Any time Robert Chaloner sees a new doctor, he walks into the medical office with trepidation, often thinking to himself, “I wonder how they’re going to react when I tell them I’m gay.”
It is an experience shared by many members of the LGBTQ+ community, the chief administrative officer of Stony Brook Southampton Hospital explained. And for the past decade, he and his team have made it their mission to end it.
“Communities can be underserved for a lot of reasons,” Mr. Chaloner said. “They can be underserved geographically. They can be underserved because of lack of financial resources. They can also be underserved because of inherent bias.
“And the LGBTQ community is a community that’s had to deal with tremendous amounts of bias, not always felt comfortable in the healthcare system,” he continued. “And if you can’t feel comfortable in an environment where you should be sharing your healthcare status openly and feeling like your healthcare provider is available to you, then that becomes a barrier to good care.”
Last week, the National LGBTQ Healthcare Equality Index of the Human Rights Campaign Foundation named Stony Brook Southampton Hospital and Stony Brook University Hospital as Leaders in LGBTQ Healthcare Equality. Out of 765 healthcare organizations that applied, 495, or 65 percent, earned the recognition.
Both hospitals received the top score of 100 on a survey that covered non-discrimination and staff training, patient services and support, employee benefits and policies, and patient and community engagement — all working together to correct vast healthcare disparities that have resulted in significant inequities nationwide, including increased rates of depression, suicide, substance abuse, HIV, obesity, tobacco use, heart conditions and different types of cancers.
“I don’t see, just because we got this award, that the journey is over,” Mr. Chaloner said. “I think it’s recognition of the work we’ve done to date, and it’s work that we’ll continue to do, and I’m viewing this award as kind of the vitamin boost that we need to keep going on the journey, and that’s really what I’m excited about. While we’ve done a lot, we have a lot more to do.”
When Southampton Hospital officially merged with Stony Brook University Hospital in 2017, Mr. Chaloner said he was pleased to see that Stony Brook Medicine had an LGBTQ initiative of its own, as well as an LGBTQ+ Committee to address the unique needs and sensitivities of the community.
“Being more sensitive means that the entire health care team is aware that the LGBTQ+ population is a growing population in Suffolk County and has specific medical needs,” explained Rose Cardin, co-chair of the committee and director of patient education for Stony Brook University Hospital. “Every person that an individual comes in contact with during a healthcare visit, from the greeter at the front desk to the medical providers, must treat all patients respectfully without judgment or discrimination. All providers are instructed to use preferred names and pronouns, and are aware of this population’s medical needs.”
When those needs are denied — such as a trans man needing a PAP test, or a trans woman requesting to stay in a female room — it leads to further alienation, Mr. Chaloner said.
“You can imagine, there’s gonna be, in any organization, doctors who are gonna say, ‘Well what do you mean, they think they’re a man? They’re not a man, they’re a woman! I’m gonna treat them like a woman,’” he said. “No. We need to work and excise those attitudes out of the organization. That’s ultimately the goal of this award: to ensure that everybody gets the access to care that they need, and are treated with dignity and respect, that everybody is treated that way. And that’s really what we should be about as organizations, anyway.”
While hospitals must know a patient’s biological sex for blood tests and some diagnoses, there is no reason for it to be displayed on an identification wristband, he said, or on a single-stall bathroom door, both of which are now gender neutral.
“Somebody in the middle of the night kept going around and putting up pink and blue paper on the doors,” he said of the new bathrooms. “So it happens, even in healthcare, but fortunately, I think we’ve improved that situation. And, you know, sometimes the national political scene can create some issues, too, for us.
“But I do think it’s less and less,” he said of the pushback, “and it’s at a level now where it’s kind of an individual staff sensitivity issue. And we have to recognize, as much as we want to set a standard for how people are treated, we can’t tell our employees how to believe. We have to respect their beliefs, as well. But we do have an expectation of customer service that we can set for everyone, regardless of their individual personal beliefs.”
Education is the key to overcoming bias in the medical field, Mr. Chaloner said. It is a slow road, but capable of achieving incredible results.
“As part of our efforts to increase visibility of our support for the LGBTQ+ community, we hold regular events to hand out gay pride and gender pride stickers and pins for employees to wear,” said Adam Gonzalez, director of behavioral health at Stony Brook Medicine. “When one employee who had a rainbow sticker on their badge went home, their daughter saw the badge and came out as a lesbian.”
Allison Elliscu, chief of the Division of Adolescent Medicine at Renaissance School of Medicine at Stony Brook University, has achieved breakthroughs with patients of her own. One, a 23-year-old nonbinary individual, told her that they had avoided seeking medical help because they did not feel comfortable when providers did not use their preferred name.
“I showed this patient that their preferred name was added to their electronic medical record and that all providers in the Stony Brook system would be able to see the name on the front of their chart,” Ms. Elliscu said. “This patient was very happy to hear about this update and said they were much more willing to see other providers now since they would be more likely to use their preferred name.”
When another patient, a 22-year-old Black woman, saw Ms. Elliscu for a routine, annual physical exam, she confessed that one week prior, she had gone to the nearest subway station with the intention of jumping in front of a train and committing suicide — ultimately deciding not to follow through with her plan.
“She had not discussed this with anyone — no medical provider, family member or friend, until this appointment,” Ms. Elliscu said. “When I asked why she decided to share this information at the appointment today, she replied that she saw my rainbow ribbon on my ID lanyard and thought that meant that I would be open to hearing what she had to say, would be supportive and nonjudgmental. She said she identifies [as a] lesbian and wishes that other providers would wear a ribbon, or have some sign that LGBTQ individuals were welcome in their office. In her words, ‘It’s such a small thing, but it means so much.’”
Now in its early stages of fundraising, Stony Brook Southampton Hospital’s newly expanded Edie Windsor Center will offer a comprehensive range of health services to the LGBTQ+ community, marking the first of its kind on Long Island.
“For straight people, to walk into a hospital or doctor’s office, you don’t really necessarily think twice about, ‘Am I going to be welcomed here?’ if you fit the profile of a ‘hetero-normative’ person,” Mr. Chaloner said. “A gay person will walk in and there’s always a little bit of a sense of, ‘Should I reveal I’m gay? And if I reveal I’m gay, what kind of reaction am I gonna get? And will I be welcomed? Will the provider have a bias, that they’ll assume things about me that are just not who I am because of my LGBTQ status?’”
The Edie Windsor Center will be an important step toward eradicating this prejudice, and Mr. Chaloner said he hopes the recent recognition will set a standard for not just LGBTQ+ healthcare, but healthcare for all.
“I think this is important not just to the LGBTQ community, but to all, because organizations that take this journey, I think it’s a commitment to health equity, generally, and there are many underserved communities. The African American community is horribly underserved in this country, in terms of healthcare, and we’ve seen the impact f that, in terms of what COVID has done.
“There are health disparities that, unfortunately, create barriers for lots of communities, and I think that this is a way that we start to question barriers.”