DIVERSE NEEDS Doctor targets better care for LGBT community BY BETH SCHWARTZAPFEL

When you get him going, Tim Cavanaugh thinks big. His blue eyes get bright and wide, and he runs his hands over his closely cropped hair. When you get right down to it, Cavanaugh, a family practitioner at Family Health Services, a community health center in Cranston, is an old-fashioned doctor. He takes care of children and their parents, he gives vaccines and does exams, he talks and he listens. As an openly gay physician, however, he also has a vision of "really basic, good community health for lesbian and gay people in Rhode Island." As such, Comprehensive Community Action, the Cranston-based agency that runs Family Health Service, recently received $15,000 from Equity Action, a new sexual orientation- and gender identity-specific philanthropic fund at the Rhode Island Foundation.

On one hand, Cavanaugh wishes that medical providers would focus more on lesbian, gay, bisexual, and transgender issues. LGBT people commonly face barriers to receiving high-quality medical care — for reasons ranging from ignorance, and a "don’t ask, don’t tell" policy, to outright discrimination. A recent survey of men who have sex with men (MSM, in public health parlance) by AIDS Project Rhode Island found that only 40 percent of respondents had discussed safer sex with a health-care provider, and almost 20 percent had experienced discrimination in the health-care system. On the other hand, Cavanaugh also bemoans the all-too-common response to this problem: focus on LGBT issues and LGBT issues alone. He points out that taking care of people’s health involves understanding "how they socialize, how they take care of themselves, how they express their sexuality. We don’t want to be the person they come to [only] when they want to get an HIV test or when they think they have an STD."

There are LGBT-specific health centers in big cities around the country, usually situated in areas with large gay communities, such as the Fenway Community Health Center in Boston’s Fenway neighborhood, and the Callen-Lorde Community Health Center in Manhattan’s Chelsea section. But Cavanaugh does not think this model would work in Rhode Island, because, as LGBT citizens, "we’re not sequestered and segregated. We really are part of a larger community with the way we all live." Therefore, one of the first steps Cavanaugh will take as part of this Equity Action award is to integrate an LGBT health clinic into the Family Health Services practice.

One benefit of this approach, he says, is that the practice will be a comfortable and appropriate place for entire LGBT families, because physicians there can take care of both children and adults. Another benefit is that it allows Family Health Services to be more accessible to people of color. The practice already serves a large Hispanic and Southeast Asian population, and Cavanaugh says people may feel more comfortable attending a community clinic than a clinic specifically identified as a gay health center.

Other plans for the funds include hiring an outreach worker, who will reach out to Rhode Island’s LGBT community in bars and clubs, distributing information and answering questions about health-care, prevention, and the services available at the clinic. The clinic will also sponsor a Men’s Health Day on March 19, with free HIV and STD testing, hepatitis vaccination, massage therapy, and body fat index testing.

These are the small steps, Cavanaugh says. Getting back to thinking big, however, if he really had enough money, he would buy a bus: "Our own, fabulous LGBT mobile clinic, with banners, great fabrics, and good music." The bus would travel the state and all of New England, attending to all the health needs of the LGBT community, offering HIV and STD testing, but also mental health and substance abuse care, and resources on exercise, sleep, diet, and healthy relationships. He gets almost a dreamy look, talking about it. "Priscilla," he would call it, "Queen of the Health-Care System."