Bal­ti­more VA works to ac­cept LGBT vet­er­ans

De­spite White House, agency bat­tles to win their trust

Baltimore Sun - - FRONT PAGE - By An­drea K. McDaniels

When Tracy Robertson served in the Air Force nearly 30 years ago, she didn’t dare re­veal to any­one that she was a les­bian.

“We had to be very care­ful,” said the 54-year-old from Bal­ti­more. “Not only could you get thrown out, but my big­gest fear was that you could go to jail.”

That dis­trust and fear of the mil­i­tary sim­mered for years after Robertson left the ser­vice. Of­fi­cials at the U.S. Depart­ment of Vet­er­ans Af­fairs, the health sys­tem for former mil­i­tary per­son­nel, think sen­ti­ments like this are keep­ing many les­bian, gay, bi­sex­ual and trans­gen­der vet­er­ans like Robertson from us­ing the ser­vices they are en­ti­tled to.

The fed­eral agency is work­ing to em­brace the very ser­vice mem­bers the mil­i­tary once os­tra­cized even as the Trump ad­min­is­tra­tion takes steps that could make such vet­er­ans feel un­wel­come.

“This is a group that has been long ne­glected his­tor­i­cally and we know that we have to put ex­tra ef­fort into mak­ing them feel welcome and cre­at­ing an en­vi­ron­ment where they feel com­fort­able,” said Michael Kauth, a direc­tor with the VA’s LGBTHealth Pro­gram.

Un­der the ini­tia­tive, the VA has placed co­or­di­na­tors in its hos­pi­tals, in­clud­ing the

one in down­town Bal­ti­more and those else­where in the re­gion. Doc­tors, nurses and so­cial work­ers have been trained to be cul­tur­ally sen­si­tive when treat­ing th­ese former ser­vice mem­bers. A web­site was cre­ated out­lin­ing the rights of th­ese vet­er­ans, and signs and other mar­ket­ing ma­te­ri­als have been placed in the lobby of VA fa­cil­i­ties. “We Serve All WhoServed,” reads one sign in a VA build­ing in Bal­ti­more. “Ex­cel­lent Care Has No Bound­aries.”

“It’s hard to get past fear,” said Jil­lian Sil­veira, the LGBT veteran care co­or­di­na­tor for the Bal­ti­more VA. “But we want them to know that we want to be their provider of choice. They de­serve the ben­e­fits they earned.”

The out­reach ef­forts were started un­der the Obama ad­min­is­tra­tion after re­peal of the “don’t ask, don’t tell” pol­icy; the re­peal al­lowed les­bian, gay and bi­sex­ual troops to serve openly in the mil­i­tary for the first time. Leg­is­la­tion a few years later lifted a ban on trans­gen­der men and women who serve.

Pres­i­dent Don­ald J. Trump has at­tempted to pull back the olive branch ex­tended to trans­gen­der sol­diers with an or­der in March that for­bids peo­ple who re­quire or have un­der­gone gen­der tran­si­tion from serv­ing. That or­der is be­ing chal­lenged in court.

For the sec­ond year, Trump also re­fused to ac­knowl­edge LGBT Pride, a month-long cel­e­bra­tion held ev­ery June to cel­e­brate the com­mu­nity.

The VA is mov­ing ahead with its out­reach any­way. LGBT co­or­di­na­tors and vet­er­ans will march in pa­rades and staff booths at gay pride celebrations around the coun­try this month. The VA has never had a pol­icy of not serv­ing the LGBT vet­er­ans, Kauth said, but agency of­fi­cials know that the per­cep­tion of the mil­i­tary in­flu­ences per­cep­tions of the VA.

The mil­i­tary doesn’t track the sex­ual ori­en­ta­tion of its sol­diers, but one count by think tank The Wil­liams In­sti­tute es­ti­mates there are about 1 mil­lion LGBT vet­er­ans.

“We know from re­search that many LGBTvet­er­ans come to the VAan­d­ex­pect to be treated just like they were in the mil­i­tary un­der ‘don’t ask, don’t tell’ and then the trans­gen­der ban,” Kauth said. “Many vet­er­ans don’t distin­guish be­tween the VA and the mil­i­tary and see it as the same or­ga­ni­za­tion. That be­lief cre­ates a high hur­dle for us in let­ting them know LGBT peo­ple will be treated well and will get good health care.”

Trump’s stance could make it more dif­fi­cult to at­tract peo­ple who al­ready may be re­luc­tant to use mil­i­tary ser­vices for fear their ben­e­fits will be taken away or that they won’t be treated hu­manely, ad­vo­cates said. They worry things could go back to the way they once were.

“The older the vet­er­ans are, the more they re­mem­ber how things were and how so­ci­ety was,” said Kim­berly Mor­ris, a trans­gen­der woman who is on the board of the Trans­gen­der Amer­i­can Vet­er­ans As­so­ci­a­tion; she served in the Marines for 20 years. “It is fear out of how things used to be.”

Mor­ris served in the mil­i­tary as a man, but now lives as a woman. She used to pay out of pocket to see coun­selors to avoid re­veal­ing to mil­i­tary and VA of­fi­cials that she was trans­gen­der. Now, she said, she gets great care from the VA.

Mark Pro­co­pio, ex­ec­u­tive direc­tor of the Mary­land LGBTQ ad­vo­cacy group FreeS­tate Jus­tice, lauded the VA’s ef­forts.

“There are mem­bers of our com­mu­nity who have served and have se­cured th­ese ben­e­fits that they have a right to,” he said. “I think it is good that the VA is at­tempt­ing to have stronger, more af­fir­ma­tive, high qual­ity care for this com­mu­nity, and they are also reach­ing out and mak­ing sure they feel com­fort­able us­ing th­ese ben­e­fits.”

Pro­co­pio added that there would be chal­lenges gain­ing trust be­cause of the Trump ad­min­is­tra­tion’s rhetoric. There are also many LGBT peo­ple who were un­fairly dis­charged be­cause of their sex­u­al­ity who don’t qualify for ser­vices, he said. At least one ad­vo­cacy group is try­ing to help th­ese per­son­nel get those dis­charges over­turned, Pro­co­pio said.

Shirley Maniece, 60, hid her sex­ual ori­en­ta­tion while serv­ing in the Air Force from 1979 to 1985. The Rosedale woman also said she was sex­u­ally as­saulted by a su­pe­rior while serv­ing.

After leav­ing the mil­i­tary she jumped from job to job. She of­ten felt de­pressed, with no real pur­pose. She wanted to bury the mem­o­ries of her mil­i­tary life, but couldn’t.

Iron­i­cally, it was the VA that helped her move on.

Afriend sug­gested she try to get help from the mil­i­tary health sys­tem. She was a lit­tle re­luc­tant, given her ex­pe­ri­ence. But when she went, she found doc­tors, nurses and staff that were sup­port­ive and helped her with her trauma. She bonded with other vet­er­ans with sim­i­lar ex­pe­ri­ences.

“I was fi­nally able to work through my is­sues in a safe en­vi­ron­ment,” Maniece said. “I felt free for the first time in years. I no longer felt like I was drift­ing.”

Robertson also suf­fered episodes of de­pres­sion so se­vere after leav­ing the mil­i­tary that she could not work. Be­ing un­able to live openly as a les­bian con­trib­uted to her feel­ings of in­ad­e­quacy, she said.

Robertson and Maniece want other LGBTvet­er­ans to start com­ing to the VA, but they know some still aren’t com­fort­able us­ing the agency’s health ser­vices.

The two now work as peer sup­port spe­cial­ists help­ing oth­ers as the VA once helped them. They will be at Pride at Druid Park this week­end reach­ing out to vet­er­ans.

While LGBT peo­ple go to the doc­tor for the flu, mi­graines and bro­ken arms just like any­one else, they also may have unique med­i­cal needs, such as anx­i­ety over not be­ing ac­cepted by so­ci­ety. Trans­gen­der pa­tients may be liv­ing as one gen­der, but still have the body parts of an­other. So a trans­gen­der man still may need to get a yearly mam­mo­gram or pap smear.

Part of Sil­veira’s job is to make sure doc­tors and other providers are sen­si­tive to th­ese is­sues.

Since the VA doesn’t track sex­ual iden­tity, it is hard to of­fi­cially track how well the out­reach is work­ing. But Kauth said there is ev­i­dence that it is. They know through med­i­cal codes that about 9,000 trans­gen­der pa­tients have got­ten hor­mone re­place­ment and other med­i­cal treat­ments. He said it used to be far fewer.

AMY DAVIS/BAL­TI­MORE SUN

Jil­lian Sil­veira, left, LGBT veteran care co­or­di­na­tor, with VA pa­tients Shirley Maniece and Tracy Robertson. Maniece and Robertson had to hide their sex­u­al­ity in the Air Force.

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