20 — OUT IN THE MOUNTAINS — FEBRUARY 1998 __he A ‘fl V 2 Church St. Burlington Leah Wittenberg I..ir,1'nsc-ti (_"Iini<:’aI Mental Hmlth (.'oun5eI()r Psychotherapy for Individuals and Couples Lesbians Considering Parenthood Body Centered Psychotherapy (802) 865-4568 Associates in Recovery Milton, Vermont (802) 893-4816 _ Janet K. Brown, M.A., C.A.D.C. LICENSED PSYCHOLOGIST - MASTER CERTIFIED ALCOHOL AND DRUG COUNSELOR Jedn Townsend, M.A., LICENSED CLINICAL MENTAL HEALTH COUNSELOR L.C.M.H.C. Burlington, Vermont (802) 863-8162 Swedish - Reflexology Prince Heal I ng Bodywork - Polarity - Reiki Master Bevel with abandonment to a truly great massage rarely found anywhere. And be your best again. Jhorev (802) 785-2244 V Professional Confidential James R. Nelson IVIACP Psychotherapist (802) 651 -7 764 Burlington, VT 05401 Iren Smolarski MA Psych.; Ph.D. Lit. Individual & Couples Psychotherapy Toward Intimacy Group for LGBT now forming . 658-8401 Fee based an Individual Means RAINBOW THE ALL INCLUSIVE ALTERNATNE PERSONAL INTRODUCTION Toll Free l-888-899-RCOF(7263) P.O.Box 518 Merrimack NH 03054 email: RainbowCOF@aol.com - SERVICE » ServingNew Enl d ellbeing Lesbians Challenging Barriers - The Search for Adequate Health Care for Older Women - Part I . BY CHRISTINE DESROSIERS AND Joy D, GRIFFITH The twentieth century's twilight is witnessing a dra- matic shift of focus in many aspects of health care and medicine. While the medical establishment's values gravi- tate towards high technology, the public’s interests surround issues of choice and respect. The quality of American health care is coming under increas- ingly close scrutiny as patients are demanding more informa- tion and more freedom to de- cide which treatment options fit in with their personal ex- planatory models and beliefs. Another apparent prior- ity of many health care con- sumers is to be treated with respect by their physicians. Many people are fed‘up with the tradition of the physician's absolute authority over diag- nosis and treatment, as well as the overwhelming paternalism encountered in the doctor’s office. This tradition comes into particular conflict with minorities, ethnic, gender, or otherwise. One such minority is the ever—growing ”older” segment of the population, those indi- viduals at and past retirement. age. These people routinely face great difficulties in finding health care appropriate to both their physical and emotional needs. Women, in particular, ‘find the attitudes of physicians towards older people trouble- some and often a magnifica- tion of the sexism inherent in Western medicine. When these older women are also lesbians, the triple threat of ageism, sex- ism, and homophobia can be enough of a barrier as to pre- clude some women from see- ing a doctor altogether. We seek to explore some of the issues surrounding older women's, especially older les- bians’, search for adequate and appropriate health care, using three personal interviews and research. In addition to high- lighting possible causes of the difficulty of this search, we will discuss ways the interviewees have found to circumvent these problems, as well as sug- gesting ideas to improve an older person's situation in so- ciety generally. The first part of the prob- lem of poor health care for older individuals is the huge body of stereotypes American society holds regarding that segment of the population. Ste- reotyped images range from the grumpy, argumentative old widower to the kindly, obse- quious old granny to the senile, fragile nursing home resident, among a host of other negative images. Of course, these people do exist, but the danger comes when their images are used to generalize across the vast range of individuals found in the vast category of ”senior citizen.” These views are seen every day in the me- dia. Television, in particular, portrays older Americans in ‘commercials for insomnia, in- digestion and hemorrhoids. The negativity of West- ern culture towards aging can find its roots in what values are held in high esteem. Ameri- cans value youth, money, and power which includes produc- tivity, independence and vigor. Western stereotypes of aging embody the opposite of each of these valued attributes, mak- ing aging one of the most un- desirable conditions possible to many people's imagina- tions. Of course, these negative stereotypes and opinions be- come deeply internalized, leading to a dissatisfaction with, or sometimes absolute hatred of, oneself as one goes through the aging process (sometimes beginning at age thirty, as is often discussed in television sitcoms). One interviewee, A.P. who is 73 years old, confessed to dislik- ing the wrinkled face she sees in the mirror. She feels ”turned off” by old people, asserting that she does ”not want to be like that.” Additionally, even she (who is quite vigorous) has been ”conditioned” and some- times finds herself passing judgment on people, making remarks about someone being too old to do something. 5. T. (71 years old), also expressed a dislike for the images of ag- ing, rejecting the term ”eld- erly” because of its connota- tions of feebleness and incom- petence. ' Considering these stereo- types are pervasive and influ- ential enough to negatively af- fect an individual’s personal experience of aging, there should be no surprise that they also are deeply ingrained in the minds of physicians and other health care workers. Add to this ageism the sexism that is still found in ev- ery corner of American society, and you have a nearly impos- sible situation for aging women. Homophobia is the fi- nal hurdle. When this is present in the health care set- ting, many problems in obtain- ing proper respect and treat- ment arise, including assump- tions of heterosexuality, lack of trust in the staff, difficulty in talking with the provider, and giving the patient wrong infor- mation. As sexism does not disappear in a woman's life, homophobia and heterosexism also do not disappear over the lifespan. Medical school gradu- ates are deeply indoctrinated in the superiority of American medicine and their own au- thority. Couple this with con- siderations of religion, race, ethnicity, gender and age and an interrelated disturbance has been formed. There seems to be a widening gap between the way doctors are practicing medicine versus what people are finding satisfactory in in- teractions with doctors. Pa- tients are now being empow- ered in their dealings with doc- tors; they are encouraged to ask questions, discuss treat- ment options, and perhaps most importantly, voice dis- agreement and not ”automati- cally assume that (they) are...wrong” states Tomb from ”Growing Old”. ‘ Yet geriatrics has many problems inherent in the field. There are only 900 gerontolo- gists across America and they are primarily middle-aged white males! Geriatrics is con- sidered a low status speciality leading to low recruitment in this field. The final stage of hu- man life is not attractive to the young graduate and this spe- ciality of ”low status” com- bined with poor facilities has created negative attitudes. On the other side of the ocean, however, England has as many geriatric psychiatrists as there are cardiologists due to their attitude that the quality of life in old age takes precedence over preventing heart attacks. The quality of life is an ac- cepted focus above the attitude of aggressive curing (or at- tempts to cure). [Part II for March: Suggested models leading towards attitudes ofchrmge...] Voices From the Mountains continued from page six critical. There is little doubt that Vermont is more supportive of questioning and queer youth than many other areas of the country; but this will not continue without the support of each individual. As gays, lesbians, bisexuals and transgendered persons, we have coined the term ”family,” so let us start to act like one. We can no longer allow members of our ”family” to commit suicide or be forced into ”unhealthy” relation- ships simply because they have nowhere" else to turn. After all, what if Peter or I had been your son?