Bianca Nicole performs at the drag show at Play Dance Bar in Louisville, Kentucky. (Photo by Natalie Keyssar)
Louisville residents say their city is more like a big small town. Its neighborhoods — Butchertown, NULU, the Highlands, Old Louisville, Downtown — are never more than a 15 minute drive from one another. And the Victorian homes peppered throughout the city are often dwarfed by ancient trees twice their height.In the middle of it all, the University of Louisville School of Medicine's modern concrete and glass campus has been home to innovation for more than 100 years. Its accomplishments include the first implantation of an artificial heart and the first successful hand transplant.
Andrea Tucker, a 29-year-old transgender woman, shops at her favorite used video and book store in Louisville. (Photo by Natalie Keyssar)
In 2009, a Louisville-based doctor insisted to a gay patient that his sore throat was likely HIV, according to a complaint the patient submitted to the Kentucky Board of Medical Licensure. He told her he had tested negative for HIV three weeks earlier, but she didn't believe him."I looked her in her eyes as I begged her to describe the other symptoms that informed her diagnosis that something as profound, as life changing, as HIV was my probable fate," the man, whom VICE News was not able to reach and therefore chose not to identify, wrote in the four-page letter obtained by VICE News. "She stared blankly back at me without answering."After leaving the man to wait for half an hour, the doctor gave him a refund and sent him away.Related: How Some US Doctors Are Hindering HIV PreventionThe next morning, his throat was so swollen that his boyfriend of eight years took him to a clinic inside a grocery store. They sent him to an emergency room, where he was diagnosed with acute pharyngitis, a sore and swollen throat likely caused by a bacterial infection. He didn't have HIV, and he recovered with some antibiotics and steroids.The doctor told the medical board that this was a lack of insurance issue, and nothing more. The board ruled that the misconduct did not warrant disciplinary action, but it did warrant a formal letter of concern.
But not all LGBT patient encounters with physicians are so extreme. In many cases, doctors just don't know how to talk to them.For instance, when second year University of Louisville medical student Adam Neff, 24, asked his physician for STD testing three years ago -- before he'd come out as gay to his extended group of friends and family -- he said his doctor acted disinterested and disregarded him."I think he knew," Neff said. "I didn't go to another physician for a year."Another medical school student, Virginia Ferguson, 24, said it was years before a doctor finally asked her about her sexual orientation, but the doctor did it in front of Ferguson's mother. Ferguson was out at the time, but if she wasn't, the doctor would have forced her to have that conversation with her family before she was ready, she said.Still, before that appointment, Ferguson said doctors asked whether she used condoms without considering that perhaps she wasn't having sex with men. When she answered that she was sexually active but didn't use them, she said doctors would give her "looks.""I was always kind of confused," she said.The University of Louisville program aims to churn out doctors who know better.
Adam Neff, a second year medical student at the University of Louisville, spoke about an awkward encounter with a doctor before he came out as gay. He said he hopes the new curriculum will help the school churn out better doctors. (Photo by Natalie Keyssar)
Virginia Ferguson, a first year med student, arrived on campus this summer. (Photo by Natalie Keyssar)
At 12 years old, Giannova said she began dabbling in hormones by stealing them from her father's drug store. At 25, in 1976, she told her wife that she was transgender, but at the time, they didn't know what it meant and hoped Giannova would outgrow it somehow.Four times over the three decades they were married, Giannova decided she couldn't take it anymore; she needed to live as a woman. But each time, her wife threatened to leave and went running to the church to tell its members."'Brother, you need help,'" Giannova recalled fellow churchgoers telling her. "The only kind of mental health you can get is conversion therapy."Wanting to hold onto her marriage and her four children, she spent 25 to 30 years in conversion therapy, which is aimed at changing someone's sexual orientation from homosexual to heterosexual. The American Psychological Association opposes it, and several states have passed laws to prevent health care providers from offering it to patients.
Bobbie Giannova sits in a pew at the Metropolitan Community Church, which serves LGBT parishioners in Louisville, Kentucky. (Photo by Natalie Keyssar)
Although the Supreme Court ruled in favor of marriage equality this summer, making same-sex marriage the law of the land nationwide, Kentucky was no where near passing any such law on its own, said Chris Hartman, who directs the Fairness Campaign in Louisville.The nonprofit LGBT advocacy group was founded in 1991 to pass an anti-discrimination ordinance after two high profile firings of gay and lesbian employees in Louisville. It finally passed in 1999, but a government restructuring meant they had to pass it again in 2004, when there was still a vocal opposition, Hartman said."We're southern-ish," Hartman said. "There's a long, storied history of republicans and democrats being opposed to LGBT rights. It's finally softening, but it's 2015."Now, seven other Kentucky cities have anti-discrimination laws, but 75 percent of Kentucky's LGBT citizens are still vulnerable."You can get married today and be denied an apartment tomorrow," Hartman said.A holy warOne of Giannova's employers is a Baptist institution, but she works remotely and they don't know about her transition, even though it's been several years. She just hopes they don't find out and use it as grounds to fire her because the anti-discrimination ordinance doesn't apply to religious institutions.
People at the University of Louisville believed it was the first school to have the capacity to pilot the eQuality program, thanks in part to its thriving LGBT center. And it didn't hurt that a straight 3rd year student primed administrators without realizing it after taking an LGBT elective course and wanting to know more, Steinbock said.
Stacie Steinbock leads the eQuality steering committee meeting. (Photo by Natalie Keyssar)