LavenderHealth joins in celebration of the US Supreme Court ruling on Marriage Equality

Today, the landmark ruling by the U.S. Supreme Court made marriage equality the rule of the nation!  While there are many challenges ahead, the fact that there are so many symbols, everywhere we turn, of support and utter joy, makes this occasion one for unrestrained celebration!  Watch this video of the comments made by the chief plaintiff in the case, Jim Obergefell, whose story is a moving example of the importance of this decision and its effect on health and well-being:

White house rainbow2

Supreme court Love

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Victimization of Transgender People

The Southern Poverty Law Center (SPLC) is an internationally known group that is dedicated to fighting hate and bigotry and to seeking justice for the most vulnerable members of our society. Their work on LGBT issues spans decades and primarily focuses on the Southeast. They recently published a poignant article, In the Crosshairs, about the victimization of transgender people. The author, Don Terry, profoundly describes the horrific crimes that are perpetrated toward transgender people. It is eye-opening and illuminates the amount of work that still needs to be done for the trans community!

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Nursing Research Interest Group Forming in US Eastern Region!

More and more frequently, we see signs that LGBTQ health is gaining attention in nursing!  Last month we posted information about two important LGBT policy statements that were issued by the American Academy of Nursing  Today, we learned of a historically significant initiative to form a research interest group in one of the largest nursing research societies in the U.S.!

The Eastern Nursing Research Society (ENRS) is calling for members of the Society to form a research interest group (RIG) focused on LGBTQI health and health disparities.  Here is what they sent out to members today:

There are a growing number of nurse scientists interested in this area of research, but few opportunities exist for collaboration, particularly for those early in their career trajectory and/or not located in urban centers. In addition, for those of us who are engaged in work in this area, there are barriers to getting research approved, funded, and published.

 Our goal is to build a network of nurse scientists to facilitate the sharing of ideas, resources, and experience in order to increase the amount of high-quality research and the dissemination of research findings in the area of LGBTQI health.

ENRS members who are interested, send an e-mail that includes your name and ENRS member number to enrs.lgbt.rig@gmail.com by July 4th, 2015.  If you are in the Eastern Region and want to support this effort, contact them to learn more! You can find out more about ENRS by visiting their web site here!

Eastern_Nursing_Research_Society_Home_Page_-_ENRS

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Meningococcal Disease Outbreak in Chicago, MSM Urged to Get Vaccinated

For at least the second time in recent years, a small but alarming outbreak of meningococcal disease has occurred among men who have sex with men.

Reported in the GLMA online update:

Chicago health officials have noted a small, but serious outbreak of meningococcal disease has been detected in the Chicago area with now four confirmed cases in a short period of time. Chicago health officials are recommending gay men, especially those living with HIV, receive a vaccination for the disease. “”We really want to interrupt the spread of exposure and we want people to hear the urgency of this call,” said David Munar, President and CEO of Howard Brown Health Center in a Windy City Times article on June 5, 2015.

More recently, the Chicago Tribune has reported on a vaccination campaign: “Chicago and national health officials are urging all gay and bisexual men to get vaccinated for meningitis, a potentially fatal bacterial disease responsible for the death of one man in a small but growing outbreak in the city.” Details here: http://www.chicagotribune.com/news/local/breaking/ct-meningitis-outbreak-vaccine-met-20150619-story.html

Particularly at risk are “HIV-positive men who have sex with other men, men having anonymous sex with other men, and men using ‘hook-up’ apps to find sexual partners.” In addition, “African-American men have been disproportionately affected by this current outbreak.”

Bacterial rather than viral meningitis, this form of meningococcal disease can cause symptoms that “include fever, headache, stiff neck, nausea, vomiting, confusion and increased sensitivity to light.” Left untreated it can quickly cause death, but, even if survived, patients may experience brain damage or hearing loss.

Vaccination locations in Chicago can be found here: http://www.cityofchicago.org/city/en/depts/cdph/supp_info/infectious/meningococcal-vaccine-locations.html

For current information from the Centers for Disease Control and Prevention, visit here:  http://www.cdc.gov/meningococcal/index.html

 

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Get your Gay Pride On! Time to Celebrate!

June is the time of year when many communities celebrate gay pride – many with a parade that features the best and most outlandish displays of pure joy at the opportunity to loudly and publicly proclaim our LGBTQ identities.  The June dates commemorate the June 1968 riots that occurred in New York City following brutal police raids on Stonewall Inn, a gay bar in Greenwich Village.  If we could re-play those riots, they would probably not seem very different from today’s protests and riots that follow police brutality that is disproportionately directed at Black and Brown men.  Like today’s protests, the riots that followed the Stonewall Inn police raids quickly spread across the country, as other LGBTQ

San Francisco Gay Pride 2006

San Francisco Gay Pride 2006

communities recognized that they too were being punished for simply being who they are – for daring to live openly.

But there is a significant thing about the riots that occurred after Stonewall – more and more the public gatherings that were initially motivated as protests against brutality and homophobia began to transform into joyous celebrations – public assemblies that had an air of demonstration against hatred, discrimination and denial of human rights, but that also proclaimed the thrill of being free to openly declare LGBTQ identities. Now, year after year, gay pride celebrations declare in no uncertain terms – we are here!  They provide a context in which we can all take the brave steps to join our LGBTQ sisters and brothers in living openly and proudly – the most important single thing we can all do in seeking a world free from discrimination.

The transformation from angry riots to joyful celebration happened very quickly – by 1970 the tradition was firmly established — check out the vintage photographs from early Pride events in this tribute to Stonewall.  Of course outrage and anger directed at hatred and brutality never went away — it is a vital energizer that moves us forward.  But it is vitally important that we also come together to celebrate, to form constructive strategies for change, and to mourn each and every instance of injustice.  So this June of 2015, I hope that you are finding a space to celebrate our diversity – and to openly acknowledge LGBTQ people and communities everywhere!

 

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AMA Adopts Policy on Transgender Military Service

If you have not heard, the American Medical Association (AMA) just passed a resolution stating that “there is no medically valid reason to exclude transgender individuals” from U.S. military service. The National Center for Transgender Equality estimates that over 15,000 trans people are serving in the military, despite rules forbidding them to serve openly. Similar to the “don’t ask don’t tell” era where lesbian and gay people were discharged from the military if they disclosed their sexual orientation, trans people are restricted from openly serving. The Pentagon still instructs military recruiters to reject anyone with a “history of major abnormalities or defects of the genitalia including but not limited to change of sex.” The AMA resolution, which was led by GLMA, will hopefully be considered when the federal government considers revising the current rules. The resolution acknowledges that the current regulations that exclude trans people from openly serving are unsupported by modern medicine, and that trans service members be provided care according to the same medical standards that apply to non-trans personnel.

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What’s sexual orientation got to do with it? LGBTQI reproductive health

Co-authored by Monica McLemore, PhD, MPH, RN, assistant professor at the University of California San Francisco, and Candace W. Burton, PhD, RN, AFN-BC, AGN-BC, FNAP assistant professor at Virginia Commonwealth University.

In 2002, the first ever, Gay, Lesbian, Bisexual, Transgender, Queer and Intersex Health Summit1 was held in Boulder Colo. This was the first time bisexual people, transgender people, and intersex people were recognized on a national level at a professional conference, included funding for travel and panels/workshops specific to bisexual, transgender and intersex issues. Additionally, it was one of the first conferences exclusively devoted to health and not centered on illness and/or risk behaviors; several panels discussed the reproductive health needs of LGBTQI individuals. Much that was discussed at that conference, specifically that health care provider assumptions about gender identity, sexual orientation and behaviors can create missed opportunities to provide clients/patients with support and education, remains true today.

Amid conflicting sexual and reproductive health information2 and political discussion of what constitutes comprehensive reproductive health care3 we believe revisiting best practices in reproductive health for LGBTQI individuals is warranted.

This post aims to offer powerful tools to educate the public and decrease reproductive stigma. Understanding basic concepts necessary to provide quality reproductive health care is essential for all health care professionals working with individuals of reproductive age. As discussed in our previous blog post4, gender identity is fluid; however, sexual orientation (defined by the Human Rights Campaign5) is “an individual’s physical and/or emotional attraction to the same and/or opposite gender,” could be distinct from gender identity or expression and can also be distinct from sexual behavior. In other words, both sexual orientation and sexual behaviors can also be fluid.

Gender identity ≠ Sexual orientation ≠ Sexual behavior

A few simple considerations can enhance practitioners’ ability to provide comprehensive reproductive health care to individuals irrespective of sexual orientation, behavior and/or gender identity.

First, it is imperative that providers develop sensitivity around these issues. Providing individuals opportunities to tell you how they identify creates a “safe space” that clients can use to make the best reproductive health care decisions for themselves and their partners. Simply asking: Do you have sex with men, women or both? of all clients/patients should be routine practice and eliminates assumptions about sexual orientation and gender identity/expression.

Asking direct questions such as do you or your partner(s) need contraceptives or birth control to prevent pregnancy? or do you want to become pregnant in the next 12 months? removes assumptions about the reproductive potentials of the gender fluid and individuals with diverse sexual behaviors.

Relatedly, it is important to be aware that assumptions about monogamy are often just as problematic in reproductive health care provision as assumptions about anything else. Again, a straightforward inquiry about the nature of a client’s relationships can help guide recommendations about contraception and other reproductive health needs. We often ask: “Are you in a defined relationship with anyone? With more than one person?” Asking all clients if they are having sex with multiple partners (and if their partners are having sex with multiple partners) should be default to avoid missed opportunities to provide comprehensive reproductive health care to individuals involved in multiple or polygamous sexual relationships or polyamorous relationships.

In all cases, revising expectations about the needs of sexual minority, gender fluid, transgender, and polyamorous individuals creates an inclusive and welcoming reproductive health practice. Doing so promotes safe and effective practices for both providers and clients.

References:

1.http://www.thetaskforce.org/static_html/downloads/reports/reports/BisexualHealth_ORIG.pdf#http://www.thetaskforce.org/static_html/downloads/reports/reports/BisexualHealth_ORIG.pdf

  1. https://storify.com/MLive/author-tweets-sex-ed-course-at-east-lansing-school
  1. http://www.scotusblog.com/case-files/cases/sebelius-v-hobby-lobby-stores-inc/
  1. http://lavenderhealth.org
  1. http://www.hrc.org/resources/entry/sexual-orientation-and-gender-identity-terminology-and-definitions
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American Academy of Nursing Issues 2 LGBTQ Policy Statements

This month the American Academy of Nursing has issued two important policy statements that affirm LGBTQ health!  Both statements are available for download from the Nursing Outlook web site:

American Academy of Nursing position statement on reparative therapy – this statement summarizes the conclusive evidence that reparative (conversion) therapies render lasting and serious harm, and concludes that  “

efforts to “repair” homosexuality, by any means, constitute health hazards to be avoided and are to be condemned as unethical assaults on human rights and individual identity, autonomy, and dignity.

Employment discrimination based on sexual orientation and gender identity – this statement emphasizes the negative health outcomes associated with LGBTQ minority stress that results from all forms of employment discrimination, declares opposition to employment discrimination based on sexual and gender identity, and urges all health care organizations, public and private, to adopt and enforce anti-discrimination policies on behalf of their LGBTQ employees

American_Academy_of_Nursing_-_Home.

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Happy & Healthy Queer Vacations

With the arrival of the Memorial Day holiday in the U.S., the American vacation season begins. While some of us of a certain age will recall that “gay vacation” or “gay resort” usually meant something that was not “family friendly” in Key West, Rehoboth, Fire Island, Provincetown, Palm Springs, Russian River, Western Michigan, or coastal Maine, today our lives and our families are much more complicated than in the past.

While all of the usual healthy travel advice applies to queer vacations, we also have some additional considerations.

All travelers should recall that the most common health problems on vacation are the result of injury. These can include transportation accidents, including automotive, sports injuries (from skiing, sailing, or hiking), sunburn or other exposure injuries, dehydration, insect, jelly fish or other animal bites, or simply being in an unfamiliar physical space. Many of these are avoidable by exercising prudent precautions.

Other familiar health problems are the result of food or water-borne infection. Keep in mind that you, your partner, and your dependents are not Anthony Bourdain. Avoid questionable meal sources (like street vendors). Learn in advance what the water and food conditions are in your travel location. Have on hand over-the-counter medication for diarrhea, and, if traveling to a location with inconsistent water quality, secure an antibiotic in advance.

The Centers for Disease Control and Prevention provide guidance for all travelers: http://wwwnc.cdc.gov/travel . Its advice includes guidance for adults traveling with children and people who are immune compromised.

A nursing specialty, travel health nursing, reminds us of the value of this cadre of health professionals, supported by the American Travel Health Nurses Association: http://www.athna.org/ . Consulting with a travel health nurse in advance of your travel will provide you with greater security while traveling.

Sexual minority travelers may have additional considerations to take into account. Legal recognition of same-sex relationships and of custody of children varies by location. Within the U.S., for example, state laws vary widely. A prudent precaution is to have photocopies of relevant legal documents to ensure that you can provide medical care to a spouse or dependents in case of health emergency. The same, of course, applies to travel outside the U.S., for which the State Department provides informative resources: http://travel.state.gov/content/passports/english/go/lgbt.html

Advanced planning, careful vacationing, and informed risk calculation will increase the probability of your happy and healthy vacation.

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Docubank – An Exemplar of LGBTQ Inclusion

Although it is still rare to discover a mainstream service or organization that is clearly and openly LGBTQ-inclusive, it is, thankfully, becoming more common.  I stumbled across just such a service recently, when I was reminded to update my personal information that is on file with Docubank – a service that provides safe storage and access for your advanced healthcare directives and emergency medical information.  A number of years ago when my partner and I updated these documents, our wonderful lesbian lawyer recommended DocuBank_-_Immediate_Access_to_Healthcare_Directives___Emergency_Medical_Information_—_Anywhere__Anytime__24_7_365this service and enrolled us in it.  That was before marriage was legal anywhere in the U.S., and long before the demise of DOMA (the U.S. law that blocked federal benefits for same sex couples) – so then healthcare advanced directives, wills, and such were absolutely essential to assure that our “affairs” would be treated with respect according to our wishes when the time comes that we cannot speak for ourselves.  Now, of course, a few of the blocks that stand in the way have been removed, but having these documents in order well in advance remain one of the most important concerns for all LGBTQ people and their families.

So when I discovered that Docubank has specific information to help LGBTQ people and Hospital Visitorfamilies understand and accomplish these protections, I was thrilled!  Their dedicated page on the web, titled “DocuBank: The Living Will Registry for the LGBT Community” explains a wide range of services they offer in addition to “banking” your legal documents such as living will and advanced healthcare directives.  They also provide guidance for such documents as hospital visitation authorization, HIPPA release, and they will store your domestic partner and/or marriage license documents.

Once your documents are stored, you carry a card and store information in your contacts so that any emergency or other healthcare personnel can access your documents at any time.  There is a nominal fee to join – and I highly recommend that you consider doing so.  But more important, do not delay in getting these documents in order, and encourage any of your LGBTQ friends and relatives to do the same.  These are critical matters for all of us as individuals.  they are also important for our community, and contribute to making our community, our families and our lives visible in the world at large!

Visit the HRC information page for more information about protecting your healtcare decision-making rights.

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