On Health & Equity: PhD Student Anthony Velasco Focuses on LGBTQ+ Communities

Why did you gravitate to nursing?

Both of my siblings are in healthcare. One of my sisters used to teach in a prominent university in the Philippines, and the other worked as a nurse. Growing up, I saw how passionate they were with their careers and it really inspired me to pursue a degree in healthcare as well. At the time, I was not sure what I wanted to do, but I knew I wanted to be in a caring profession. As I grew older, I realized that nursing is in line with my personal and professional goals. I also liked the flexibility of nursing.

You said in a recent podcast that there’s a dearth of research in clinical practices for the LGBTQ+ community. At what point did you realize that should become your research emphasis?

There have been so many people in the LGBTQ+ community who have inspired me and made me realize I have the agency to be who I am, who I want to be, and to live my truth. Addressing health disparities and doing research with my community is a way for me to give back. I’ve also had several conversations where I’ve been able to sit down with my patients and hear their stories and learn about the conditions that made them more susceptible to poor health outcomes. For instance, poor access to care, income inequality or poor access to critical resources along with homophobia, transphobia, racism, and stigma all contributes to the risk of getting HIV. Understanding these complex relationships is critical for nurse researchers so we could be more effective in our interventions.

The data really bear out these disparities, but throughout your career, you have really observed them first hand.

I could talk all day about these disparities. In 2015, there was a landmark study that surveyed almost 27,000 transgender or gender-diverse adults 18 years or older in the U.S. It showed that 23% of gender-diverse people avoid getting medical care. Transgender people also have higher rates of multiple chronic conditions, higher rates of smoking and alcohol use. They are more likely to report a poorer quality of life or have higher rates of disability. There are so many ways that transgender people aren’t doing very well. If you look at mental health, 40% of transgender and gender-diverse people have attempted to commit suicide at least once in their lifetime. That’s nine times the rate of the population of the U.S.

As far as a dearth of research, when I look at literature, most studies aggregate transgender people with cisgender lesbian, gay and bisexual people. It’s a disservice because transgender people have needs that are different from cis LGB people. Gender identity and sexual orientation are also completely different but oftentimes, people conflate them together. And when data is collected, it’s often aggregated so it’s hard to discern the experiences of trans people in different aspects of life.

You decided to pursue your PhD. Why did you decide to do that?

I felt that a PhD would give me the tools that I need. I applied to a number of PhD programs and I was accepted to all of them. Some of them were fully funded but I still chose the PhD program at the CU College of Nursing because it was more in line with my professional goals. I am interested in exploring primary access among transgender older adults using a socio-ecological model and I thought the CU Nursing program had the tools I needed to do my research properly. It was only one of four programs in the U.S. that had a healthcare systems research focus and the only one in the western United States.

I also looked at the faculty list and what their research programs were. I was so impressed by the faculty members at CU Nursing, such as (Assistant Professor) Kate Coleman-Minahan (PhD, RN) and (Associate Professor) Scott Harpin (PhD, MPH, RN). Both of them were among the major reasons I chose CU Nursing. Dr. Coleman-Minahan’s research is on reproductive justice – especially among migrant Latinx people, and Dr. Harpin’s research is around unhoused youth. Even though our population interests are different, there are parallel stories. All of the research we are working on is on historically minoritized communities. Their work revolves around social justice and access to care.

Has the program been everything you thought it would be?

Yes, absolutely, that and more – especially with my cohort. Our cohort started at the height of the pandemic but the faculty and the college in general have been so supportive in making sure that we develop good camaraderie and really good bonds. It’s also a very small cohort, so that’s been helpful in making us a very tight-knit group. I also appreciate that we meet for intensives every semester because that gives us the ability to reconnect with colleagues, faculty, and the PhD advisors in person.

How do you hope your work will make a difference in the long term?

I am really optimistic about the work that I am doing. I read this book by Dr. Musimbi Kanyoro, a human rights advocate, who talked about “choked silence.” This is when people have a voice but they are not really being heard. I think that’s what really inspired me in the research I am doing. I am using narrative inquiry and storytelling to amplify people’s voices. I also want to continue building my research program and taking part in educating this new generation of nurses. There’s a big need to really educate healthcare providers to be culturally humble and understand the needs of LGBTQ+ people and I think being involved in academics will hopefully help address the deficiencies we’re seeing in practice.

October is LGBT History Month. Why do you think it’s appropriate to honor that history?

It’s important to recognize the struggles of certain communities – especially in a time like now where there are a lot of actors who are creating barriers for getting care. LGBTQ+ people resist all of the barriers that we as a community are facing, but we also need people who are not part of the LGBTQ+ community to be good allies and fight social injustice and barriers to healthcare.

What do you consider to be your “superpower” in life and in work?

I think my superpower would be empathy. I think having so many overlapping identities that are often minoritized – like being a person of color, being LGBTQ+, and all of these overlapping identities – have helped me become more acutely aware of experiences of other people, and that’s helped me to listen, to hear, and to connect.