Speakers included Howard Brown Health Center's Cecilia Hardacker R.N., the geriatric education program trainer, and Dr. Magda Houlberg, chief medical officer and provider of internal medicine, HIV and geriatric medicine care. Houlberg is also assistant professor in the section of geriatric medicine and palliative care at Rush University Medical Center. They presented their findings to about 50 people, including nursing, pharmacy, psychology, social work and medical students.

Hardacker began by showing a clip from the film Gen Silent, exploring the lives of LGBT elders. Hardacker then explained that there are societal, personal, financial and healthcare barriers that LGBT elders face when trying to gain access to healthcare: "One-third of LGBT elders are at or below the poverty level and more women than men are in that situation." LGBT people, especially elder LGBT people, are less likely to access preventative care; more likely to enter the healthcare system later in the disease process; and less likely to be screened properly due to provider assumptions, misinformation and patient nondisclosure of their identity and/or behaviors, Hardacker explained.

Houlberg outlined the health disparities that occur with women who have sex with women, men who have sex with men, transgender women and transgender men. Houlberg explained that smoking, alcohol and illicit behavior due to minority stress are linked to worse health outcomes, adding that those who have experienced prejudice-related major life events are about three times more likely to have suffered a serious physical health problem over a one-year follow-up period than those who had not experienced such events. She also said health disparities among LGBT people increase for members of more than one vulnerable population, such as the poverty-stricken or a racial minority.

Houlberg added that health issues among women who have sex with women include ovarian cancer due to lower rates of pregnancy and less use of oral contraception; higher rates of breast cancer, due to obesity and lower rates of pregnancy/breast feeding; cervical cancer, since the time between pap smears is up to three times longer than heterosexual women; and cardiovascular health due to smoking and stress. Also sexually transmitted infections (STIs) and HIV among lesbians are still a concern since 70 percent of lesbians have reported that they have had sex with a man sometime in their lives. There are lower rates of most STIs but there are similar risks with those who have vaginal infections.

As for men who have sex with men, Houlberg said, their specific health issues include everything from lung cancer since GBT men smoke 50 percent more than other men to anal cancer due rectal administration of recreational drugs and a higher number of sexual partners.

Within the transgender community, Houlberg said "it is important to screen the organs that they have." Violence/murder, substance abuse, surgeries performed by untrained surgeons and mental-health issues affect the transgender community as a whole, Houlberg explained. In addition, she said the long-term use of hormones in transgender patients has not been studied.

Transgender women face cardiovascular risk and breast cancer related to estrogen use, and the uninsured are more likely to use street hormones— which leaves them at a higher risk for HIV and hepatitis C due to needle use, according to Houlberg.

As for transgender men, Houlberg explained, there is a potential for ovarian and cervical cancer related to the lack of screening in those areas by healthcare professionals. Breast cancer is also a risk due to residual breast cancer tissue left after a mastectomy. Testosterone use can also cause liver damage among transgender men. As with transgender women, there are also health risks when uninsured transgender men use street hormones.

A Q&A discussion with the speakers followed their talk.

The Chicago Area Albert Schweitzer Fellowship and Rush University presented the symposium.

To learn more about the film, visit stumaddux.com/GEN_SILENT.html .