05/23/2011
● feature
www.OutFrontColorado.com
By Carolee Laughton
Every day hundreds of people arrive at emergency
rooms all over the metro area – sick, injured and worried. Without health insurance
or jobs, hospital emergency rooms are often the only recourse.
This scenario can be particularly true for trans people, who are frequently uninsured
at a higher rate than the general population or the rest of the LGBT community.
A 2010 needs assessment survey of Colorado’s LGBT community, conducted
by One Colorado Education Fund, an arm of the statewide LGBT advocacy organization
One Colorado, found that 29 percent of trans respondents report being uninsured,
compared to 15 percent of survey respondents overall.
Denver Health Medical Center is one institution that serves as a safety net for uninsured
patients, including the trans population. “Twenty-five percent of all Denver
patients come through Denver Health. Onethird of all Denver kids get their treatment
here. We don’t turn people away,” says Dr. Mark Thrun, Director of HIV Prevention and
STD Control at Denver Health. As part of former Mayor John Hickenlooper’s GLBT
Commission, Thrun helped ensure diversity training for some Metro area school systems,
as well as at Denver Health.
“Hospital employees receive yearly diversity training,” Thrun says.
Thrun says that diversity training is paramount for Denver Health employees, and that
nowhere else within Denver Health is sensitivity more vital than in the Emergency
Department (ED). That unit treats more diverse populations than any other part of the
hospital, so that department demands a staff responsive and understanding of various
communities.
But Crystal Ann Gray, a trans woman who lived in Denver until recently, has alleged that
Denver Health not only failed to address her complaints, but exacerbated her medical
problems through discrimination. Gray says, “December 4, 2009, was my
first visit to Denver Health due to rectal bleeding. … I was taken directly to a room in
the Emergency Department [for immediate evaluation].” She speculated that the problem
likely resulted from a complication of genital surgery undergone during transition.
While awaiting results of the blood test, Gray claims, an ED doctor told her he
received a call from a physician at the OB/GYN Women’s Clinic saying they were
familiar with transgender patients and should be able to help. Discharged, Gray left the
hospital with an appointment at the clinic two weeks later. However, shortly after that, the
problem resurfaced.
Gray claims that when she returned to the ED a second time for the same problem a few
weeks later, a doctor told her that she needed more care and sent her to the Adult Acute
Care Center for a CT scan. However, the scan showed nothing, she says, so she was
instructed to make appointments with both the Surgical and the GI Clinics.
“Things were still bad and got worse,” Gray says. By mid-January, she says, the
infection caused a vaginal discharge, and “[lab work showed that] I was severely dehydrated
due to not eating well because of my condition.” When a nurse drew two vials of blood,
Gray passed out. Later, when she awoke, Gray says she realized that “the ED thought I
was (at Denver Health) as a psych patient – not for a medical condition. ... I was forced
out without being admitted – no meds and no discharge orders.”
Gray claims that she has been in contact with Denver Health Patient Advocate Ely
Singleton since her first ED incident in 2009 and has filed several complaints that she
feels have not been resolved. She says that Singleton launched an investigation and she
was told that she would receive a final decision, which she has not received. Singleton
did not respond to calls for comment for this story.
Thrun, however, who is not associated in any way with Gray’s case or familiar with her
complaints, explained how the hospital handles patient grievances and provided possible
explanations for the results Gray experienced. An out gay man, Thrun is active in
Denver’s LGBT community, has served on the Mayor’s GLBT Commission, and is both
an employee and patient at Denver Health.
“As for Gray’s case, there may have been a very good reason why she ended up being
given a referral to another department,” Thrun said. She would have been assessed
in the ED, he says, and then it could have been determined that she needed more specialized
or non-emergency care. Thrun explained that, in the case of a complaint, a Patient Advocate serves as a
liaison between the hospital and patient. “Patient Advocates do an internal investigation,” he says. PA’s will
also facilitate a meeting between the patient and a care provider. Speaking generally about complaint outcomes
where the patient is not satisfied, Thrun said, “We are not always able to offer easy resolutions.” However,
he said, “It’s rare that I know of any complaint that hasn’t been resolved.”
Another trans woman, Stephanie Hickey, has also expressed frustration with the medical
center, attributing her problems to “a lack of communication between hospital and
patients.” In Hickey’s case, she complained to patient advocates from Medicare Select,
rather than Denver Health and decided to seek care elsewhere.
Gray, meanwhile, moved to Illinois, where she is happy with her medical care. She says,
“I’m OK here in Illinois. I’m not sure I would be in Denver.” While Gray and Hickey took different
actions, both women feel that they experienced discrimination because they are trans.
Gray is a trainer on transgender issues and has compiled a training manual that has been
used in various organizations. “I’d be very interested in seeing Crystal’s
TG 101,” Thrun says, “and happy to chat with her about the training.”
Dee Martinez, Director of Public Relations and Marketing at Denver Health, says that the Health insurance
Portability and Accountability Act (HIPAA) protects patient privacy and prevents anyone at Denver
Health from discussing specific cases. However, Martinez states that every patient complaint is
looked into. “Patient (Advocates) work very hard to work with the patient to make sure
that everything is rectified to their satisfaction,” she says. With Gray’s case, Martinez says, “We
took everything very seriously. ... There were a lot of conversations with Crystal.” Martinez
was not able to discuss those conversations. Because Denver Health does not issue
specific findings or a final report after dealing with a patient complaint, it is impossible to
determine the outcome of Gray’s complaint.
However, health care and health-related concerns in general continue to be an important
issue for Colorado’s LGBT community. In One Colorado Education Fund’s survey, this
issue ranked third in priority of needs within the community. As a result, One Colorado
has launched a health and human services initiative that will provide recommendations
designed to help Colorado’s LGBT community reach health equality.
“During our travels around the sate, we heard stories of LGBT people facing discrimination
and an array of difficulties in health care situations,” says Brad Clark, executive director of
One Colorado. “Gay teens coming out and being sent to mental health professionals who
recommend exgay therapy. Transgender Coloradans leaving the state in order to gain access to the
care they need. Individuals, couples, and families living without health insurance. From these stories,
we know that LGBT people in our state have unique health care needs and concerns. Through
our health and human services initiative, we are seeking to understand the state of LGBT health
and wellness in Colorado so that we can address the issues facing our community.”
More information on this initiative can be found at www.one-colorado.org.
● feature
www.OutFrontColorado.com
By Carolee Laughton
Every day hundreds of people arrive at emergency
rooms all over the metro area – sick, injured and worried. Without health insurance
or jobs, hospital emergency rooms are often the only recourse.
This scenario can be particularly true for trans people, who are frequently uninsured
at a higher rate than the general population or the rest of the LGBT community.
A 2010 needs assessment survey of Colorado’s LGBT community, conducted
by One Colorado Education Fund, an arm of the statewide LGBT advocacy organization
One Colorado, found that 29 percent of trans respondents report being uninsured,
compared to 15 percent of survey respondents overall.
Denver Health Medical Center is one institution that serves as a safety net for uninsured
patients, including the trans population. “Twenty-five percent of all Denver
patients come through Denver Health. Onethird of all Denver kids get their treatment
here. We don’t turn people away,” says Dr. Mark Thrun, Director of HIV Prevention and
STD Control at Denver Health. As part of former Mayor John Hickenlooper’s GLBT
Commission, Thrun helped ensure diversity training for some Metro area school systems,
as well as at Denver Health.
“Hospital employees receive yearly diversity training,” Thrun says.
Thrun says that diversity training is paramount for Denver Health employees, and that
nowhere else within Denver Health is sensitivity more vital than in the Emergency
Department (ED). That unit treats more diverse populations than any other part of the
hospital, so that department demands a staff responsive and understanding of various
communities.
But Crystal Ann Gray, a trans woman who lived in Denver until recently, has alleged that
Denver Health not only failed to address her complaints, but exacerbated her medical
problems through discrimination. Gray says, “December 4, 2009, was my
first visit to Denver Health due to rectal bleeding. … I was taken directly to a room in
the Emergency Department [for immediate evaluation].” She speculated that the problem
likely resulted from a complication of genital surgery undergone during transition.
While awaiting results of the blood test, Gray claims, an ED doctor told her he
received a call from a physician at the OB/GYN Women’s Clinic saying they were
familiar with transgender patients and should be able to help. Discharged, Gray left the
hospital with an appointment at the clinic two weeks later. However, shortly after that, the
problem resurfaced.
Gray claims that when she returned to the ED a second time for the same problem a few
weeks later, a doctor told her that she needed more care and sent her to the Adult Acute
Care Center for a CT scan. However, the scan showed nothing, she says, so she was
instructed to make appointments with both the Surgical and the GI Clinics.
“Things were still bad and got worse,” Gray says. By mid-January, she says, the
infection caused a vaginal discharge, and “[lab work showed that] I was severely dehydrated
due to not eating well because of my condition.” When a nurse drew two vials of blood,
Gray passed out. Later, when she awoke, Gray says she realized that “the ED thought I
was (at Denver Health) as a psych patient – not for a medical condition. ... I was forced
out without being admitted – no meds and no discharge orders.”
Gray claims that she has been in contact with Denver Health Patient Advocate Ely
Singleton since her first ED incident in 2009 and has filed several complaints that she
feels have not been resolved. She says that Singleton launched an investigation and she
was told that she would receive a final decision, which she has not received. Singleton
did not respond to calls for comment for this story.
Thrun, however, who is not associated in any way with Gray’s case or familiar with her
complaints, explained how the hospital handles patient grievances and provided possible
explanations for the results Gray experienced. An out gay man, Thrun is active in
Denver’s LGBT community, has served on the Mayor’s GLBT Commission, and is both
an employee and patient at Denver Health.
“As for Gray’s case, there may have been a very good reason why she ended up being
given a referral to another department,” Thrun said. She would have been assessed
in the ED, he says, and then it could have been determined that she needed more specialized
or non-emergency care. Thrun explained that, in the case of a complaint, a Patient Advocate serves as a
liaison between the hospital and patient. “Patient Advocates do an internal investigation,” he says. PA’s will
also facilitate a meeting between the patient and a care provider. Speaking generally about complaint outcomes
where the patient is not satisfied, Thrun said, “We are not always able to offer easy resolutions.” However,
he said, “It’s rare that I know of any complaint that hasn’t been resolved.”
Another trans woman, Stephanie Hickey, has also expressed frustration with the medical
center, attributing her problems to “a lack of communication between hospital and
patients.” In Hickey’s case, she complained to patient advocates from Medicare Select,
rather than Denver Health and decided to seek care elsewhere.
Gray, meanwhile, moved to Illinois, where she is happy with her medical care. She says,
“I’m OK here in Illinois. I’m not sure I would be in Denver.” While Gray and Hickey took different
actions, both women feel that they experienced discrimination because they are trans.
Gray is a trainer on transgender issues and has compiled a training manual that has been
used in various organizations. “I’d be very interested in seeing Crystal’s
TG 101,” Thrun says, “and happy to chat with her about the training.”
Dee Martinez, Director of Public Relations and Marketing at Denver Health, says that the Health insurance
Portability and Accountability Act (HIPAA) protects patient privacy and prevents anyone at Denver
Health from discussing specific cases. However, Martinez states that every patient complaint is
looked into. “Patient (Advocates) work very hard to work with the patient to make sure
that everything is rectified to their satisfaction,” she says. With Gray’s case, Martinez says, “We
took everything very seriously. ... There were a lot of conversations with Crystal.” Martinez
was not able to discuss those conversations. Because Denver Health does not issue
specific findings or a final report after dealing with a patient complaint, it is impossible to
determine the outcome of Gray’s complaint.
However, health care and health-related concerns in general continue to be an important
issue for Colorado’s LGBT community. In One Colorado Education Fund’s survey, this
issue ranked third in priority of needs within the community. As a result, One Colorado
has launched a health and human services initiative that will provide recommendations
designed to help Colorado’s LGBT community reach health equality.
“During our travels around the sate, we heard stories of LGBT people facing discrimination
and an array of difficulties in health care situations,” says Brad Clark, executive director of
One Colorado. “Gay teens coming out and being sent to mental health professionals who
recommend exgay therapy. Transgender Coloradans leaving the state in order to gain access to the
care they need. Individuals, couples, and families living without health insurance. From these stories,
we know that LGBT people in our state have unique health care needs and concerns. Through
our health and human services initiative, we are seeking to understand the state of LGBT health
and wellness in Colorado so that we can address the issues facing our community.”
More information on this initiative can be found at www.one-colorado.org.