Department of Health Commissioner Dr. Shereef Elnahal

A few years ago, a surprising number of lesbian, gay, and transgender New Jerseyans regularly made the trip to New York City or Philadelphia to obtain medical and behavioral healthcare services tailored to their needs, from providers who didn’t judge their lifestyle or discriminate in their treatment. But that is starting to change.

LGBTQ-focused healthcare services are now taking root in the Garden State, with new clinics and support groups dedicated to serving the community and a growing number of hospitals adopting policies designed to promote equitable and inclusive care. State health officials and some professional provider organizations have also embraced the need for more extensive training for healthcare providers to help improve the quality of care for lesbian, gay, and transgender patients.

Deputy Commissioner for Public Health Jackie Cornell celebrates a new healthcare program dedicated to LGBTQ care.

On Thursday, Jackie Cornell, a deputy commissioner in the Department of Health, joined state and local officials in Asbury Park to celebrate the opening of a new healthcare program dedicated to LGBTQ care. Created by the nonprofit Visiting Nurse Association of Central Jersey’s Prevention Resource Network, with help from a Department of Health grant, the program provides testing for sexually transmitted diseases, including HIV/AIDS, and related care. Primary care, behavioral health, and transgender-focused services are expected to be added soon.

“Disparities in healthcare still exist within the LGBTQ+ community, causing many to delay or ignore their healthcare needs,” said Shannon Preston, director of HIV Community Services at the VNA Health Group. “We are very excited to have this opportunity to provide a culturally competent healthcare setting.”

In June, DOH Commissioner Dr. Shereef Elnahal visited the state’s first LGBTQ healthcare program, the PROUD Family Health Center, which opened in late 2016 at Robert Wood Johnson University Hospital in Somerset. The program is focused on transgender individuals, some of whom undergo hormone therapy or surgery to align their physical appearance with their gender, and can face unique health challenges.

Unique LGBTQ healthcare issues

“As a doctor, I know that many people in the medical community are either uncomfortable or unskilled in treating the LGBT community,” Elnahal said at the time, adding that his own education, at Harvard Medical School, lacked training in the unique health issues related to this population. “This has got to change. People in the LGBT community deserve to be treated with dignity and professionalism so they can openly discuss their health issues without fear of being judged or mistreated.”

More than half of lesbian, gay, or bisexual patients — and 70 percent of transgender patients — have experienced some kind of discrimination in healthcare services, according to a survey by gay rights advocates Lambda Legal, included in the Human Rights Campaign Foundation’s Healthcare Equity Index 2018. Individuals describe being disrespected by providers, prohibited from visiting hospitalized family, and pressured to consent to a genital exam when the problem was a broken rib, according to testimony shared in the March report.

The Healthcare Equity Index survey, which dates back to 2007, is designed to help healthcare providers counter these concerns with policies that foster inclusive, nondiscriminatory patient care and workplaces. This year’s index assesses more than 600 hospitals and healthcare systems nationwide, including more than two dozen from New Jersey, 16 of which were awarded “leader” status for their efforts to improve LGBTQ care. (See page 71 in the index for ratings on all New Jersey facilities.)

“It’s important to create an environment where all patients can receive equitable treatment and where no one faces discrimination,” said Edward Hamaty Jr., a doctor of osteopathy who chairs the critical-care department at AtlantiCare Regional Medical Center, in Atlantic City, when the report was released this spring. AtlantiCare has received “leadership” status for six years, he said.

Tailoring programs to LGBTQ community

Other providers, like Care Plus New Jersey, a behavioral health provider in the northern part of the state, have created addiction recovery programs tailored to the LGBTQ community, including the ALLIES program, a peer-support group for teens. The Pride Center of New Jersey also hosts a diverse array of support groups, some of which address behavioral health needs.

New Jersey has also made state-policy strides in recent years to protect the rights of LGBTQ residents. Earlier this year, Gov. Phil Murphy signed legislation allowing for transgender individuals to amend the sex listed on their birth certificates by simply signing a statement attesting to their true identity, and another law ensuring death certificates match an individual’s accepted gender, which may not align with their biological characteristics.

More dedicated programs needed

But the role of community healthcare providers trained to address LGBTQ needs remains critical, and — while the options are growing — more dedicated programs are needed, deputy commissioner Cornell said Thursday in Asbury Park. In June, Elnahal also called on more providers to follow the lead of RWJUH and its PROUD center.

“When you go to a doctor’s office, you should feel welcome, comfortable, and confident that your medical issues will be addressed,” Cornell said, noting that social inequity is often associated with poorer health and wellbeing. The dedicated clinic will initially be opened several evenings a week and on Saturday afternoons.

Cornell also highlighted the important larger role played by the VNA’s Community Health Center, the federally qualified health center in Monmouth County that hosts the new LGBTQ program. Founded some two decades ago, the facility also provides dental care, mental health, and addiction treatment, as well as a wide variety of family health programs.

Cornell’s visit also served as a lead-in to National Health Center Week, recognized from August 12 to 18, during which DOH leaders will visit several FQHCs around the state, the network of 24 community-based centers that treat more than 500,000 New Jersey residents each year.

On Monday, state officials joined the New Jersey Primary Care Association — which represents these clinics — for a kickoff event in North Hudson.On Tuesday, Elnahal will return to the Newark Community Health Center along with Department of Education Commissioner Lamont Repollet and others to highlight the importance of back-to-school vaccines. On Thursday, DOH leaders will visit the Henry J. Austin Health Center in Trenton.