CU Introduces an LGBT-Focused  Mental Health Clinic

Building 500 on the CU Anschutz campus looms above modern cars in lots like an art-deco anomaly amid fresher brick buildings and swift-footed millennials in scrubs. The arcane remnant has a distinctly noir feel to go with its solid reputation for being haunted by dead soldiers. Built in the time when Ford Model Ts were all the rage, the hospital was constructed specifically for WWI patients suffering from chemical-warfare injuries during missions throughout Europe. And until very recently, the campus itself was a chorus of groans from hopeful LGBT mental-health patients who desired targeted, specific mental healthcare for their unique needs.<

“There just wasn’t any,” admits Dr. Robert Davies, MD, associate professor in the Department of Psychiatry at the University of Colorado School of Medicine./p>

And it’s not uncommon. Healthcare tailored to the needs of the LGBT community is at a glaring lack in this country. As well, people who identify as LGBT often don’t seek healthcare that’s specific to their needs.

“I read the One Colorado report on access to healthcare and mental healthcare in the LGBT community,” he says, “and it struck me that so many people avoided mental healthcare because of fear. One of the biggest obstacles [isn’t] that people were being necessarily treated poorly, but that they just expect to be treated poorly, so they were avoiding mental healthcare altogether.

And thus, the foundation of the first LGBT-centered, mental-health clinic in the state of Colorado was wrought.

Dr. Davies spearheaded the addition of a mental-health clinic at CU that caters specifically to the LGBT community, and it’s known as the CU Health LGBTQ Mental Health Clinic at the University of Colorado Hospital.

The clinic is staffed by second- and third-year psych residents who deeply understand the upset of being cared for by LGBT-clueless providers who (often unwittingly) ruin even the most mundane of experiences and, in the process, deter future visits to healthcare facilities — in some cases, permanently.

One of those residents is Lexi Chavez, MD, a second-year psych resident who identifies as transgender. Her large, expressive eyes imbue conviction as she recalls past visits.

“When I’ve been to various providers, they’ve refused to use whatever pronouns I’ve asked them to. They’ve called me the wrong name, and they do it with a smile. They’re like, ‘How are you doing, [wrong name]?’ and, “He’s coming back,’ or something like that. I mean, I appreciate that, but it’s totally off base.” She shakes her head slightly.

So what does one do?

“You try and plow through it, and just be like, ‘Look. I’m here. I have this half an hour. I really need such and such,” she says. “At times, they’ll circle back around like, ‘No, really. Tell me this and that about your transition, but it’s like, ‘That’s not why I’m here.’ And they’re really focused on it. They’re like, ‘Ok, I’ve never dealt with this before. I don’t know anyone that’s trans, so what I want to do is stop all your medications.’”

(Repeat: “What I want to do is stop all your medications.”) For a trans patient dealing with say, cancer, such a move could spell a death sentence. In the wild, wild west of LGBT health issues, however, not knowing how medications and hormones some trans individuals take will interact with other drugs, doctors are hard-pressed to prescribe something that may cause or exacerbate sickness.

“I have hypothyroidism,” Lexi tells OUT FRONT. She needs proper medication for the illness, but “I can’t get that approved by my insurance company because my provider put that I’m trans in my medical record.” She’s exasperated. “I can’t get it approved. I think that [physicians] want to do right, but they don’t necessarily know the right way.”

But the omission of quality LGBT healthcare doesn’t rest entirely on the shoulders of mental-health clinics. For generations, the LGBT community has shied away from seeing a doctor for the very real fear of mistreatment.

“I refuse to go to the doctor, actually,” Lexi admits. “Not until I know I can get a good one. You don’t schedule appointments to have arguments.”

“For a long time, people haven’t sought mental health treatment in the LGBT community because of their fear of not being understood or being referred for reparative therapy or seeing being gay as pathology,” Dr. Davies adds.

Pathology refers to illness and disease, and reparative therapy, of course, is the contested practice of “curing” someone of their LGBT nature. And about those reparative therapies?

“There’s no evidence that it works or that it does anything,” he says. “It is a despicable practice which offers no benefit and most often causes irreparable harm.”

As a gay man who wasn’t always comfortable with that side of himself — for 41 years, to be exact — he knows what staying in the closet can do to a person’s mental health. Hiding who he truly was, he tells OUT FRONT:

“I was married to a woman for 20 years and have two wonderful children, both of whom are now adults and both of whom are now gay,” he says. “[41 years] was a long time and part of [being closeted] was just growing up in the family I grew up in, and fear of how that was going to be perceived.”

In the meantime, he says he had lots of gay friends, and “was a huge advocate on their behalf because it was the closest I could get to being who I was.” Eventually he came out and, as fate would have it, his family was fine with it. But often, the years-long suppression of self takes its toll.

“Why I’m doing child [psychiatry] in general is you can really make an impact on people early on that can change the entire trajectory of their life,” says Child Psychiatry Fellow Barbara Kessel, DO. “That, to me, is just so powerful.”

Lexi agrees. “We talk about how people are socialized and you’re trained from a very early age how to be a ‘good’ girl, how to be a ‘good’ boy and what that means. [There are] very strict, defined gender roles and you feel a conflict with that; not really feeling like what you’re being taught matches up with you know. It adds this layer of not feeling that people understand you to a certain degree, because there’s always something they don’t know.”

For trans people, that can result in a disconnect from a typical lived experience once he or she enters adulthood.

“You have to re-experience your own growing up, your own adolescence, and your childhood from a different lens,” she explains. “[You have] to understand what it means to live in the world a certain way because you don’t have the same kind of experiences other people do to identify with.”

Along with the clinic, Dr. Davies has put together a program for psych residents that trains them on LGBT-related health issues. As it stands, there’s “very little,” says third-year psych resident Cassidy Williams, MD. “There’s some kind of formal education that we get, in a scheme of, ‘Here’s a lot of cultural sensitivity and LGBTQ sensitivity that’s all been grouped together. But other than that, it’s pretty brief.”

Beyond the mental health aspect, there’s also a physical wellbeing factor that many doctors don’t take into account when dealing with transgender patients. Such as: “Cervical cancer screening,” Lexi says. “Pap smears are important for anyone with a cervix. So even if you have a [transgender] man coming in, if he has a cervix, he needs a pap smear. If you have a [transgender] woman coming in who has a prostate, when they get older they’re going to need that checked, as well.”

These are but a few among the exhaustive list of needs that the clinic aims to provide the community.

“When I interviewed here, Dr. Davies said, ‘Well, what are your interests?’” Lexi says. “I said, ‘I talked to some people about my child and research interests, but who do I talk to about expanding LGBT health?’ And he gets this grin and was like, ‘Well, that would be me.’”

Dr. Davies beams at the memory.

Lexi continues: “I’m amazed that this happened so fast. In my mind, I expected this to take five, six years — my entire residency — of working with this, trying to get people on board. And so [Dr. Davies] calls me into his office one day and says, ‘I’ve got good news: I got the go-ahead.’”

Her response? “Let’s do this!”

And now, with a supportive family and a passionate staff at his back, Dr. Davies can pay it all forward. Finally, the LGBT community here in Colorado is welcome to a mental-health clinic of their own.

That puts a mind at ease.