, may feel unsafe visiting their local doctor, which means putting off healthcare appointments. Given that the dedicated LGBTIQ-friendly clinics are usually overbooked and frequently won’t take new patients, this can cause a lot of problems even for people in inner-city areas. The increased minority stress this places on LGBTIQ patients has the opposite of a healing effect.

When we’re at our most needy and vulnerable, all humans want to feel safe and accepted. Having to go back into the closet, or continually explain one’s correct pronouns, or temporarily losing contact with a partner, is the last thing a sick or injured person needs. Marriage equality legislation has made some of our relationships more visible and our rights clearer, but there are many in the LGBTIQ community for whom little has changed. Healthcare professionals need to make sure that first, they do no harm -- and that means leaving prejudice behind.


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6 min read
Published 8 May 2018 11:53am
By Elizabeth Sutherland


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