The Path to Acceptance: An Account of LGBT Healthcare Transformation with Phil Mccabe of Rutgers University

Join us as we journey through the past with Phil McCabe, who lived the harsh realities of being closeted in the 1970s, to the present where he champions for a transformation in LGBT healthcare. Imagine living in a time where exploring your sexual identity was met, not with understanding, but with ridicule and harmful medical practices. Our guest takes you through his personal narrative, painting a vivid picture of the societal indignities he faced and the impact of inadequate medical responses. He emphasizes the urgent need for role models, affirmative care, and acceptance from our families and communities, making you question if our societies today have truly progressed.

Chapters

• 0:00 Improving LGBT Healthcare and Support
• 11:53 Gender Identity and Society's Expectations

Transcript

Speaker 1: 0:00

Welcome to Hatching Creativity. This isn't just another behavioral health podcast. This is the place where thought leaders converge to talk about real life challenges, breakthroughs and pivotal aha moments.

Speaker 2: 0:17

Mike, where I want to begin, also because you know you're inviting me to tell a little bit of my story also. Okay, so I was a college student in the mid-70s. I was also now I identify as the gay man, but I was married to a woman at that time. Okay, so I had a lot of confusion around my sexual identity. I went to the college library and these were some of the books that I found. Now there was a very limited, limited amount of books available in my research library. In fact, for those of us who don't remember, the card index probably had that little wooden box and find an ID card and then you saw who took the book out before you and that was also part of my curiosity. So who else took some of these books out? But because I never found anyone else that I could talk to or knew about. So you know I talk about the limited information that was sometimes out there. So previous generations you know these are some of the stories that were passed on to them. That was kind of limited.

Speaker 2: 1:13

The other point I wish to make is I did go at the time to talk to my family physician, my primary care doctor, who not only treated me treated my then ex soon to be ex-wife my parents, my grandparents, even my in-laws and I asked him how would someone know if they were gay? And what he did was he asked me, why would I ask that question? And I immediately sensed that sense of shame that even by asking someone how would you know if you were gay, I was doing something wrong. But the next thing he did was even more impactful. He said if you're gay, you're gonna need a lot of help. And I said, yes, I'm like nodding, that's why I'm talking to you. But then he said that is a very sad and lonely life. So talk about getting a negative message. And this message is coming from a physician, a person that I trust, that my family trusted. He not only said that's a very negative and lonely life, sad, lonely life, you're gonna need a lot of help. And he reached over and he got a script pad and he wrote me a script for benzodiazepines tranquilizers liver met the time 10 milligrams three times a day. More is needed. Just because, at the age of 21, I asked a doctor how would someone know if they were gay or not?

Speaker 2: 2:31

So when I talk about why this became my life passion, I know, looking back on my history, I was not experiencing a lot of anxiety, a lot of depression or anything else that warranted me being prescribed medications. What I did is I had a question and the doctor, instead of answering the question or having a positive response for me, chose to medicate me. And that really was, I'll be honest with you, where my addiction kind of spiral, because once the medication came from a doctor, it opened the door for me to using all other kinds of substances. And it's not about blaming him, but it's about recognized what inappropriate or negative treatment can have an effect on someone. And that's like the general theme of what I talk about is how we need to improve our treatment and improve the standards of what kind of treatment we offer to LGBT individuals.

Speaker 2: 3:23

Back then there was no one that I could talk to. I went to. After getting the medication from the psychiatrist, I actually called up the local hospital and asked to talk to someone in their mental health department and I on the phone said Is there like a gay therapist I can talk to? And they asked me why would I ask that question? I said Well, I'm kind of struggling with my own identity. I think if I had a gay therapist to talk to. And the person on the phone said to me that's a very inappropriate question. Wow, they're like you know, if you need help, we'll help you, but there has nothing. You know, we don't have gay therapists in this facility, nor do we have anyone that you know. And I'm like again did I do something wrong? Just for asking that question? I really thought, hey, maybe I need someone that kind of understands.

Speaker 2: 4:12

Now I was very fortunate I eventually did go to a mental health center and the therapist I worked with was not gay.

Speaker 2: 4:18

So I'm not saying that you have to be a gay therapist to provide LGBT affirmative care, but what I'm saying is our systems of care sometimes don't even recognize the specific needs of an LGBT person.

Speaker 2: 4:30

My need at the time was to have some type of a role model, some type of a positive influence, because up until that time, none of my teachers, none of the friends of the families, none of my relative, no one I knew in my neighborhood, had ever come out. This is again. This is going back to 1976, 1978, and it was all part of the process I had to go through, and I hope that by the work that I and my colleagues do. We are perhaps preventing someone from having. We have lost so many young people, trans people, to suicide, to drug overdose, that it's really important that we recognize some of the treatment needs that are necessary for someone to embrace and develop and maintain their sobriety or their mental health well-being. Not everyone necessarily has a problem with active addiction, but there's many behavioral health issues that come into play and those issues also affect the family and there's a lot of things that a family can do to provide acceptance to a young person in their family.

Speaker 1: 5:33

You know, phil a couple of things really just struck me there and I just want to pull back for a second. You know the story that you talked about in 1976, coming to your physician and asking for some advice right, this seems like it's a 1970s kind of a thing, but in many places this is still happening. It's we're not that far from it and it really is important that that is understood. You know, there are certain places in the country, maybe California, you know the Northeast, some places, maybe certain areas of Florida, and there are pockets right, but in terms of generalities, we really have to talk about how to one.

Speaker 1: 6:27

You know when this is happening, what's, and this is kind of a couple of questions I have for you. When somebody does find themselves in a situation like this with a doctor, or in a situation like that kind of, what do they do? I also want to talk a little bit about resources and getting into that. So we can do that now and we can wait a little bit, but people have to know of a safe place that they can go to get quality information, and I want to make sure that we touch on that too.

Speaker 2: 7:01

Sure thanks, mike. It is an excellent question. And you know, again, my personal history goes back to being alive and present during the early years of the feminist movement and also hearing and reading on the newspapers about how lesbians were not actively included, but the feminist ideas and the feminist theories were so important, including recognizing how women need to learn to take care of their bodies because they couldn't rely on the healthcare system to adequately do that. And you know these early publications some of them are still in existence now was like the benchmark of women's health and I think that we now have. There are actual resources that we have that talk about the healthcare needs of gay men, of lesbians, of transgender individuals. There's federal documents that have been published by SAMHSA that include these healthcare needs.

Speaker 2: 7:50

Now I'm a health educator, recognized, working at a major university, one of the largest healthcare training universities. I work at the medical school, the school of nursing, the school of public health, so I teach this to our students and Personally, there are times that I'm in the doctor's office as a patient and they're like oh, so you work at Rutgers, you're an educator, and what do you do there? And I tell them and they're like oh, wow, and I asked them did you have training on LGBT healthcare when you were in med school or nursing school? And they're like oh, absolutely not. No, never, never. And then they start asking me some questions. But for everyone that asks me questions and I'm able to educate them, there's so many others that again are ignorant. The ignorance is, again, that's not putting blame and saying like they were never taught it, so therefore they don't recognize the importance of it. Once a healthcare recognizes the importance of LGBT understanding of health issues, the disparities that exist, then they're going to be more inclined to utilize preventive strategies that can also help the community.

Speaker 1: 8:48

Well, you know, it's also interesting that you mentioned that, because part of the conversations that I've been hearing and people have been pushing on me which you know, I try to push back to the best I can which is they don't want to teach their kids about LGBTQ because they feel that that's going to influence the decisions that their kid makes, and I think that's extremely harmful. You know, again, you're really telling people that this is not a thing, but pay no attention to what's really going on. You're not mature enough to know the truth and it's. It really is very damaging for a lot of people.

Speaker 2: 9:37

Mike, I mean, that is such a again, it's a powerful question that you're asking. I can only tell you, as a sexologist I know that adolescent child sexual understanding begins at about age three. Not about age three we begin to recognize there's a distinction between our gender, the gender we were born in or assigned when we were born, and then the gender of others, and it continues for another three or four years where we come to an understanding. It's very typical for many, you know. I think of my play school years in in kindergarten, how people played house and set up different roles and different games that they played, that many of it was gender based. But the reality is not everyone subscribed to that. You know, a young child said well, today I'm going to play the daddy and you can play the mommy. And it wasn't based on what the gender of the person was. It was based on how they felt in the play that they were doing.

Speaker 2: 10:31

And yet we then have adults come in and say, oh, no, no, no, no, boys have to act this way, girls have to act that way. So think about the significance of gender stereotyping. That begins in our early adolescent development. And yet children by themselves make no judgment about it. They're very comfortable and in fact we know it's been shown in research that has been done and I know as a community we are often under researched.

Speaker 2: 10:58

But many young children are very adaptable when a friend, one of their fellow students, come out as saying they're gender nonconforming or they don't relate to being a boy or a girl or any gender other, and the kids just go OK and they're like you know so. Do you want to play? That's. I mean, that's all they want to do. They want to. They want to play, they want to talk, they want to. You know it's when the adults come in and say, oh no, no, no, you can't do that, or you should do that, or we have to. You know, protect it's not if we were protecting children. There's so many other things children are at risk for.

Speaker 2: 11:29

Yeah, we spend so much time talking about stranger danger and yet many children are harmed in their own family, household, not just because they're gay or lesbian, just because of their innocence as children. And yet we sometimes are in some areas we're ignorant about that happening also. That's also, you know, I work on sexual violence prevention, not just about LGBT kids being abused, but many children are abused and they're abused by someone that's known to the family. So, again, the family has a responsibility to raise healthy children. Healthy children should not be judged because they have beliefs about their gender. That's normal and part of their natural process. And, yes, there are times that a child might enjoy.

Speaker 2: 12:13

I think of like young boys or young girls who dress in like opposite gender. They wanna be a fairy princess one day, they wanna be a GI Joe the next, and you know what. And that's just part of child curiosity and that's what people do. And then eventually they come to an understanding of their gender and what is significant to them. So there's a variation here when we talk about gender identity and gender expression, but people sometimes get so fixated on oh my God, why is that little boy walking around the amusement park with a tiara and a fairy wand? Why? Because he's in a happy place, you know. Or why is that girl wearing a cowboy hat? And because she wants to pretend to be a cowboy, because she sees cowboys as exciting, and you know. So, again, we put those conditions on children, which is really unfortunate.

Speaker 1: 13:02

We do that in so many areas of society too. You know, even to pull the lens back a little bit, right, what a man is, what a man should be, what a woman is, what a woman should be, you know. For those of you who know me, you know I had I came from an abusive first marriage where I was always told what a man should be and what I was and what I wasn't, and what a woman was and what a woman should be and what she was and what she wasn't. And it was so harmful, these constructs and that was, you know, and that was without dealing with all of the other layers of shame that other aspects of society puts on you. It really is damaging and it really is bothersome. These constructs, these stereotypes that we're kind of pushed to live in and to conform to. You know, it's really against the basic idea of United States and America, right. I mean, this is really flies right in the face of the whole purpose of the liberty that we all talk about.