The first time Robert Davies mentioned to a therapist that he might be gay, she asked if he wanted to accept that or have it “fixed.”
Davies, now a psychiatrist and associate professor at the University of Colorado School of Medicine, did not talk about his sexuality again for years. His mission these days is to make it easier for other LGBT people to find mental health and medical care free of judgment or fear.
“The importance of just being able to go see someone for therapy, without any fear of how you are going to be perceived and if they are going to reject you, is a huge thing,” said Dr. Davies, who is vice chair of education in the medical school’s psychiatry department.
Last week, the new UCHealth LGBTQ Clinic opened at University of Colorado Hospital, a first-of-its-kind clinic in this state. The clinic provides mental health care, but can help patients create a network of medical care with doctors who are accepting and experienced in health issues for transgender people and gay men and women.
A sign in the waiting room says “I am,” followed by the words “gay, straight, trans,” all crossed out. “A person,” it ends.
Davies first thought of opening the clinic after reading a One Colorado report that found more than half of gay and trans people surveyed were afraid of how doctors would treat them when they found out they were LGBT. Nearly 30 percent of the 1,200 surveyed said their sexual orientation had prevented them from seeking medical or mental health care. Gay and trans people are also more likely to die by suicide. “There were so many people in this community who simply avoided health care because they assumed they were going to have a bad experience,” Davies said.
The statistics stuck in Davies’ head as he preached to his psychiatry residents that they should “find their passion,” seek outreach work and avoid thinking of psychiatry as a 9-to-5 job. One of his interns spoke about her plans to help the LGBT community. “It dawned on me that I needed to do something about one of my passions,” he said.
Psychiatry residents and faculty at the clinic will offer the psychological evaluations often required by surgeons before gender reassignment surgeries, as well as group therapy for families of transgender people. The clinic also has mental health services for people who are HIV positive and people — from adolescents to senior citizens — who are coming out as gay to friends and family.
Patients will get wellness assessments to see if they have primary care doctors or need help finding one with LGBT-related medical experience. The clinic can connect patients to HIV specialists and endocrinologists for hormone therapy on the Anschutz campus in Aurora. For trans people who have transitioned from female to male, finding a gynecologist is among the most daunting tasks.
Owen Ziegler, a patient of Davies who began his transition to male three years ago, has avoided making that appointment because he doesn’t want to answer waiting room questions about why a man is at the gynecologist.
Ziegler, 24, said his problems with depression and anxiety are biological, but also related to “living in a society that does not have space for you.” When he tried to end his life at age 23, he ended up in a Colorado Springs mental health clinic where he was treated “sort of like an alien.” That was before Ziegler had medically transitioned to male, and some of the clinic staff did not use male pronouns or his preferred name. They didn’t give him a roommate because they didn’t know whether to bunk him with a man or a woman.
“They didn’t know what to do with me,” Ziegler said. “I felt like I was being treated like less human, like I needed to be separated from everyone else because they didn’t know who I was.”
Besides the clinic, the medical school’s psychiatry department also has changed its curriculum in recent years to train residents in LGBT mental health care. The course, created by Davies about five years ago, is now required.
The point is to change the thinking that all people develop the same way, that, for example, adolescence is when all people develop a strong sense of identity. For a gay teenager, adolescence is often about “hiding who you are and developing an identity that is acceptable to people around you,” Davies said. Not understanding the difference in those experiences can cause mental health professionals to “pathologize things they don’t understand,” meaning it is seen as a symptom of an illness instead of a different life experience.
Third-year psychiatry residents will staff the clinic, along with several faculty from the psychiatry department. Social workers and psychologists also will see patients.
