Diana Fraser says her work on “Patient No More” started because she didn’t want anyone to feel afraid seeking health care.
“I have always been a public health nerd, and in all my pre-med experiences I never heard about queer health care. I learned a lot while candy striping at my local hospital in rural Pennsylvania, but nothing about queer health. I went to a summer pre-med program in Pittsburgh, and still didn’t learn about queer health. I was pre-med in college before switching to a film major — I never heard about queer health there either. When I graduated and had to establish my own health care, I still had never heard about queer health in a mainstream, medical fashion.
“Thankfully, the queer community takes care of its own. When I mentioned my concerns to queer friends, I learned about the underground queer health care network. I also discovered there was no film at the time that talked specifically about the barriers queer womxn face in accessing affirming care. I felt very strongly that our community, and perhaps even more so the medical community, needed an educational documentary that could name these barriers in a human voice. For more than two years, I wrote grant proposals. I finally received funding through the Minnesota State Arts Board in 2018.
The film opens with the question, “In the broad scale of things, when I say ‘health care,’ what do you think of?” Leisha Suggs, a mental health therapist, responds, “The first image that comes to mind is a dude in a white coat.”
Historically, as Dr. Deb Thorp of the Park Nicollet Gender Services Clinic points out, clinicians were not required to be educated in LGBTQ+ health care. That is why patients like Venus DeMars, a trans artist and musician, was told by their health care provider in the 1980s that care could no longer be provided because “there is no health care system for trans people.”
DeMars, who was assigned male at birth, discovered a hereditary thyroid condition that is typically passed down to women. After discussion with their mother, DeMars found out that they were likely born intersex.
“I was born in the 1960s, and a lot was going on without discussion with the parents,” DeMars says. “The doctors would just make that decision and do the surgery.”
DeMars’s spouse, poet Lynette Reini-Grandell, says when they were in their mid-30s, thinking of getting pregnant, DeMars had already started treatment. They would need a sperm donor.
“We went to a fertility specialist and got a very cold response. I didn’t feel confident enough to advocate for myself at that time,” Reini-Grandell says. “I got to know a nurse there pretty well, who told me the donor we were using was pretty old sperm. Why didn’t the doctor tell me that, you know?”
As the documentary shows, the process of trying to conceive for same-sex couples looks different than it does for heterosexual couples. Megan Peterson of Gender Justice points out that straight couples can tell doctors they are having trouble getting pregnant. If they have attempted to conceive naturally for at least six months, they will likely get insurance coverage for infertility treatments. For same-sex couples, that same six-month criteria cannot apply, and many receive no insurance coverage as a result.
The Trump Administration’s rollback on Obama-era transgender health care protections targets LGBTQ+ health care as well as insurance.
“We need advocates not just with health care providers, but with health insurance, too,” says Joann Usher of JustUs Health. Having proper health care and well-trained doctors doesn’t mean anything if LGBTQ+ patients can’t afford the care.
In the film, former Minnesota House Representative Erin Maye Quade discusses her experiences as a lesbian, as well as comments she has heard from community regarding health care.
“I have had people from all over the state tell me how badly they want to have children but how difficult it is because doctors don’t understand the process for same-sex couples,” Maye Quade says. “It’s so expensive, or same-sex couples get locked out of adoption. Judgment [can] get in the way of quality health care.”
Dr. Haylee Veazey of Hennepin Healthcare begins each session with a patient by letting them know how they can refer to her. “I say ‘My name is Dr. Haylee Veazey. You can call me Haylee, Dr. Veazey, or Dr. Haylee Veazey. I identify as a trans woman, and my pronouns are she/her. What about you?’ Hopefully [that enables] my patients to feel comfortable sharing that, too.”
For many LGBTQ+ people, finding a health care provider with similar experiences is nearly impossible.
“It is very likely for a white queer woman to have a white health care provider, and it is probably likely that a white queer woman will have a white queer woman provider,” says Nafeesa Dawoodbhoy, formerly of SPIRAL Collective. “But the chances of a queer woman of color having a queer woman of color provider are like like . . . magical unicorns.”
The documentary addresses this disparity by exploring how demographics — especially queer folx of color — are left out of the health care industry, leaving queer patients of color unlikely to find providers with shared identities and experiences.
As Katie Robinson, an educator with Family Tree Clinic, puts it: “Western science downplays what it doesn’t know.”
Looking to the future of health care, the message of “Patient No More” comes from a cautiously optimistic lens. There is an understanding that things can improve, but it will take a lot of work — and change — to get there. “We don’t need allies. We need accomplices at this point,” Maye Quade says.
With a short 53-minute runtime, “Patient No More” doesn’t cover all of the ways LGBTQ+ people are discriminated against in the health care system, but it opens up the public conversation about the work that needs to happen in order to improve on LGBTQ+ health care.
“Patient No More is available to stream now on TPT.
a documentary directed and produced by Diana Fraser of Pigtail Brigade Productions, LLC,