How You Gon’ Tell Me?!
The audacity of some people, man! Credit: Unsplash
Learning is lifelong, not just something that occurs only in K-12. Anytime I have the opportunity to learn something that benefits me or those around me, I pay attention so I can absorb the knowledge and use it. So, when my job offered free courses on rural health through the History and Health Program, I jumped on it.
Now, I don’t live in the country, but I grew up there, and I have relatives who still live out in “the woods.” I was also curious about what rural health is and how it differs from urban health, aside from location and the limited availability of medicine in the country. So, I scrolled through the different courses, selecting whatever caught my attention, when I saw it: LGBTQIA+ Health.
I said, “Fuck yeah!” and added it to the mountain of selected courses I’d chosen. (I have no idea how I’m gonna finish all of this shit. Someone help!)
After taking a couple of courses, I finally found my way to the LGBTQIA+ Health one. On the module overview page, it starts with how LGBTQ individuals, especially BIPOC LGBTQ and trans people, face many barriers when seeking healthcare in rural spaces. Then, it goes into the objectives. There were 3 in total:
1. Understanding the intersectionality of LGBTQ and rural identities in relation to the health disparities,
2. Identify at least 3 barriers and facilitators to accessing care for LGBTQ individuals, and (the most important part to this story—you’ll see why later)
3. Develop at least 2 resources or strategies to help support allyship to diverse rural LGBTQ communities.
Cool! I knew what to expect. I clicked next to continue.
The lesson started with basic LGBTQ terminology to help people familiarize themselves with it prior to the core lesson. There were 19 terms altogether, and I knew all of them except gender-expansive. I think it may have been my first time seeing that, not entirely sure. So, I familiarized myself and kept it pushing.
Gender-expansive: An umbrella term for a person with a wider, more flexible range of gender identity and/or expression than typically associated with the binary gender system. Often used when referring to young people still exploring the possibilities of their gender expression and/or gender identity.
After this section, I quickly realized that the main portion of the lesson seemed to focus on AIDS and HIV, even though there’s more to LGBTQ Health than that! There’s mental health, substance use, cancer screenings, gender-affirming care, etc. We are experiencing so many other issues along with or besides AIDS and HIV that need addressing, but what do I know? And who the hell created this course!? Uh, I digress….
The lesson listed all kinds of statistics and facts, and I was soaking it in. “Between 2.9 and 3.8 million LGBTQ people live in rural USA,” and there’s no solid definition for “rural” when it comes to collecting data. One thing that was interesting, but not surprising, was that even though the AIDS epidemic began in the early 1980’s, the CDC didn’t start collecting data in rural USA until 1991—a whole decade later! Particularly in the southern USA, rural areas saw the highest increases in AIDS causes (yes, causes, not cases), which doesn’t surprise me. I grew up in the rural south, so I can just imagine.
Sometime after this point, minority stress theory was mentioned without a follow-up or definition, and I was lost. I hadn’t heard of this theory before. So, I looked it up:
Minority Stress Theory suggests that because of stigma, prejudice, and discrimination, lesbian, gay, bisexual, trans, and other queer people experience more stress than do heterosexuals and that this stress can lead to mental and physical disorders.1 Although this is heavily associated with Ilan Meyer’s sexual and gender minority research, it can be applied to other marginalized groups.
Makes sense! The more stress you have to deal with, the more your mental and physical health are at risk. As a Black queer woman, I can attest to this. Nerves? Good bill of health? Peace of mind? What are those? Wish I had them!
But mostly, the lesson listed things that I already knew, like how hospitals and clinics aren’t well equipped, lack AIDS and HIV resources, educational materials, and training. Confidentiality breaches, low testing, stigma, and high rates of uninsured people. The list was long, so I won’t mention everything; these are all things I’ve witnessed growing up in Bumfuck, Virginia, though. I've even experienced some of them myself, unfortunately, and it’s left some scars. It’s one of the reasons why I jumped on this learning opportunity so fast.
As I neared the end of the lesson, I realized it provided many case studies but few ways to advocate for ourselves or to explain how allies could assist. I know this lesson was geared toward LGBTQ allies, but it didn’t give them or us, LGBTQ people, much. I did leave some feedback at the end of the course, and hopefully, they change that in the future.
Anyways, the very last section was a prompt. There were 3 I could choose from, and I chose the easiest one. “How will you use what you’ve learned in your community and workplace to help the rural LGBTQ individuals in the scope of healthcare?” Not sure if that was the question word-for-word, but that’s the gist of it.
At first, I didn’t know what to write. Even though I have this blog and the podcast, I didn’t feel like I could do much beyond that, especially since I don’t work in healthcare. I thought I had to bullshit my way through this question, but then I realized that I really didn’t have to because 1) I am a Black queer woman from the rural south, 2) a person whose come up against ridicule and discrimination in healthcare spaces, and 3) just took a whole basic ass course on this. So, all I really had to do was relax and write from a place of thoughtfulness and experience.
So, I got to writing!
I wrote about the familiarity of the course's concerns and issues, and how it also highlighted new ones. Then I described how I’d apply this new knowledge in my community and workplace by keeping an open mind and heart, directing people to various resources, and sharing my own experiences. I won’t go into great detail and list all the flowery stuff I put down, but I did mention the blog, podcast, and volunteering in my spare time, and how I use those spaces to create awareness.
Once I typed all that out, I hit submit and patted myself on the back. I was so proud of myself for finishing the course and writing something genuine that I almost wondered why I felt a tinge of uncertainty when faced with the prompt. Energized and ready to tackle anything, I logged out of my student portal and began working on several tasks for the blog.
For these courses, you don’t receive a letter grade. It’s either completed or incomplete. Completed means that you fulfilled the assignment or prompt at the end of the course and are knowledgeable of the lesson’s materials. Incomplete, obviously, means you did not fulfill the assignment or prompt and don’t know shit. So, you have to go back and at least redo the assignment or prompt.
Thus far, I’d passed every course I’d taken. They were pretty easy, and it helped that I was deeply interested in the topics, so not passing wasn’t a worry of mine. I don’t know how long it took for the instructor to actually grade it, but it seemed like forever. When I finally got the email saying the instructor had left a comment on my submission, I logged into my student portal immediately… and was not happy!
“Incomplete,” was all it said.
“What the fuck?!” is what I said.
I was trying to figure out why they gave me an incomplete as I scanned through my prompt, but I couldn’t come up with an answer on my own. I addressed everything they asked me to: how I’d communicate with those in my community about the struggles of those in rural areas, share my own experiences, and share resources. I mentioned a whole bunch of things that would help LGBTQ people in the rural USA. But it wasn’t good enough, and I just couldn’t wrap my head around why they’d think that, especially seeing as I am from a rural area.
Like, how you gon’ tell me, of all people, that I don’t know what I’m talking about? I lived in that lame, country ass place for 18+ years and had to put up with some wild, unnecessary shit. Racism, homophobia, sexism, harassment, and so much more, on top of being uninsured, afraid of disclosing my sexuality at hospital visits, and not getting the care I needed because I had to rely on someone else to foot the bill. I could add more to this list, but we’d be here all day. I may live in the city now, but the country is where I was born and raised. I know exactly what LGBTQ people who live in the woods go through. When I go into the hospital or a clinic, I am still that country girl who wishes to be heard and treated fairly.
Promptly, I sent that instructor a message, asking what it would take to get a complete because it just didn’t make sense to me why I didn’t pass. I figured it’d take at least a few days for them to get back to me since it took them a while to grade me.
Several days passed before I finally got a response.
“Hi, Toni! This assignment is complete, and no further action is needed.”
When I checked the course on the overview page, it still said incomplete, but when I clicked it, it did indeed say complete. Complete was also listed in the link attached to the email. With this, I was satisfied. Then, I moved on to the next course.
I know I needed the instructor's approval to pass the course, but the fact that my lived experience, one that mirrored many of the concerns and topics within the lesson, wasn’t enough blew my mind. Were they the expert of LGBTQ trauma in LGBTQIA+ healthcare? What did they know that I didn’t? I was almost curious to ask in the comments, but I left it alone. I deal with people like that on a regular basis and didn’t want to get my blood pressure up.
And maybe the instructor just accidentally clicked the wrong button, making a mistake, but that mistake hit a nerve. There are so many people who are unwilling and willing to listen to our woes, only to tell us we’re trippin’ or don’t know what we’re talking about. It’s like they want to invalidate us so that we conform or just shut the fuck up because people like that don’t truly care, and those people aren’t allies. They aren’t understanding, knowledgeable, kind, or who they portray themselves to be. They’re absolute shit! Bottom of the barrel! People who perpetuate the discrimination we face in most, if not all, aspects of life.
I’m glad I’m taking these courses. I’ve learned quite a bit about midwifery, mental health, and more. There’s more on Black rural health that I can’t wait to dive into. It’s feeding my soul and desire to learn. I just wonder if I’ll get the same instructor for another course. I hope not, but if I do, I’ll be ready to put their ass in check.
I wanted to share some of the knowledge and information I gained from the course. I can’t share everything, since most of the content is available only to students, but it’s better than nothing, right?
Resources:
Inclusive Language Guide, https://www.ohsu.edu/inclusive-language-guide#section-1615981
LGBTQ Glossary, https://lgbtqia.ucdavis.edu/educated/glossary
Science Direct’s Minority Stress Model, https://www.sciencedirect.com/topics/psychology/minority-stress-model
RHV Podcast, Episode 61: Transgender Health, https://vrha.org/2021/08/04/rhv-61-transgender-health/
Where We Call Home: LGBT Rural People of Color in Rural America, https://www.lgbtmap.org/file/lgbt-rural-poc-report.pdf
