Dr. Allison Eliscu, left, meets with Cassandra Paciella,19, and her mother,...

Dr. Allison Eliscu, left, meets with Cassandra Paciella,19, and her mother, Mary Paciella, both of Port Jefferson Station, at Stony Brook Medicine’s Advanced Specialty Care Center in Lake Grove on March 23. Credit: Rick Kopstein

When Cassandra Paciella came out to her mother as a transgender person three years ago, her mother knew she had to find the right health care to support her then 16-year-old daughter's journey.

Mary Paciella, a Stony Brook University Hospital director of employee health from Port Jefferson Station, had read about teen suicide rates and the threats posed to the LGBTQ+ community for those unable to get medical and psychological help.

“I wanted to make sure we got it right,” Mary Paciella said. “I wanted to find the right therapist and move through the process slowly. We just wanted her to know we loved her no matter what. She’s still our daughter and nothing changed. It was never a matter if you’re a girl you can do this or boy who can’t do this.”

Medical services that support the LGBTQ+ community's unique needs have become more widely available on Long Island in recent years, experts say, and matching community members with the right provider remains critical to making them feel accepted. Local health care systems are revamping intake forms and reaching out to gay and nonbinary individuals, letting them know that there is specialty care to support them. 

 WHAT TO KNOW

  • Long Island medical providers are reaching out to the LGBTQ+ community, letting them know that care for their unique needs is available.
  • The community's inability to meet their medical needs is sometimes linked to poor mental health, according to one survey.
  • Connecting community members to a medical provider who is accepting of their needs is critical, physicians say. 

Cassandra Paciella, who was born male, said she knew at 12 she was a girl, but didn’t come out until about four years later, she said. She told her parents, who helped her match with a therapist and began treatment with Dr. Allison Eliscu, medical director of the Adolescent LGBTQ+ Care Program at Stony Brook Medicine.

“Gender was never a barrier. I was never really told I was not allowed to do something because you’re a boy,” Cassandra Paciella said. “The biggest thing for me was the dysphoria and that I was socially expected to be a man, which is not who I am. At 16, I decided I couldn’t not say anything anymore and it’s been great ever since.”

LGBTQ+ outreach

Stony Brook Medicine has been reaching out to the LGBTQ+ community, seeking to expand awareness of the Edie Windsor Healthcare Center in Hampton Bays by making presentations on the North Fork about LGBTQ+ inclusivity and services ranging from HIV care to transgender services. The center was one of the first comprehensive medical facilities for the LGBTQ+ community.

Stony Brook also has expanded inclusivity through its own offices, including some staff wearing rainbow flag pins and documents giving patients the option to list their preferred gender, orientation and preferred name.

Cristina Witzke, site administrator at the Edie Windsor Healthcare Center...

Cristina Witzke, site administrator at the Edie Windsor Healthcare Center in Hampton Bays, speaks at a symposium on LGBTQ+ issues hosted by Stony Brook Medicine and Stony Brook Eastern Long Island Hospital in Peconic on March 20. Credit: Newsday/John Paraskevas

“More gender diverse people were traveling into the city from all parts of Long Island to get care when we can provide it in their own backyard,” Eliscu said. “Unfortunately, many people have had a negative experience in health care, so it makes sense they are nervous about how they’d be perceived by nursing staff and providers.

“We want to make sure they have positive interactions on their medical journey," Eliscu added. “They’re not going to share and get what they truly need without them feeling comfortable."

Stony Brook, Northwell Health and NYU Langone health care systems were each designated as LGBTQ+ Healthcare Equality Leaders by the Human Rights Campaign Foundation, the nation’s largest LGBTQ+ advocacy group, in its most recent report.

Providers can designate LGBTQ+ health care as a clinical priority on their physician profiles so patients can search for this label specifically, the network said, and staff at NYU Langone Hospital–Long Island complete regular training in LGBTQ+ health care.

NYU Langone Hospital–Long Island also has an LGBTQ+ Committee and a dedicated director of LGBTQ+ services. The hospital has performed gender-affirming surgery since January 2023, and has a dedicated director of LGBTQ+ clinical services.

Northwell Health also has worked to make LGBTQ+ patients more comfortable, offering specialized treatments and transgender health care. The system created the Center for Transgender Care in 2016, and doctors have seen more than 3,000 patients. The center opened a free-standing office in New Hyde Park in 2020.

“After a few years, we saw a significant need to address LGBT health care needs,” said Dr. David Rosenthal, a pediatrician who is the medical director for both the center for Young Adult Adolescent and Pediatric HIV and the founding medical director for the Center for Transgender Care.

“I think there’s an increasing need and individuals have not received health care because of the lack of connection to health care providers,” he said.

Need to raise awareness

The need to raise awareness of the medical and psychological needs in the LGBTQ+ community is one focus of Sunday's National Day of Transgender Visibility. Experts say challenges in getting gender-affirming services sometimes is linked with poor mental health, a connection that borne out to others in the LGBTQ+ community.

A 2021 Stony Brook survey of Long Island LGBQT+ adults found that nearly half, 44% of 1,150 respondents, reported being in fair to poor mental health, more than 60% reported feeling depressed and up to 33% of respondents had considered suicide.

About 55% said they had a routine checkup, and 37% of those surveyed said they felt disrespected for non-affirming treatment, according to the study.

Buttons display pronouns used by many in the LGBTQ+ community...

Buttons display pronouns used by many in the LGBTQ+ community at the Peconic symposium. Credit: Newsday/John Paraskevas

Eliscu said she realized the importance of her work when a young LGBTQ+ woman said she had considered stepping in front of a train. The woman said she shared the story after noticing her doctor’s rainbow pin.

“Everybody regardless of how they identify should have a primary care and medical home where they feel comfortable, getting the consultations and diagnosis they require,” Eliscu said. “That study underscored the multiple barriers people may be facing when seeking medical care and having a negative experience.”

Anne O’Rourke, 28, of Centereach, who identifies as nonbinary and prefers the pronouns  “they" or “them," said they didn’t know where to start transition care. O'Rourke said they had a bad experience with their former primary care doctor, who questioned their decision to pursue surgery.

“It was disheartening and a scary place to be where my medical needs and needs as a person were being overridden by an article the doctor read online,” O’Rourke said. “It was really upsetting and unfortunately I was in a position where I couldn’t leave and I didn’t know how to get out of the situation.”

They said they later connected with a Stony Brook doctor in Setauket and a surgeon with Northwell, who asked about their preferred pronouns and preferences. O’Rourke, who grew up on the North Fork, said they were glad to find accepting health care on Long Island.

“They put so much care to make sure my health needs and my level of comfort take priority and comfort in my body was so clearly emphasized in the office,” O’Rourke said. “It’s really important to me after I had a recent positive experience after a scary experience. I had no idea that community existed in my own backyard.”

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