In Her Words: a Pride Month Spotlight on Julia DiCola

By: Jackie Nappo and Julia DiCola

Julia DiCola is a fierce advocate for the homeless, particularly homeless youth, in Connecticut. She’s the first transgender board chair for Optimus Health Care, which is the second largest community health care clinic in Connecticut. She works as the Strategic Development Director for the Greater Bridgeport Area Prevention Program, or GBAPP.

We spoke about the challenges facing the LGBTQ community in Connecticut, and how so many of the issues facing people are interconnected.

Q: Tell me a little about yourself.

A: I live in downtown Bridgeport, and this has been my adopted and spiritual home for 10 years. I’m a late life transgender-woman, and started transition journey in my mid-50s; I’m currently 64 years old. I’ve been blessed with a rather smooth transition. I haven’t had any social intolerance issues with regards to it, at least none that I am directly aware of. I guess this might be due, in part anyway, because in my mind I wouldn’t allow that to happen. I just confidently presented myself as who I am, with no excuses or any expectations of others, and I was very confident, even in the beginning. So I think my confidence helped in my public persona as well as the public receiving me.

Additionally, I feel a lot of that has to do with the fact that we live in a more enlightened world, despite the past 4 to 5 years. Notwithstanding, I would like to also mention that for many transgender individuals, transitioning is fraught with individual and complex struggles. Regarding my own struggles, the family aspect was and continues to be very difficult, l have asked a lot of my sons to accept and embrace their father as a woman, it is not easy for them and we struggle with this. But these are things that we work on and continue to deal with.

Q: How did transitioning impact your worldview?

A: I became interested in social issues during my transition, because frankly I was never previously aware of social issues, it was always someone else’s problem or concern. As I became more and more in tune with who I am and what my needs are, I realized all of a sudden that I’m a member of a marginalized group of people. I’m transgender and as such I am a member of the LGBTQ (lesbian, gay, bisexual, transgender, queer) community. Which, along with so many other groups of marginalized peoples, comes with an abundance of inequalities. To help deal with my struggles of coming to peace within myself, and issues with family, I just became very aware of social issues and I decided to dedicate myself to doing what I could.

Q: What did you do?

A: I started on my own doing some outreach work. Initially my interests lay with the homeless, particularly homeless and at risk youth. I was just going out after work doing what I perceived to be outreach, on my own — I wasn’t affiliated as a volunteer with any organization. Just going out on my own, a sort of “save the world” idealism and offering some sort of compassion.

I had no idea what I was doing and no idea how I would help people. I would set out to find homeless youths and adults and when I came across individuals, I would listen to their story, and offer them a little bag of lunch with a sandwich in it. Eventually, I started to network with nonprofits and work as a volunteer in soup kitchens, food pantries, and outreach programs for the homeless. Through that networking, I was introduced to an organization called GBAPP, which is an organization in Bridgeport that works with and has housing programs for homeless youth, as well as an HIV/AIDS prevention program. It’s a national program called The Ryan White Foundation as well as other associated programs such as the KYS (know your status) program.

The executive director and I hit it off and I started working for them in the capacity as the Strategic Development Director. A little later on, I was asked to join Triangle Community Center as Director of Program and Services and Operations. All throughout this period, I had been and continue to be a patient (consumer) of Optimus Health Care, before and during my transitioning. I became involved as a member of their patient advisory committee and then one day I was nominated to the Board as a Director and just recently I was selected to be Board Chair and needless to say, I’m the first transgender Board Chair they’ve ever had. I haven’t done the research but I’d venture to say it’s a safe assumption that I’m the first transgender board chair of any non-LGBTQ organization in the state.

Q: Could you talk a little more about Optimus Health Care and the services they offer?

A: Well if you don’t know about Optimus Health Care, let me give you some highlights. We are the second largest federally qualified community health care center in CT and by far the largest in south western CT. We serve approximately 50k patients in our 33 facilities through 430 clinical and professional staff members and basically provide about a quarter million individual patient visits a year for service and care ranging from general wellbeing, pediatrics, dental care, behavioral health, and OBGYN services. We even have limited capacities with specialties like optometry and podiatry and acupuncture.

We’re a full service medical center, and we do great work. Our primary focus is to be in the community and serve those who may be marginalized and underserved and maybe don’t have the ability to pay for medical services. Most of our patients are HUSKY (Medicaid) patients. But we have a fair amount of patients who simply don’t have the ability to pay. Nobody gets turned away. We have a threshold tolerance, which means anyone who crosses the threshold of our doors is welcome and will receive services. It’s a wonderful organization.

Q: What is the landscape like for a transgender person in Connecticut who needs health care?

A: I have to share with you that I didn’t really jump through a lot of hoops to get the care I needed. I just was able to find care, and where I found it there were really never any problems. I think a lot of that has to do with the fact that the Affordable Care Act also included sweeping changes in medical diagnosis and coverage; the deletion for preexisting medical exclusions for instance. But also, it’s important to always keep in mind that the medical community treats transgender care and needs as real medically clinical issues. Being transgender is a misassignment of gender, and that is not an abnormality. It’s a medical issue that requires mental and emotional health care, physical health care, and social change.

Because I’ve been able to find competent care, it’s been my experience that the barriers to getting appropriate care as a transgender person can be more social barriers, and can occur when individuals aren’t comfortable or supported through their transition. That becomes a barrier. This is certainly prevalent amongst teens, to get medical help their barrier can be and very often is their parents. Their parents haven’t accepted them.

Actually, I’m going to cross over to talk about my interest in homeless youth and youth at risk. In CT, there are an estimated 5,500 youth and young adults under the age of 23 who are considered being unstably housed (which is a nice way to say in some state of being homeless). Of these, we estimate anywhere from 40 to over 50 percent of all homeless youth are members of the LGBTQ community, with the majority of them being transgender. One of the barriers for receiving transgender health care for young people, for teenagers, often starts with the family. The family doesn’t condone or allow them to begin their transition, and often it is dangerous environment from external and/or internal conflicts, and the young transgender individual chooses what they perceive to be a more safe environment for them on the streets on their own. That is a tragedy, quite frankly.

I think a lot of why transgender health care has a tenuous future is because of social and political circumstances. We had an effort in the previous federal administration to eliminate transgender health care from the medical guidelines as far as qualifying for Medicaid benefits, and you know in the course of the previous administration the banning of transgender individuals from the military, and even recently there was an issue with young transgender athletes being banned from competing.

So there’s a lot of social pushback. Even though I mentioned earlier that we live in a more enlightened age, it doesn’t mean the prejudices and pushback and condescending judgment don’t exist. They’re still there. And depending on the temperament of whoever’s in office, that pushback is muffled or amplified. And we’ve had some instances where it’s been amplified again.

We’re very fortunate that we have a current administration that is trying to undo some of the pushback that’s occurred over the past four years, and I think as society becomes more and more educated on LGBTQ issues and more and more LGBTQ individuals serve within society in the greater whole, I think we’ll eventually get to that point where it’s not nearly as much of an issue as it has been.

Q: What threatens the possibility of a better future?

A: It’s a possibility, and a dangerous one, that society once again reclassifies transgender individuals as having an abnormality as opposed to a treatable medical issue. As I pointed out, the previous federal administration went out of their way to create barriers for transgender people. But we’re lucky now that those barriers are being torn down again.

As long as insurance is able to pay for transgender health, as long as it’s classified as a medical condition and not an abnormality, then in my opinion there really shouldn’t be barriers so difficult that someone wouldn’t be able to find transgender care if they started out with a purposeful intent to do so. And I’m only using myself as an example, and I don’t mean to make commentary on my transgender siblings. Every transgender person has their own individual struggles, and I respect that.

Q: What gaps exist in advocacy for transgender health care?

A: I would like to point out that there are not enough LGBTQ organizations serving the LGBTQ community. That’s what I think is at the core of the issue. the agencies that I’m aware of, Triangle Community Center in Norwalk, New Haven Pride…they are really to the best of my knowledge the two primary LGBTQ community centers that offer social services for a whole range of issues, including housing issues for those who are struggling with housing.

Both centers have support programs for primarily youth, but they offer adult services, too. And I know firsthand with regards to Triangle Community Center, they offer somewhere in the area of 30 different support programs whether you’re gay, lesbian, transgender or questioning a youth, or a senior, social programs and substance abuse recovery…they have all of these programs, and I know that the New Haven Pride Center has similar programs though I’m not 100% familiar with width and breadth of them all. True Colors in Hartford works with the LGBTQ school aged youth.

So then that leaves the traditional non LGBTQ nonprofit agencies that work with various issues. To be frank with you, in my experience, there are no barriers to LGBTQ individuals within these organizations. These organizations are dedicated to serving the community, no matter what race, creed, color, orientation, etc. someone is.

It’s available, but what’s difficult; is navigating the waters of receiving social services or health care.

Getting back to LGBTQ youth, often, navigating the waters is impossible because of the dynamics of the family. As I mentioned previously, 40 to 50 percent of homeless youth are part of the LGBTQ community. And what happens because of that is these youth are not only homeless, but they are now at risk for many other social ills. Many of them are resorting to sex trafficking, for perceived safety. Many of them are trafficked against their will. Many of them fall into drug abuse. They’re very often vulnerable for violent acts against them, or various illnesses, just by being homeless. So what happens is that these issues are all interconnected with one another.

With regards to LGBTQ individuals, thank God we have the resources and safe space we do, even if it’s only a few. They’re there because at the very least it’s a neon sign that says we’re a LGBTQ center and they know this could be a safe haven for people who are struggling or lack support or resources.

It’s all very interconnected, and health care is a big part of that. Because again, people may not have knowledge that there’s a community health care center that’s an open door for them and that health care is available. Many of them are getting health treatment in emergency rooms, and that’s a very costly proposition for society in general. The most costly place for somebody to go for medical treatment is an ER. Community health centers actually save society money because we’re helping people outside of the ER.

It always boils down to funding. In a world where funding was abundant, we would have a lot more outreach in the streets looking for individuals that we could help. I think we would have more open structured drop-in centers, for lack of a better description.

As a matter of fact, that was a vision of mine. To open a drop-in center for young people and adults where it has no structure but it’s just a safe haven to come. My vision was to be named the August West House, named after a fictional homeless individual in the song Wharf Rat by the Grateful Dead. Within there, we could help individuals navigate to the care they need. It’s a vision that I have and still have and I would love one day perhaps to bring it to fruition. But it’s very difficult and challenging. If I keep working on it sooner or later it might become a reality. But that would be something that would help all these issues.