It's Time For Full-Spectrum Queer Gynecological Care

In the HIV/AIDS era, gay men organized, marched, and demanded that medicine move faster. They changed healthcare forever. Dr. Homyra Hadavand trained as a doctor in that era. She calls witnessing that advocacy one of the best things in her career. Her message in this episode: "Now we're going to do it for queer women." Queer women face their own gaps such as delayed screenings, providers who don't ask the right questions, and misinformation. The Full-Spectrum Queer Gyno Care Initiative is how Spectrum Medical answers that gap. It's time.

Spectrum Medical Care Centre
Maricopa County Community Resources
LGBTQ+ Healthcare Directory
Vitalyst Health Foundation

Mental health resources:

Crisis & Suicide Prevention

• 988 Suicide & Crisis Lifeline — Call or text 988, available 24/7. LGBTQ+ individuals can still call 988 and receive caring, confidential support, though the specialized "Press 3" option is no longer available. EveryMind
• The Trevor Project (LGBTQ+ youth ages 24 and under) — TrevorLifeline: 1-866-488-7386 (24/7) | TrevorText: Text START to 678-678 (24/7) | TrevorChat available at thetrevorproject.org/get-help AFSP
• Trans Lifeline (by and for trans people) — 1-877-565-8860 (US), available 24/7 AFSP
• Crisis Text Line — Text HOME to 741741, available 24/7 Human Rights Campaign
• RAINN National Sexual Assault ...

Transcript

SPEAKER_01 0:08

Welcome to the Lavender Lounge. I've heard so much about your work and the history and experience that you bring to Spectrum Medical Care Center. So it's such an honor to have you on the podcast. Can you please just introduce yourself to our listeners and who you are and what you do? Okay.

SPEAKER_00 0:26

It's an honor to work with Spectrum Medical. I mean, honestly, it's one of the best things for me. My name is Homeira Hadavan, Dr. Hadavan. I'm an OBGYN. I've been working at Phoenix India Medical Center for the past 15 years. And I enjoy taking care of Native Americans. And basically, I learned public health when I was in residency and I was in the era of HIV AIDS. And I just learned at that time that public health is basically the best thing that we can do because a lot of people don't have the information, people don't have the care, people don't have access to care. And that's started my passion for public health. And now with the Spectrum Medical initiating this beautiful full spectrum queer gynecare initiative, we're planning to take care of queer women because historically women are misunderstood. It's very hard for women to get good care. Or any female at birth assigned at birth.

SPEAKER_01 1:46

What drew you? Thank you so much for sharing that. What drew you towards the field of gynecology, if you don't mind sharing that? Was there like a specific experience? Or what made you think, okay, yes, I want to dedicate my life to being a gynecologist?

SPEAKER_00 2:00

Honestly, when I delivered my first baby in medical school, I thought that was the greatest thing in my entire life. It was so joyful. It was the best thing. And I love surgery. So that was a combination of gynecology, surgery, and delivering babies. So that was the best thing. And and and I love babies. And I love taking care of women. I always say that unfortunately we take care of everybody else around us. We're always the last. And somebody needs to take care of female patients.

SPEAKER_01 2:40

When you say that, I feel the impact of that. And it's like, I guess, why do you think that women, why do you think we get left last?

SPEAKER_00 2:48

Honestly, because we get caught up in life so much that we forget about ourselves. Men, when they have a cold, they stay home and somebody has to take care of them. We take care of the partner, we go back to work, we just wear a mask, make sure that all the patients, everybody around us, I mean, we just keep on going. We're just energized bunnies. We never stop to think, oh, what about me? What about me? Who's gonna take care of me? And that's why I think gynecologists' job is so important. Because when you have a good gynecologist, they become your friends, they become your part part of your family. So I love I love taking care of patients.

SPEAKER_01 3:38

That's really cool. So, what specifically about LGBTQ plus care drew you to working with Spectrum Medicals? What about that community drew you towards wanting to help them with with public health?

SPEAKER_00 3:51

You know, in our traditional training, we don't concentrate on LGBTQ health. And we learn on the job basically. We see patients, they come, they have problems, and eventually we learn, oh my god, they they need a lot of work. Like queer women, they don't like to go to doctors, they don't think they can have infections, they don't think they can like perimenopausal patients, they bleed a lot. So they they think it's part of the journey of being a woman. You know, you have your period, then you go the stages of life, and perimenopausal, menopausal symptoms are part of the life. No, we're here to help. We make sure that if you're bleeding, we test people. Like I had a patient who her actually her partner brought her in. And partner was like, she keeps bleeding, but she keeps ignoring it. And I told her we need to go. So she came in. Unfortunately, she ended up having cancer of the uterus, and she had to have a hysterectomy. So these are the things, you know, people think that, oh, it's nothing. It's it's gonna go away, it will clear itself. It will I'm going through a menopause. But no, there's so many things that is involved, and people are not educated, not everybody knows what's going on. You know, patients come in with tons of questions, rightfully so, because I don't know anything about programming a computer. I have to ask somebody. So that's why we're here. And and because I learned all this around queer women, that I'm like, they need somebody or some group of people like Spectrum Medical to start a program. And we I I started looking for him, and they don't have a lot of programs like this. You know, Phoenix is the fifth largest city in the United States. And I kept on looking, I'm like, wow, this is not very common that group of people decide to take care of queer women.

SPEAKER_01 6:08

Yeah.

SPEAKER_00 6:09

That was that was the basic when when they approached me when this opportunity arose, I was like, this is exactly what I wanted to do.

SPEAKER_01 6:17

Because you sense that need.

SPEAKER_00 6:19

Oh, absolutely. Every day, every day. I see I see a lot of lesbian, bisexual, queer women, young, old, and I keep thinking that why didn't they come before? I want them to feel comfortable. I want them to go to a place that they're seen, heard, understood, and then we take care of them. That's our job. That's what we do. We take care of women.

SPEAKER_01 6:47

Do you do you notice that a lot that a lot of your patients will delay care and will wait to the last possible moment until it gets more serious to come see a doctor?

SPEAKER_00 6:57

Unfortunately, a lot of people do that. Like for example, Pap smear. If you don't have Pap smear, or if you have Pap smear at age 21, that's when we start. And you don't like your doctor, you don't like your environment, you don't like the exam, you don't want you don't like any of this. You just delay going back. Mind you, the first one was a slightly abnormal. When you wait 10, 15 years, it becomes most of the time it becomes really abnormal and it becomes cervical cancer. And then that's that's a whole different ballgame. That's a whole different thing that we have to take care of. So when you start with something that is a slightly abnormal, it's much easier to take care of it till you let it grow to a point that requires surgery, more care, you know. Um and heterosexual, bisexual, trans, the people people do it all the time. Queer women, they're all they all learn that, oh, it's okay, I can do it next year, or I can do it next year. That's not that's not acceptable. They should feel confident in their health, go and follow up. If you have a slightly abnormal, I had a patient who didn't have a PAP for 20 years. First experience was not good, jumped back in the closet, didn't want to come out, and now 40-some years old, and and and I said, let's move on from here. It's okay. Past experience, I understand. It's done. Let's move forward. So that's what that's what I want to make sure that this gap of 20 years, 10 years does not happen with queer women at a spectrum medical.

SPEAKER_01 8:54

I mean, I also sometimes will I'm I'm gonna be honest, sometimes I will delay care as well.

SPEAKER_00 8:59

Sometimes you're I know you're a cis woman. Doesn't matter. I'm telling you, even men sometimes do that. I have a friend who had abnormal um prostate test, and I kept on telling him, why don't you go? And he said, Well, you know, they're gonna I'm like, you're a doctor. I shouldn't tell you to go. And he laughed. He said, Yeah, I'm going. You know, even a doctor, we're we're we're the worst patients stuff.

SPEAKER_01 9:31

Going to the doctors does hard. Sometimes it's just so uncomfortable. Um, do you have like ways that you try to make your patients more at ease or just like make them feel more comfortable during the appointment?

SPEAKER_00 9:43

Always. Like if I have, for example, if I have an abnormal pap, I put pictures up on my computer, I make sure I explain everything, I make sure they understand what my intention is for doing, for example, biopsies. It's not easy to do biopsies. We make sure that they're comfortable. We make sure that they have um, you know, I I put some uh lidoquin or something. If they're anxious, I try to calm them down. I sit down with them, I ask them to ask me questions. Do you understand everything I said? You have to sign a consent. I want to make sure you understand everything. And by explaining to patients, that unknown becomes known and it's much easier after that.

SPEAKER_01 10:37

Right. That unknown is so scary because I I know as someone that has, for example, has recently gotten a pap sphere, you always have it in the back of your mind of like, oh no, like what if it's abnormal? And so I know for myself, I feel like I sometimes will delay it just because I'm so anxious about hearing the result, you know what I mean? It can be really unnerving.

SPEAKER_00 10:57

That's human nature. That's human nature. But I always tell my patients, if we know, for example, if we know you have a small calcification in your breast when you start your uh breast uh mammogram, when we start with a small problem, it's much easier to take care of. When it's already spread, it it's it's so hard. Then you have to go through chemo, then you have to go it becomes a it's like a um snowball effect. If you don't take care of it early enough, it can become a very bad thing. But if you if it's something that's easy to take care of, why not? And and most of my patients, when I tell them these things, they're like, Oh, yeah, you're right. Why do I want to wait till this gets even if it's a bad news? But it's better to know and take care of it rather than not take care of it. But it's there. My own brother had colon cancer. He told me that every time you go to doctors, they find something. And I you know what my answer was? If it's not there, we don't find it. We don't find something that's not there. It's there.

SPEAKER_01 12:17

Thinking that it's like the worst case scenario, even though it's not, right?

SPEAKER_00 12:21

And I always tell my patients, it's my job to think the worst so I can help you the best. Okay, that makes sense.

SPEAKER_01 12:30

That makes sense. That's a good one.

SPEAKER_00 12:33

Honestly, um I understand because um, you know, people have different experiences, especially with exams, because it's not an easy exam. You know, it's not a skin test. It's not like something somebody's listening to your lungs, you know, somebody is listening to your heart. Gynecology is a little bit more difficult for everybody, even for myself when I have it. It's not an easy task, but we have it's our job to make it easy for patients. Like listening to patients, to me, I always say that, and I always say to young doctors too. When you listen to patients, they tell you exactly what's wrong with them. They know their bodies, they know that the difference between the disease one and the normal one. They will tell you my period was normal. Now I'm getting it every two weeks. But it's not heavy, but it is heavier. You know, they tell you exactly what's wrong with them. That's half of the diagnosis. The ultrasound, the CT scan, the the others are just addition to have a better diagnosis. But patients always tell you what's wrong with them. It's just listening to patients. And I think my in my life, I think the best thing that happened to me that I have this patience to listen and sit there and let people talk to me. They tell me I've never told us all, but I'm telling you this. And I'm like, oh okay, this is great. So, like, for example, my patient, one of my patients said, you know, uh I was appropriately uh touched at age swan. So then everybody wrote she has difficulty with pelvic exam. That was the reason she had problems with pelvic exam. Nobody wrote down that she had a bad experience as a child, she was molested. That's the base of her fear that trauma-informed care is very important. A lot of women like listen to what's happening in the world right now. So-and-so was raped, so-and-so was touched, so-and-so. All the things that goes around us, just listen to news. All those people, they're telling you exactly what happened to them. We have to be sensitive. We have to care about people who had trauma before. That's our job. Everybody's job, mostly doctors and gynecologists, but you know, it's everybody's job to take care of these people. Yeah. And and and and if your doctor doesn't listen to you, who is supposed to listen to your pain, your concerns? It's just everything, like um sexual health, um sexually transmitted diseases. I teach my young people, I have pictures all over my computer. If I see I'm seeing a 16-year-old, you know I have all these pictures out to explain all the sexually transmitted disease, to show them what it looks like, to what to look for in a partner. I don't think in Arizona in general, the um health education is really good in schools because it I'm from New York and New Jersey and we we start very early. So all our kids get a good amount of health education. But I I tell you, there are people who don't know different parts of their body, and you'll be surprised how old they are, and they ask when you ask a question, they're like, What? What is that? One of my patients said I've never had orgasm. Oh my god. Like, what a what does that mean?

SPEAKER_01 17:04

That is so no, that's not okay. I know that's like that's like the best part of life. What are you yes?

SPEAKER_00 17:14

That's the best part of life. That's a good part of life.

SPEAKER_01 17:19

Like, you got to do not that. So these are some heavy topics, and I think they're so important to talk about, but I'd love to talk about the full spectrum gyno care initiative that you are directing at Spectrum Medical. What is the importance of this initiative and uh why is why does it matter?

SPEAKER_00 17:42

Um, we want to get the words out that we're here to help and take care of queer women. That's the basic, and we had very good, we had a group that helped us to recognize what is important, what is needed, and we do have great people to take care of queer women, and I want them to understand we're here for personalized care. Each patient is important, each patient is different than the next one. We care for each individual. We want to have them keep coming back, making sure they continue the health journey, and we love to be part of that journey for them. And um I think our mission is just to care for people who think that nobody else cares. I cannot wait to start this. We have a beautiful, beautiful clinic that is getting redone, and everything is gonna be beautiful so people don't think that uh it's just the clinic we're going to. It's gonna be a great place to come and it's beautiful, it's uh the colors are beautiful, everything. We were just talking about the procedure rooms that I will be using, so it's gonna be fun from what I've what I've seen so far. I'm like, this is gonna be like a country club, and because it's a big place, hopefully we will have residents and medical students to come and rotate with us. So we will teach them because in in traditional medical education, it really doesn't um emphasize on LGBTQ plus community, right? So maybe somebody would love to do that. Maybe that somebody who is queer and wants to just do gynecology for queer women, only for queer. You know, you never know what people would like and start doing after you start something new and teach them new stuff.

SPEAKER_01 20:12

That is so amazing because it's like you're not only providing care, but you're also providing the actual like prevention and education and and like the whole knowledge's power. Absolutely. It's completely wraparound care. That's amazing. I love that so much.

SPEAKER_00 20:28

Education is always important because as long as you don't know what to ask. Right. You're confused, you feel like this is you know, going to a doctor, going to a health care, it it becomes overwhelming. But it doesn't need to, it's part of life, something that you gotta do. It's like checking your cholesterol, checking your blood glucose. You know, these are these are normal stuff that we do. And after you know, seeing gynecologists, we have primary care at uh spectrum medical. So maybe they can just start going to a spectrum medical, primary care uh nurse practitioners, doctors, and you know, they they can have their whole care in one place instead of going to different places.

SPEAKER_01 21:21

That is life-changing, genuinely. Like having care all in one place. Oh my god, like that is just hearing that, I'm like, that makes life so much easier and would make, I would imagine, like more people stay engaged with their care because it's like it's a one one and done thing. That's so cool.

SPEAKER_00 21:38

Yeah, because if you have one test here, one test there, these don't communicate. These different places do not share information unless you ask them to. But if you go to one place, if you have all your labs in one place, all your ultrasound in one place, all your other care medication. When I open my computer, I see exactly what medication patient is taking. These are all positive things about spectrum medical. That's what we're trying to do to give patients the best care.

SPEAKER_01 22:16

I'm curious about the name, how you decided on the name for the full spectrum queer gyno care. Because I also heard that you guys had an initial name and you changed it as you were formulating it. So I'm so what was that process like?

SPEAKER_00 22:27

And why did you because we had a very, as I said, we had a very good advisory group. So we kept on changing the name to be basically inviting to any female assigned at birth or whomever has any anatomical female parts so they will feel good about it. So that's where we came up with the name. It was it was a challenge. Um, everybody was involved, actually. I hope it uh resonates with people so they will they will see it as a whole complete care. Right.

SPEAKER_01 23:06

Yeah, that is really cool. Like you were saying, I've never heard of a specifically queer women's health program.

SPEAKER_00 23:13

So it'll be like some, but they're in other uh states. But um we're trying to even make it better than others so we can go to different parts of Phoenix. Phoenix Phoenix has Gilbert, Phoenix has uh Arrowhead, Phoenix has, you know, we have some it's such a big place, you know. Maybe hopefully soon we expand to different parts of the city so people don't have to travel long. These are all the future of spectrum medical. That is so exciting. I'm very excited. We we will make this work, for example. Like when we had HIV-8 era, all gay men went out and made sure that we expedite medication, we expedite everything, we we take care of them, and that was the best thing in my career that I witnessed that they did for their community. Now we're gonna do it for career women. Now it's our time. It's the time.

SPEAKER_01 24:19

That is so inspiring. And Dr. Hodiman, thank you so much for sharing about the Career Women's Health Initiative, about your experience and everything that you're bringing to Spectrum Medical Care. It's truly been a pleasure to speak with you today. And thank you so much for being on the Lavender Lounge.

SPEAKER_00 24:36

Thank you for inviting me to Lavender Lounge. And I honestly cannot wait to start this initiative. I think it's gonna be very, very, very good. I am very excited. Yeah. Oh, we'll we have a lot more topics to talk about.