Family genogram

Introduction to family and community

This part provides a series of case studies about an older gay couple, named Jay and Giani. They moved to northern New South Wales soon after they met to establish a lifestyle that suits their values and enhances their wellbeing. They set up a beautiful home in an inclusive community and were very actively involved in social and community events.

This part illustrates how both men experience life changing health concerns and the challenges they face in navigating the health system in a regional area. The part begins with a section outlining family background, history and relationships, with a brief overview of their lifestyles as they transition to retirement. This is followed by 4 case studies including: 1) a total knee replacement, 2) complex issues in equity and inclusion, 3) dementia, and 4) climate emergencies affecting health outcomes.

The Calos-Clark family

Giani Calos (56) and Jay Clark (62) are cisgender men in a same-sex relationship who met 16 years ago at an event hosted by mutual friends in Sydney. At the time of their meeting, Jay had recently left his marriage to his wife Jules, whom he had been with since he was 25. Jay had felt for some time he was gay and had come out to Jules resulting in tension and eventual separation. When he met Giani, who was originally from Ecuador, it was his first real same-sex relationship. He says he found his soulmate when they met at a music festival in Sydney. On the other hand, Giani thought Jay a bit boring at first and took several weeks to warm to him. They are now a deeply loving couple and strongly committed to each other.

Shortly after getting together, they felt called to have a sea-tree change and make the move to a more rural setting. They each felt a bit burnt out by the Sydney scene and moved to Brunswick Heads in an area known as the ‘rainbow region’ of northern NSW. Upon moving to Brunswick Heads, the couple developed a block of land on Riverside Crescent, originally purchased by Jay and Jules. Now owned solely by Jay, it has a beautiful view of the Brunswick River and the forest that surrounds the block. They brought in a Queenslander house they had saved from demolition in Beenleigh. They had it lifted to create storage and covered parking underneath for their primary vehicles and Jay’s vintage car. They lovingly restored the house to its original 1930s federation style condition, and it is now their pride and joy.

Giani and Jay are extremely happy following the move to Brunswick Heads. Giani became a spiritual healer following a life changing retreat in the Byron Hinterland 10 years earlier. Jay retired from teaching music in high schools about 3 years ago, and since then, he and Giani have opened Natural Rhythms, a business that offers private music lessons and spiritual healing. They are very popular in the area and have created a great reputation in the community. Their social circle is extensive. Giani and Jay consider themselves activists and agents of change. They work closely with local community organisations in a small town that is becoming more supportive, running fundraisers, often raising money in unconventional ways, such as drag bingo events, for the benefit of the  LGBTIQ+ community.

Calos family members

Katarina Calos: 32 years old at time of death

Thiago Calos: age unknown when he married Katarina

Katarina, Giani’s mother, was born in Ecuador to older parents. She was the youngest child of 10 and was frequently left alone with her older siblings, as her parents both had to work full time. Her family considered her ‘spacey’. While her father, Iberto, often berated her for daydreaming, her mother, Lucina, loved her deeply and encouraged her creativity. Katarina had hopes of either being a doctor or a nurse when she grew up. Her father worked as a subsistence farmer. Her mother was part of the Panama hat trade, weaving hats for export to New York. In winter, Katarina’s father travelled to the coast to find work, as the crops did not grow during the cold season. The older children were capable of maintaining the livestock in his absence.

Katarina met Thiago when she was 14. Thiago was the grandson of their neighbour and visited each summer. The details of their early relationship are unknown. What is known, however, is that Katarina did not like Thiago at first, staying away from the neighbour’s farm while he was there. She only grew to really love him after their marriage. When Katarina was 15, she told her older sister Livvia that she might be pregnant. When it became clear she was indeed pregnant, her father forced Katarina to marry Thiago, despite her begging not to as she wanted to continue her education.

When Katarina gave birth to Giani at 16, she and Thiago settled into parenthood uneasily. Katarina often resented that Thiago was able to leave home to go to work for the day while she was at home with the baby, weaving hats like her mother. Katarina eventually got the hang of it and when Giani was about 2 years old, she found she really loved being a mother. She started doing small jobs outside of the home, taking Giani with her.

When Katarina was 20 and Giani 4 years old, Thiago went to the coast with Katarina’s father to find work over winter. But Thiago never returned. It later transpired that Thiago had been having an affair with a local woman, telling her he planned to migrate to Los Angeles and she was to join him. Neither Katarina nor the other woman ever heard from Thiago again. Around this time Katarina discovered she was pregnant again, but miscarried the baby at 23 weeks, her fourth miscarriage since Giani’s birth. Katarina sunk into a heavy depression following the loss of this last baby, a depression that lasted for 4-5 years. During this time, Giani was largely attended to by his grandmother and aunt Betina. While Giani did his best to keep his mother’s spirits up, there were long periods of time when Katarina was unable to get out of bed or go to work.

The bills piled up during this period. However, when Giani was nearing 10, Katarina seemed to improve, and she was able to work again. Giani remembers the next 5 years as an extremely happy time, surrounded by his mother’s loving family. Tragedy struck Katarina at age 31 when she was diagnosed with multiple sclerosis. At the same time, Katarina’s sister Betina and her mother, who had both raised Giani for a long period of time during Katarina’s period of depression, were killed in an accident on the family farm. Katarina again sunk into a heavy depression, from which she never recovered. At the age of 32, Katarina committed suicide in her family home, leaving Giani to be cared for by his grandfather, Aunt Livvia and her husband Calos.

Giani Calos (aka ‘Monty Carlo’): 56 years old

Giani was born to Katarina and Thiago Calos in Ecuador. English is Giani’s second language. He has an accent and sometimes finds it difficult to read and write in English. At age 25 Giani came out as gay. His grandfather disowned him but his aunt Livvia continues to be a strong presence in his life at the age of 84. Giani worked in the oil industry in his 20s, like his uncle Calos, Giani’s self-adopted father.

At age 27, Giani migrated to Spain from Ecuador during an economic crisis where the unemployment rate was 15%. When Giani was unable to get a job in the oil industry in Spain, he migrated the following year to Australia to work in the mining industry. He later relocated to Sydney and joined a cabaret. At age 30, Giani opened an art gallery in Oxford Street and later opened a drag bar 100 metres down the road.

That’s where Giani created his drag persona ‘Monty Carlo’. She became a big part of Giani’s life and has been there to help him through a number of difficult situations. Monty Carlo and Jay host regular bingo nights, which have been helping to raise funds for research and community services for those living with health problems like HIV and their families.

Giani has a past history of smoking, but quit 5 years ago after losing a close friend to cancer. His GP has recently prescribed an ACE inhibitor, perindopril, for hypertension. While Giani’s blood pressure was previously under control with diet and exercise, he has lost a lot of mobility more recently due to a bad knee. He is now awaiting a total knee replacement.

Giani has a large extended family with lots of relatives in Melbourne and Sydney, whom he lived with when he migrated to Australia. As he had significant trauma following his mother’s suicide when he was 16 years old, he sometimes experiences periods of depression that require intensive cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs). In general, though, he is able to self-manage with good nutrition, sleep and exercise and aims to live a healthy lifestyle. He is a vegetarian and loves his garden. He has always been a professional performer and is an excellent dancer.

Clark family members

Jay Clark: 62 years old

Jay was born in Melbourne but his birth parents are unknown. Jay was adopted to a childless couple at the age of 6 months. He had a very happy upbringing, first with his adoptive parents Martha and Rob, and then 3 years later with his adopted twin sisters Maggie and Hope. He is unaware of any family medical history.

Jay loved music as a child and had hoped to perform professionally. He later decided he would have greater stability in life if he pursued a teaching career like his father Rob. This worked out very well for Jay. Becoming a music teacher allowed him to keep his passion for music, while passing this onto many generations of students who thought he was the best teacher they ever had. Jay moved to North Sydney in his mid-20s and lived and worked there until he met Giani. Jay has now been retired from teaching for about 3 years.

Jay met Jules when he was 25. Jules worked in the front office of the school where Jay was working as a music teacher in North Sydney. Jay loved that Jules was a funny and irreverent sort of person, as he had been quite serious for most of his life. They dated for about 8 years before getting married and some years later had their first child, Quinn now aged 24, followed 4 years later by Regan now 20 and then Sasha now 19 years old. About the time Regan was born, Jay began to explore his attraction to men and pushed aside his sexual needs for the marriage and family. However, when he discussed this with Jules, she did not receive it well. Given her response, Jay decided to let it go and they went on to have another child, Sasha. By the time Sasha was 2 years old, Jay decided he needed to be true to both himself and Jules and asked for a separation.

After commencing his relationship with Giani following a few flings with other men, Jay’s separation from Jules became very hostile. Jules had often felt Jay was deceiving her about his reasons for unhappiness in the marriage. This was confirmed for her when he began his relationship with Giani. On the other hand, Jay believes he had been very forthcoming about his feelings during the marriage. They split their assets 50/50, but had to sell the family home in Manly to liquidate their joint assets. Jay bought out Jules’ stake in the block of land in Brunswick Heads. Jules was then forced to rent a 3-bed bungalow in Revesby, a long distance from her workplace and the rent has recently increased.

The breakdown of the relationship led to ongoing conflict with Jules, who still feels she was taken advantage of both during the marriage and after their separation. While Jay maintains a very strong relationship with his 2 younger children, Regan and Sasha, his relationship with Quinn is very strained, an ongoing point of contention between Jay and Jules. Although Jay has spent many years trying to bridge the gap with his oldest son, Quinn is not receptive to a closer relationship. He is very protective of his mum and blames his father for her struggles in later life.

Given the children were so young when Giani and Jay became involved, they have been raised with Giani in their lives from a very early age. Regan and Sasha have a very close relationship with Giani, love him dearly, and call him ‘papi’. Giani considers the 3 children to be his and is very proud of their achievements and who they have grown up to be. This is very upsetting for Jules, as she sees Giani as the man who broke up her marriage. Quinn refused to stay with Giani and Jay after the age of 12 and insisted instead on his father seeing him in Sydney for their visitation. Quinn refuses contact with Giani and will not attend family events if he knows Giani will be there. This has created conflict between the siblings, who believe their mother has influenced Quinn’s opinion of Giani.

Lately Jay has been struggling with his memory, and Giani has noticed some personality changes. They initially put this down to exhaustion from setting up the business but are now considering consulting a doctor.

Jules Clark: 58 years old

Jules was born in Sydney and had a middle-class Australian upbringing. She completed her retail training certificate at age 20, and later went on to complete her training in office work. She worked in a number of temporary positions in offices in central Sydney, before applying for and getting the position in the front office of the school where she met Jay.

Jules was 21 when she met Jay and they dated for some years. Her friends used to tease her that she would never get Jay to propose, but he finally did after 8 years of dating. They eloped to Tasmania to get married 3 months later. When Jules was 41, she was blindsided when Jay said he was gay and wanted to separate. When they separated, Jules was very angry. Although she had known for some time that Jay was gay, she didn’t think he would ever leave her. During the separation, they had to sell the home Jules and Jay had bought in the early years of their relationship, during a downturn in the housing market, losing money on their purchase price. Once all the assets had been sold, all that was left was a block of land in Brunswick Heads they had purchased to build an investment property. Given Jules was left with very little financially at the end of the marriage, she jumped at the chance to sell her half of the property to Jay so she could afford to rebuild her life. However, she was devastated to part with it. She had always seen the investment property as her nest egg in retirement.

Jules still lives in Sydney with her child Sasha. She is very close with Quinn who she leaned on during the separation. She also enjoys a close loving relationship with her other 2 children, Regan and Sasha, although they disagree with her stance on Giani. They elect not to discuss Giani in the family setting to avoid conflict.

Jules has been struggling financially since the separation, because she had stopped working to be a stay-at-home parent during the marriage and did not have any superannuation prior to having children. She always worked in casual jobs during the years of their relationship because Jay was the breadwinner. Jules was told last month by the GP practice where she has been an office manager for the last 2 years, that after merging with a larger practice down the street, they will need to cut her hours to 20 hours per week so they can keep as many staff as possible. She also discovered in the last 6 months that the practice she worked at previously for 10 years had been faking deposits into her superannuation account, and she has been left with nothing. She does not have the money to pay the legal fees to take the case to court which is the only option her lawyer could suggest.

Jules has recently been told the rent on the 3-bed bungalow she has lived in for the last 16 years is going to be increased. Jules is in no financial position to buy her own property, but also can’t afford the rent increase. One-bed flats in the area are the only option she can see at the moment, but she is not wanting to downsize her life that much, as Sasha is still living at home, and feels she was cheated out of income during the marriage.

She has had to continue to be strong for the last 16 years and get the kids through their education. Now that all the children have good jobs, except Sasha who is still completing university, she feels it is time to focus on her needs.

Quinn Clark: 24 years old

Quinn was Jules and Jay’s first child. He is a very serious and well-liked young man. When his parents separated, Quinn was nearly 8 years old and his entire world fell apart. His mother, who was previously happy, fun and full of laughter, became sad and serious. His father moved nearly 800km away a year later to start a new relationship with a man.

Quinn’s mother gained full custody during school terms, and his dad had access for one week each school holiday and 3 weeks over the Christmas break. Jay paid $250 child support per week. When Quinn was 12, he refused to go to Brunswick Heads to see his dad anymore and cut off all contact with Giani. From that time, Jay came to Sydney for a week every 3 months. During those weeks Quinn stayed with Jay at Jay’s sister place.

Quinn became more and more resentful of his father as he watched his mother struggle while Jay and Giani lived an idyllic life in Brunswick Heads. Quinn now has minimal contact with his father and none with Giani. He feels the couple cheated his mother and their family out of a happy life; he blames them entirely for the disruption to his childhood.

Aside from the strained relationship with his father, Quinn got good grades at school, despite a diagnosis of dyslexia at age 10. He completed numerous sessions with a speech therapist and managed to develop successful strategies for reading and writing. After graduating, Quinn took an apprenticeship as an electrician. He loves his job and is considering returning to university to study electrical engineering. He is dating a woman called Clare and they are very happy, recently returning from a trip to New Zealand.

Regan Clark: 20 years old

Regan was only 4 years old when her parents separated. She does remember some occasions from her childhood when her parents were together, but for the most part, unlike Quinn, she mostly remembers them being apart. Regan loves her visits to Jay and Giani during the school breaks and adores it when Monty Carlo is around. Regan feels right at home in Brunswick Heads and has developed a good social circle in the town over the years. She is currently sharing a flat with a girlfriend she met when she was 10 in Brunswick Heads.

While Regan is saddened by her mothers’ feelings towards Jay and Giani, she doesn’t blame her; she has watched her mother financially struggle for the last 16 years. Regan learned in her early teens it was best not to bring up the subject of Giani as it would send her mother into a spin. Regan shares a loving bond with her mother, although at times she worries her mother takes on too much to try and keep them afloat. Regan’s relationship with both her father and Giani is both serious and light-hearted. She considers herself lucky to have two amazing dads and a very loving mum.

Regan is in her final year of university, studying a Bachelor of Arts in international policy. She hopes to become an ambassador in the future and recently was awarded an internship with the United Nations in New York. It was a highly coveted position, only awarded to 3 people per year. Regan now works as a model to make ends meet. She has been lucky to travel all over the world with her modelling. However, her priority is to use her modelling social media profile for her work on equality and climate change.

Sasha Clark: 19 years old

Sasha is Jules and Jay’s youngest child, only 2 years old when their parents separated. Sasha has no memory of their separation at all, and only knows them apart. Sasha loves their parents equally, and feels they have mostly been able to keep out of the conflict, using the same strategies as Regan. They spent an extended period of time with Giani and Jay in years 11 and 12 when they did a transfer of study arrangement between their Sydney school and one in Byron Bay. At that time Sasha wanted to study marine biology and it was around then that they came out as non-binary. Now in their first year of university studying a Bachelor of Laws (honours), they are so far managing their study load quite well. They managed to get a scholarship to study their degree, which was a relief to them as they were worried about financially burdening their mother. Sasha is very close with Giani and talks to him several times per week on the phone. They feel that Giani is the one they would go to in a crisis and that Giani understands them the most.