Street Outreach to Youth

Today was the beginning of my adventure on my final rotation of medical school (last but not least!). I'm living and working in the Bronx for the next month as I delve into the study of LGBT health - or for those of you who are less-than-savvy on the latest acronyms, Lesbian/Gay/Bisexual/Transgender health.

For Day 1 of the elective, I joined some of the amazing staff of the New York Children's Health Project through their ongoing mobile clinic campaign. There is a medical clinic bus (where I worked) and a dental clinic bus that set up shop at various locations throughout the week. Monday mornings are spent parked outside of the Safe Horizon youth shelter in Harlem, and the afternoons are based at the StreetWork drop-in center reserved for "street-involved" youth (currently homeless, previously homeless, or otherwise at-risk).

This experience is a part of my LGBT health elective because there is a disproportionate amount of LGBT adolescents represented amongst homeless youth due to several social factors. There is a saddening number of queer*-identified youth who have been shunned by their families and kicked out of their homes simply for who they are. These vulnerable adolescents also tend to have higher risk of abuse, untreated mental health issues, as well as substance abuse and other risky behaviors.

With this in mind, I remembered the HEADS mnemonic for adolescent interviews that I learned during my pediatrics rotation:

Home life

Education

Activities

Drugs/alcohol

Sexuality

Safety

Suicidality

Spirituality

As I went over it with my preceptor today, she called attention to a number of specific topics that I might explore with these at-risk youth, such as: survival sex, abuse history, panhandling, and crime. While it might be shocking that health care providers have to broach such serious issues with young people, it's the reality for these youth and the responsibility of the provider to be comfortable initiating dialogue on historically taboo topics. With communication, we can end the silence, reach out, offer options, and create change.

*Throughout the next several entries, I may use the terms "LGBT" and "queer" interchangeably. While for some, the use of "queer" may still seem to be controversial, it has become an accepted catch-all term for sexual minorities (both in terms of sexual identity and orientation) that has been accepted into the semantics of academia.