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Going to the doctor can be confusing and stressful — sometimes even a little scary. And at the intersection of health care and LGBTQ rights, the struggle is especially real.

Unfortunately, ignorance in medical spaces can expose LGBTQ people to discrimination. They can face difficulty finding an affirming health care provider, and sometimes even violence at the hands of medical professionals.

Systemic barriers also limit LGBTQ people’s access to health care. Twenty-four percent of lesbian and bisexual women experience poverty, compared to 19 percent for heterosexual women. Transgender people are four times as likely to be living in poverty, making under $10,000 a year.

That’s why we sat down with Kat Smith and Alex Eleazar, two badass activists for LGBTQ and reproductive rights. They recently traveled to Washington, D.C. to attend Creating Change, an annual summit held by the National LGBTQ Task Force. Kat, a junior at Hofstra University, and Alex, a sophomore at Smith College, are outspoken leaders on their campuses.

We spoke to Kat and Alex about the importance of quality LGBTQ health care, and how they’re showing up to #ReclaimOurRights in a time when LGBTQ rights are under attack. Read our conversation below.

Planned Parenthood Action Fund (PPAF): Why is it so important to have affordable LGBTQ health care?

ALEX ELEAZAR (AE): When you have people who are coming from economically marginalized backgrounds, having access to health care is so crucial and important — especially having health care that respects people’s identities. Even if a person has health care, they might not be able to use it because of their identities not being respected within those spaces.

KAT SMITH (KS): We see groups of LGBTQ folks with higher rates of medical problems and higher rates of unintended pregnancies. We need to go out of our way to provide health care for LGBTQ folks.

PPAF: Many LGBTQ people experience having to teach their doctor about their health care needs. Have you ever faced stigma when going to the doctor?

AE: It doesn’t have to be clear discrimination to make a person feel unsafe — microaggressions can happen. Pronouns are not often asked for in the medical space, so for a lot of trans and gender nonconforming people, it can be hard to navigate. Having to educate the people who are taking care of you and making sure that you’re healthy adds another layer of stress.

KS: Then there’s that awkward moment when the doctor’s like, “Have you had unprotected sex or are on birth control?” in a way that ignores my sexuality.

PPAF: How are you able to overcome those barriers?

KS: I have found that my most affirming health care experiences have been at Planned Parenthood health centers. But I realize that it is my privilege to be able to choose Planned Parenthood, and not everyone is able to do so.

AE: For most of my life I’ve had health insurance, which does make a big difference in the type of doctor I’m able to go to. I am privileged to have a little choice in making sure that the doctor I’m going to will be understanding.

PPAF: Is there a particular stigma around LGBTQ health care that you’d like to dispel?

KS: So many. A lot of times, when I tell people who know that I’m queer that I support Planned Parenthood, they’re so confused. It’s wild — they don’t realize that queer people can still get STDs, still get pregnant, and still need safer sex resources.

ALEX: In many sex ed curricula, the end goal is “don’t get pregnant,” which erases a lot of people from the conversation. Already, that is a stigma in itself.

KS: Also — there’s the hypersexualization of queer people. A lot of people will be like, “queer women are so accepted in society!” And I’m like no, they’re fetishized.

PPAF: Many high school sex education curricula lack important information about LGBTQ health. What was your high school sex education like? Did you have to seek additional education about your health?

KS: I went to Catholic high school, where we had abstinence-only sex education. Myself and a lot of other queer folks use the internet to seek information about health care, which can be dangerous. When anyone can post anything, there is a lot of misinformation.

AE: I went to a super tiny high school. They started teaching sex ed when I was in 10th grade. It was pretty limited — all we learned about was condoms. Around that time, though, I started working at my local pride center. Planned Parenthood came in a few times and taught us safe sex from an LGBTQ perspective. It didn’t assume your gender or sexuality. It totally changed my concept of what sex and sex ed could be.

KS: We need sex ed that is gender neutral and does not conflate gender and sex.

PPAF: Mental illness disproportionately affects LGBTQ people. What are some self-care strategies you rely on?

KS: As a queer person who has mental health issues, I suggest finding a support system. I’m a firm believer in making your own family. So if your biological family doesn’t support your identity, then surround yourself with people who do.

AE: I try to surround myself with people who I can call at any time. As a queer person of color with an immigrant family — there’s a lot going on in the world right now. Trying to keep up with everything can be exhausting.

KS: I tell myself that I don’t have to read every news alert right away — I can take a couple hours. It’s also okay to have feelings and do things on my own terms.

AE: I try to just be, and breathe. I think there’s so much stigma around getting help for mental health. Having friends are wonderful, but it’s okay to seek professional resources.

PPAF: You’re in D.C. to attend the Creating Change conference. How did you get started with LGBTQ activism?

AE: I worked at a pride center in high school, and that was sort of the beginning of my activism. It was a super supportive space that made me feel comfortable with myself. That’s where I was first introduced to sex ed and Planned Parenthood.

KS: I wanted to get more involved with organizing, and queer organizations in particular. On campus, I’ve been able to get more involved with issues I care about.

PPAF: One of the Creating Change keynote speakers included Andrea Jenkins, a trans woman of color who was elected to the Minneapolis city council this past November. Why is it so important to elect diverse people in government?

Jenkins, above, is the first openly transgender Black woman elected to public office in the U.S.

AE: Having people with diverse identities in office means more people can be represented. It’s important to have lawmakers who understand what different communities are going through.

KS: People shouldn’t speak for those communities — those communities should speak for themselves and be representing themselves.

PPAF: In this political moment, how do you make space for yourself and #ReclaimOurRights?

AE: I’ve been doing it mostly through my organizing on campus. It’s also important to create space for yourself. I strongly believe that self-care is an act of resistance.

KS: That reminds me of the Audre Lorde quote, “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.” I also try to really own my identity and live up to it.

This interview has been edited and condensed for clarity.

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