Snohomish County Health Department Director Dennis Worsham on Tuesday, June 11, 2024, in Everett, Washington. (Olivia Vanni / The Herald)

Snohomish County Health Department Director Dennis Worsham on Tuesday, June 11, 2024, in Everett, Washington. (Olivia Vanni / The Herald)

Long after AIDS crisis peak, LGBTQ+ health care still limited in Everett

A reopened free STI clinic signals some progress. But securing inclusive health services in Snohomish County is an uphill battle, local experts say.

EVERETT — Every Monday morning, someone read aloud a list of names. Staff then moved blooming plants into the atrium, one for each person who had died of AIDS the previous week.

It was the 1990s, and then-29-year-old Dennis Worsham was new to the Snohomish Health District. He’d come out as gay in college and joined the public health sector to fight the disease killing gay men at a terrifying rate. At that time, gay and bisexual men made up about three-fourths of AIDS cases in the United States, according to the Centers for Disease Control and Prevention. Patients often lived no more than two years after diagnosis.

Worsham, tasked with managing sexually transmitted diseases in Snohomish County, watched flowers fill the atrium in the Rucker Avenue building. He wondered if that was his destiny, too.

“You’re coming out as a gay man, and you see all these other men dying around you,” Worsham said. “It was a community that was very scared.”

Worsham, now as the county health director, has seen up close how prevention, treatment and attitudes around AIDS have changed dramatically in the past decades.

By September 1990, Snohomish County had seen 96 AIDS cases, and 91% of those cases were men, according to a county report. The county had an HIV prevention program, free testing clinic and case management team.

But more than half of Snohomish County AIDS patients were traveling to King County for treatment and support services, the report said. Many doctors here had refused to work with AIDS patients, The Seattle Times reported in 1987. LGBTQ-friendly resources, such as AIDS Project Snohomish County and then-popular Everett gay bar, the Stage Stop, stepped up to help bridge the gap.

“(Gay) communities historically have been disproportionately impacted by a number of STIs,” said James Lewis, the current health officer in Snohomish County. “And that group often has not felt comfortable in more traditional medical settings.”

Nationwide, stereotypes aligning gay men with the disease affected health care policy. In one notorious example, in 1985, the federal government banned gay and bisexual men from donating blood. That ban has been gradually relaxed only in the past decade.

When Worsham started at the health district, he was the first openly gay staff member in his position.

“There was a lot of homophobia,” Worsham said. “Being gay didn’t put you at risk for HIV. Sexual behaviors put people at risk.”

‘People have to feel safe’

LGBTQ+ people continue to face disproportionate emotional and tangible barriers to health care, said Kate Rowe, a Kaiser Permanente nurse who serves residents in King and Snohomish counties. This is partly due to “stigma and discrimination towards sexual and gender minorities,” according to a study the National Institute of Health published in 2023.

One Granite Falls resident, who asked for anonymity to protect family from backlash, met Rowe at a “Gender Affirming Health Care” seminar at Lake Stevens Pride earlier this month. The 51-year-old resident said they are biologically male, identify as nonbinary and haven’t used a urinal in 20 years.

In the past three years, the resident has spent weeks in local hospital beds due to serious health conditions. Despite their preferences, nurses only gave them the option of using a urinal, they said.

“People have to feel safe,” Worsham said. “I don’t mean just safe physically, but it’s safe emotionally, where they can come and be who they are, and not have to have a facade in order to navigate good health.”

Rowe said most local providers are still years away from providing inclusive health care. LGBTQ-specific needs are not typically taught in medical school, Rowe said, but they should be.

That includes gender-affirming health care — a growing need in the region, Rowe said. Few providers in the area offer puberty blockers, hormone therapy and cosmetic procedures.

“If you can manage someone’s insulin, you can manage someone’s hormones,” Rowe said.

Recently, Worsham helped facilitate a conversation with Kaiser staff about local gender-affirming care needs. Kaiser has one of few gender health programs in Washington.

Rowe said Ingersoll Gender Center in Seattle is another “shining light” of gender-affirming health care in the state. But Snohomish County resources are slim. Often, the best chance at finding a supportive health care provider is through word-of-mouth.

“Their best resource is their community,” Rowe said.

‘A constant battle’

In the 1990s and early 2000s, the Snohomish Health District funded the Gay Men’s Taskforce to co-lead HIV interventions, as well as Globe, a prevention group for teens and young adults. PFLAG, the Parents and Friends of Lesbian and Gay Group, and the University of Washington were also critical to the district’s outreach, Worsham said.

“Oftentimes in public health, we are very focused on what is not going well and trying to change those behaviors,” he said. “Now, I’m always mindful of pointing out what is positive within the data. Talking about the resilience and strength within communities, not attaching the stigma of disease to a population.”

By 2009, deadly AIDS cases had abated thanks to the development of lifesaving medication. But as cases declined, state and federal funding for sexual health dried up.

The Snohomish Health District was forced to close its STI clinic. Community-based prevention efforts tapered off. Many longtime advocates for LGBTQ-friendly health care moved out of the county to continue their work elsewhere.

By 2022, all sexually transmitted infection case rates in the county had at least doubled since 2009. For years, the county had asked for money to help reopen the clinic, but the state only agreed after a group of health care experts in 2022 made recommendations to control a statewide rise in sexually transmitted infections.

Last winter, after 14 years, the renamed Snohomish County Health Department reopened its free STI clinic. Once again, the clinic provides free testing, treatment, education and case management for those in need, regardless of insurance status.

In the first three months, the clinic saw 390 visits. Providers identified 64 new cases — two positive tests for HIV, eight for syphilis and 17 for gonorrhea. People who identify as LGBTQ+ make up a “large proportion” of clients, and clinic is a LGBTQ-friendly environment, said Lewis, the public health officer.

“In order for us to successfully mitigate the spread of these diseases, we need to be able to gain trust,” Lewis said. “We need to have staff who are familiar with the community, and sensitive to the concerns the community has.”

The nearly $1 million in state money used to reopen the clinic was a one-time grant to last two years. The health department plans to partner with lawmakers and create a data report on its care efforts to help secure the clinic’s future.

“All this money comes in when you have a health issue,” Worsham said. “Then you get it under control, and the funding gets pulled, and you’re at risk again. It’s a constant battle in public health.”

Aside from the clinic, Lewis said he didn’t know of any public health care programs or campaigns targeting Snohomish County’s LGBTQ+ demographic. Globe, the local LGBTQ+ youth support group based in Everett, is looking to expand, Worsham said.

“It’s really hard to try to provide services to a community where people don’t feel supported,” Worsham said. The goal is “understanding the sensitivity and raising the voice of people who have lived experience as part of the work.”

Sydney Jackson: 425-339-3430; sydney.jackson@heraldnet.com; Twitter: @_sydneyajackson.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

Kim Skarda points at her home on a map on Thursday, June 20, 2024 in Concrete, Washington. A community called Sauk River Estates has a very steep slope above it. There is a DNR-approved timber sale that boarders the estate properties, yet they were not consulted about the sale before approval. The community has already appealed the sale and has hired their own geologist to conduct a slope stability report at the site. (Annie Barker / The Herald)
Beneath steep slope, Concrete neighbors fear landslides from logging above

Nielsen Brothers plans to cut 54 acres of timber directly behind the community of 83 homes. Locals said they were never consulted.

Law enforcement respond to a person hit by a train near the Port of Everett Mount Baker Terminal on Thursday, June 27, 2024 in Mukilteo, Washington. (Annie Barker / The Herald)
2 killed in waterfront train crashes were near Mukilteo ‘quiet zone’

In June, two people were hit by trains on separate days near Mukilteo Boulevard. “These situations are incredibly tragic,” Everett’s mayor said.

Rob Plotnikoff takes a measurement as a part of the county's State of Our Waters survey at Tambark Creek in Bothell, Washington on Monday, July 1, 2024. (Annie Barker / The Herald)
Snohomish County stream team bushwhacks a path to healthier waterways

This summer, the crew of three will survey 40 sites for the State of Our Waters program. It’s science in locals’ backyards.

Logo for news use featuring the municipality of Mountlake Terrace in Snohomish County, Washington. 220118
4th suspect arrested after Mountlake Terrace home robbery

Police arrested Taievion Rogers, 19, on Tuesday. Prosecutors charged his three alleged accomplices in April.

A 10 acre parcel off of Highway 99, between 240th and 242nd Street Southwest that the city of Edmonds is currently in the process of acquiring on Monday, July 10, 2023 in Edmonds, Washington. (Olivia Vanni / The Herald)
Edmonds ditches $37M Landmark public park project off Highway 99

The previous mayor envisioned parks and more in south Edmonds, in a historically neglected area. The new administration is battling budget woes.

Edmonds school official sworn in as Mount Vernon supe

Victor Vergara took his oath of office last week. He was assistant superintendent of equity and student success in Edmonds.

Lynnwood appoints new council member after abrupt resignation

Derica Escamilla will take the seat vacated by Shirley Sutton in May, who claimed the city had a “total lack of leadership.”

Everett Housing Authority is asking for city approval for its proposed development of 16 acres of land currently occupied by the vacant Baker Heights public housing development on Tuesday, Oct. 18, 2022, in Everett, Washington. (Olivia Vanni / The Herald)
Everett council locks in building heights for Park District

After months of negotiation, the council approved on Wednesday the 1,500-home project with buildings as high as 12 stories.

Onions are grilled up at the Walla Walla Burger booth during opening day of the Evergreen State Fair on Aug. 25, 2022 in Monroe, Washington. (Olivia Vanni / The Herald)
Save money and time with advance ticket sales for Evergreen State Fair

The fair’s 115th installment runs 11 days starting Aug. 22 in Monroe. “Bright Lights, Summer Nights” is the theme.

Jayden Hill, 15, an incoming sophomore at Monroe High School is reflected in the screen of a cellphone on Wednesday, July 10, 2024 in Monroe, Washington. (Olivia Vanni / The Herald)
Come fall, Monroe students must silence their cellphones in class

Elementary and middle school students won’t be allowed to use phones in schools. High schoolers will have more leeway.

Members of “Everett Deserves a Raise” group turn in their signed patients to the the clerk at City Hall on Thursday, July 11, 2024 in Everett, Washington. (Olivia Vanni / The Herald)
Everett minimum wage initiative submits signatures to get on ballot

Meanwhile, another group is leading a campaign for a similar local measure, but with a few notable differences.

The winner of the 2023 Great Mukilteo Dog Show at Lighthouse Park in Mukilteo. (Photo provided by Kandace Barnes)
All dogs are show dogs at the Great Mukilteo Dog Show on Saturday

The mayor “double dog” dares you to attend. Categories include Best Wiggles and Most Slobbery at the show at Lighthouse Park.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.