14/04/2020 | Writer: Koray Başar

Assoc. Prof. Dr. Koray Başar: The difficulty that LGBTI+'s are facing multiplies in such epidemics, disasters and mass traumas.

LGBTI+'s during COVID-19 outbreak: Are we all in the same boat? Kaos GL - News Portal for LGBTI+

Assoc. Dr. Koray Başar from Hacettepe University Faculty of Medicine, Department of Mental Health and Diseases evaluated the COVID-19 outbreak to KaosGL.org from LGBTI+'s perspective:

Unfortunately, the COVID-19 outbreak is now affecting almost the entire world, and its effects on bodily, mental and social welfare in every society are not equal. It is not possible to not to be directly or indirectly affected by this outbreak, this is the right side of the trending saying 'we are on the same boat'. But there is more to it, we are not on the same compartment of that boat. It doesn't matter if the boat is steadily sailing, taking water or sinking. Among those at greater risk of the effects of the outbreak, those who are deprived of the blessings of living in a society for almost every period takes an important part. The difficulty that is faced by those who are admitted outside the ring because of their gender identity, gender expression, sexual orientation, is exponentially increased in such epidemics, disasters and mass traumas. There's another risk group here, which isn't excluded under normal circumstances, and that's health care workers. I will not go into the details of the reasons for this, but the difficulties of the health care system, organizations, and employees in the face of the epidemic have an impact on LGBTI+ health and welfare, so it cannot be ignored.

The suggestion that we often reiterate to protect everyone from the negative effects of the outbreak on mental health is to keep the physical distance, while maintaining social intimacy, keeping interpersonal ties strong. A significant proportion of LGBTI+ community members are disadvantaged in this respect, we know that social support for them is less. Especially if they live with a family that does not accept the person by their own identity, similar to the women who are victims of domestic violence, the state of being locked in these houses risks increasing physical, verbal, sexual violence. In these respects, I am aware even in the usual circumstances that health care providers can't provide the necessary support. This group is far behind the rest of the public in terms of access to health care in a similar way to the disadvantaged state of social support. Yet, the lack of professional support seems to be a major problem at such a time when it’s needed the most. I think LGBTI+ organizations, which have survived despite all the pressures for years, have an important task to meet the need for social support for both those who are at risk of violence and oppression and those who are not with their families. Apart from associations, this community needs to think about developing new ways and mechanisms of solidarity, as we can't predict how long this process will take.

We know that the LGBTI+ group has seen more mental and physical diseases than the rest of the public due to the stress experienced in a chronic way. The execution of health services in exceptional circumstances by prioritizing COVID-19 means that the need for medical support during this period, especially psychiatric support, is not met. For example, if you are being treated for depression, hypertension or HIV, you may have difficulty maintaining them during this period. Moreover, many previously diagnosed health conditions are increasing the tendency to the mental and physical negative effects of this process. When you try to access health care, albeit limited, the access of LGBTI+ may not be equal to everyone's, similar to the usual circumstances. Although professional associations of healthcare workers emphasize that they are sensitive, this period also lays the groundwork for discrimination in the health service, unfortunately.

The difficulty in accessing health care may well be associated with COVID-19. Aside from inequality in accessing measures that may be necessary like masks, there is a risk of discriminatory treatment such as in every period, being tested or treated when symptoms are developed. I think it is important that LGBTI+ organizations inform and encourage members of the community that they can get in touch and develop a model of solidarity.

Apart from these general health issues, I should stress that there is a significant disruption to the gender transition process. Psychiatric monitoring, hormone therapy and surgical procedures related to the transition process, such as other medical practices that are not considered urgent or vital, cannot be continued during this period. As a doctor, I suggest that no one should risk themselves by going to hospitals to maintain these services, because hospitals are now an important source of infection. So even if you can access it, I wouldn't suggest you to go to the hospitals. I know it's hard to accept, but delaying the operations that have not yet been initiated to the end of this unusual period would be more appropriate for the health of the person. However, it is necessary to continue the hormone therapy you started. This can disrupt the necessary checks in the routine a little bit, you can discuss the effects and side effects over the phone or online support centers developed in many hospitals. An important problem here in our country is that there are problems with issuing medical reports and prescribing these drugs when the gender info is not changed, you may not find these drugs available in the market. I don't know the level of the problem on this issue, but I suggest that treatments shouldn't be increased or decreased according to the person's own decision or by the suggestion of others without consulting a doctor. We recommend surgical procedures be postponed. However, if surgery is performed and there is a problem, the doctor must be contacted. It would be appropriate for the doctor to decide if any intervention is medically suitable to postpone and to what extent.

The effects of this outbreak are expected to continue even if the epidemic has subsided. In other words, problems are expected in the medium and long term in the health service due to the exacerbation of health problems that are not now less prioritized after the outbreak or the continued physical and mental effects of the outbreak. Unfortunately, this is not an issue where the LGBTI+ community can intervene with their own means, it is the work of the administrators. However, by keeping this in mind, it is necessary to give priority to surviving this period and as healthy as possible. We must do as hard as we can to protect ourselves and each other and to raise this effort with solidarity.

Translation: Yiğit E. Korkmaz


Tags: human rights, health
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