Report on LGBT health Priorities for 2015

Earlier this month, the U.S. Department of Health and Human Services (DHHS) released a report titled “Advancing LGBT Health & Well-being.”  This is the 4th annual report that is the outcome of the President’s directive to identify steps that the DHHS can take to improve the health of LGBT Americans.  Before the Affordable Care Act, one in three lower income LGBT Americans did not have medical insurance.  Recognizing that insurance alone will not improve the health of our communities, the reports provide specific recommendations for steps that still need to be taken to address this need.

The new recommendations for 2015 are:

1. Prohibiting Discrimination Based on Sexual Orientation or Gender IdentityLGBT_Health_and_Well-being___HHS_gov

2. Funding Research on LGBT Health Inequities

3. Improving Health Data on LGBT Populations

4. Research on the Blood Donation Deferral Policy for Men Who Have Sex with Other Men

5. Improving Cultural Competency with Respect to the Two Spirit Community

6. Further Addressing the Human Services Needs of LGBT Populations

7. Re-Launching the HHS LGBT Issues Webpage

For more about what the Affordable Care Act means for LGBT Americans and their families, visit the HHS web pages dedicated focusing on LGBT health!  And  remember to spread the word — enrollment is open until Feburary 2015!  Be sure everyone you know has the information they need to get coverage!

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Promoting a research study

Can you help my colleague spread the word about her important research?  See below.

Participate in a Study on Fertility Treatment Experiences

(With a Chance to Win $100)

Are you currently trying to get pregnant using donor sperm? If so, you are invited to participate in a study being conducted by researchers at San Francisco State University and the University of California, San Francisco. The study aims to investigate various aspects of fertility treatment experiences for heterosexual and lesbian women.

To participate, you MUST be:  

•      Currently pursuing pregnancy using donor sperm

•      18 years of age or older

•      Fluent in English

Participating involves completing an online survey. If you are currently in a romantic relationship, your partner will be invited to participate as well. The survey takes approximately 30 minutes to complete. After you complete the survey, you will be entered into a raffle for $100. Drawings will be held at the end of each month. The odds of winning the prize will depend on the number of entries received each month.

Participation is voluntary and all information will be kept anonymous and confidential. You are free to decline to participate at any time even after the survey has begun.

If you are willing to participate, please click the link below to register. You will then be sent a Study ID number and a link to the survey. Please feel free to contact the lead researcher, Sarah Holley, Ph.D., with any questions via e-mail ( or via phone (415-747-9990). This study is IRB approved by San Francisco State University and the University of California, San Francisco.

Thank you for your time and interest!

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Kelli Dunham calls for LGBT Culturally Competent Care on NPR Blog!

“Health News from NPR” just posted an excellent article by nurse Kelli Dunham focused on health disparities in the LGBT community that are aided and abetted by inadequate Kelli-Dunham-at-FF-October-2013-300x300care for LGBT people and their families.  She points to the recent American Association of Medical College’s report titled “Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born with DSD: A Resource for Medical Educators” as a major step in guiding health care professions to prepare providers who are culturally competent to provide quality care for LGBT folks.

As Kelli points out, the challenges to providing universally competent care for all people are huge, but just a few very simple changes can be implemented now, including fundamental acceptance of each person as a person  and acceptance of each patient’s significant other, regardless of who that person is.  Kelli brings her wonderful comedic talent to addressing this very important, and sensitive issue in health care -

There is no such thing as a lesbian knee, or a lesbian armpit or a lesbian neck — at least I’ve never dated one — but each human being comes to health care with a context and a story, and they both are vitally important.

Congratulations, Kelli on your excellent report, and thank you for getting this message out on a major news outlet!!

Posted in Activism, Best practices, Education, Humor, LGBT Health, LGBT Services, LGBTQ rights | Tagged , | Leave a comment

Transgender Day of Remembrance, November 20

In the hopes that this memorial will one day become unnecessary, we mark Transgender Day of Remembrance (November 20) with attention to health issues.

The 2011 Institute of Medicine report The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding provided alarming but not entirely surprising information about health disparities among sexual minority people, including transgender people.

Among its more salient findings:

  • Some research suggests that young transgender women are at significant risk for homelessness.
  • Research based on smaller convenience samples suggests that elevated rates of suicidal ideation and attempts as well as depression exist among transgender adults; however, little research has examined the prevalence of mood and anxiety disorders in this population.
  • Limited research among transgender adults indicates that substance use is a concern for this population.
  • Limited research suggests that transgender elders may experience negative health outcomes as a result of long-term hormone use.

These data are significant and persuasive. The human dimensions, however, may be more powerfully represented in the documentary Transgender Tuesdays: A Clinic in the Tenderloin.

Transgender lives are more than statistics.

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Medical-Colleges Group Releases Standards for Treating LGBT Patients

Announced today by the Chronicle of Higher Education:

The Association of American Medical Colleges has released a set of guidelines aimed at helping medical schools better train physicians to treat people who are LGBT, don’t identify with a gender, or are born with differences of sex development. The guidelines, contained in a report, are the first comprehensive set of standards for treating lesbian, gay, bisexual, and transgender patients, according to a news release from the organization.

The AAMC report can be downloaded here:

Posted in LGBT Health | 1 Comment

November 20th – International Transgender Day of Remembrance

Ceremonies are being held worldwide during the month of November to memorialize those who have been killed as a result of anti-transgender hatred or prejudice.  The Transgender Day of Remembrance web site provides a list of events that will be occuring throughout the month, many on November 20th.  They also publish a list of all who have been killed throughout the previous year; this list consists of deaths that were corroborated by media accounts.

This is a senseless and horrifying tragedy.  Please join us in pausing for a moment of reflection to remember those who have perished, and to focus our energies on all the ways we can work together to end the violence.  Statistics_and_other_info____Transgender_Day_of_Remembrance

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What are you working on?

We’ve been blogging about a number of topics in the past year or so, all very interesting, but not terribly interactive. I’d like to start a discussion of the types of research on LGBTQ issues that our followers are up to. We’ve heard that nursing journal editors are eager to publish LGBTQ-themed articles, so we need to be submitting quality work to them to educate our colleagues. So here are some questions to chew on:

  • What are you interested in?
    What challenges are you having to doing your project?
    Have you experienced any resistance from faculty colleagues or professors?
    What methodological challenges are you experiencing in developing instruments, recruiting, analyzing data?
    Do you need a co-author to help you get over the hump?
    Are you wondering where to publish?
    And anything else that keeps you awake at night…

So weigh in and let’s talk!  If you have not already joined the GLMA Nursing Section’s Research Group, that is another forum for discussing research and finding collaborators.

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Understanding Queer!

Even though the term “queer” has been used for many many decades as a pejorative term, and now has been re-claimed as a term of pride to deliberately dismantle its negative implications, there still are many  folks that I encounter who are puzzled, mystified, and perhaps even revolted by the term.  LGBT_HealthLink__The_Network_for_Health_Equity___Linking_People_and_InformationI can understand each and every one of these reactions, because over the years I, like practically everyone else who uses the English language, have had the full range of reaction!

One of the earliest encounters I had with the term after I realized my own lesbian identity was with my young son.  He had been part of my lesbian social network throughout most of his childhood, but I had failed to “come out” to him explicitly, thinking that when he wanted to talk about it, he would ask.  When he confronted me and I told him I was waiting for him to ask he said “Mom, you do not just ask your mom if she is queer!”

This was in 1980, when our now rich vocabulary was just beginning to emerge, and so started my personal quest to figure out what was meant by a host of terms, including queer.  This was also just about the time of the height of the feminist movement in the U.S., and only about a decade after the Stonewall riots in New York City that launched the modern gay rights movement.  It was not long before Women’s Studies in colleges and universities were shifting from “women’s studies” to “gender studies” and even lo and behold – “queer studies.” Today, queer is here – full tilt!  The poster above is just one of hundreds of examples – it is advertising the 6th annual Genderevolution conference in Salt Lake City on November 15th, sponsored by the Utah Pride Center, the aims of which “are to deconstruct gender mythology, explore the implications of socially constructed gender norms, and integrate our many intersecting identities.” (See Utah Pride Center)

Many LGBTQI folks now prefer the term “Queer” to the alphabet soup that always excludes someone, and it is generally the preferred term of gender identity for young people who view gender identity as a restrictive and harmful social construction that should not be inextricably linked to sexual identity.  The term is problematic for some feminists and others who are concerned about and sensitive to the huge gender inequities and gaps that privilege male persons and masculine values and behaviors, and disadvantage women and women’s traditional values and roles.   From this perspective, the power of language to render women invisible remains a fundamental challenge at a time when huge gender inequities remain the norm. From a queer perspective, the path to destroying these inequities is to dismantle gender altogether.

You could probably get as many perspectives and definitions of the term “Queer” as there are people to ask, but here are common understandings of what it can mean:

  • In the context of the acronym LGBTQ, the “Q” stands for queer, questioning, or both, and is meant to cover any person who prefers Queer as their personal identity, regardless of what that means exactly to them.  Queer is not necessarily connected to one’s sexual identity.
  • From a political perspective, it generally refers to an identity that does not conform to gender binaries and that values a chosen expression of Self that is not restricted by traditional gender norms based on sex of behavior, dress, or social comportment.
  • From a philosophic perspective, “queer” points to the belief that gender is socially constructed, and that the gender norms that have dictated human behavior based on sex can be changed. From this perspective, each person, regardless of biological or assigned sex, should behave and live their lives as an authentic human being and not be restricted by gender norms that govern behavior, dress, interests, occupations or other expressions of Self.

When we take a closer look at the implications of the political and philosophic values that “queer” represents, it becomes apparent that this is a social phenomenon that has the potential to actually change the world!  Even though the Queer movement has grown and flourished within and from the LGBT movement, it is not simply a phenomenon of the LGBT communities.   “Queer” embraces all realms of life where gender has played as significant role – which in fact encompasses all of life.

So here’s to Queer!  Please add your comments and questions below .. we would be delighted to have a conversation with you!

Posted in Definitions, Education | Tagged , , | 2 Comments

The LGBT Checkbox on Medical Forms

The Washington PosCheckmarkt recently published a piece on its advice column about the importance of including check boxes on medical forms to identify LGBT people. The advice column included quotes from Hector Vargas, executive director of GLMA, and Liz Margolies, founder and director of the National LGBT Cancer Network. Both strongly support including questions on medical forms to identify LGBT people.

Anyone versed in LGBT health know that chronic stigma has resulted in numerous health disparities. Research has shown numerous negative health outcomes among LGBT populations, such as mood and anxiety disorders, obesity, HIV/AIDS, and lower utilization of healthcare services. In fact, the Institute of Medicine (IOM) published a report in 2011 recommending the collection of sexual orientation and gender identity (SOGI) in medical records. Collecting SOGI information could assist in identifying and addressing LGBT health and healthcare disparities.

Since the release of the IOM report in 2011, there has been overwhelming support for the routine collection of SOGI data in medical records. Drs. Cahill and Makadon’s recent publication did a remarkable job of arguing for the inclusion of SOGI questions on medical forms. They argued that SOGI questions are the key to ending LGBT health disparities. Many others have also published research or commentary publications that argue or show the importance of SOGI questions.

I am also a supporter of including SOGI questions on medical forms. Sexual orientation and gender identity are blind spots to healthcare professionals. Most medical, nursing, and health education programs emphasize treating the individual. If health professionals are not taking sexual orientation and gender identity into account when caring for people, how can they claim that they are individualizing care?

With all of that said, there are numerous challenges to including SOGI questions on medical forms. First, although numerous organizations have published “Best Practice” guidelines on proper wording and placement of SOGI questions, there is not much evidence to show how these questions will be perceived or understood by the public. Second, for SOGI data to be meaningful, patients need to be willing to disclose their SOGI. Numerous studies have found that disclosure of SOGI is dependent on the patient-provider relationship, the perceived risk in disclosing, and internal attributes of the patient. How will this translate when SOGI questions appear on a medical form? Last, will health professionals and providers know how to use this data in meaningful ways? I think the last challenge is most important. If SOGI questions become mandated, LGBT people should feel safe in disclosing and be assured that they would not encounter discrimination as a result.

With careful thought, I think all of these challenges can be negotiated and overcome. SOGI questions will not happen overnight, but we are headed in the right direction.

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Open Enrollment for starts on November 15th!

Health_Insurance_Marketplace__Enroll_for_2015_Healthcare_Coverage___HealthCare_govWith the US mid-term elections, Ebola, and act-alone terror attacks, there is not much oxygen left in the current news cycles for information about the Affordable Care Act Open Enrollment period that starts on November 15th, and lasts through February 15, 2015!  For many many Americans, this is huge news, yet many of us are totally oblivious to what this means.  So we want to make sure that everyone who follows knows the facts, because health care for LGBTQ individuals and families is one of the most important things we can do to improve well-being for our communities.

Right now, you can explore the options that will be available, and you can sign up for news and updates from here.  If you recently got married, you do not have to even wait until November 15th to get started!  Your “change of status” qualifies you to apply now! There are many concerns, including marital status, that are are specific for all LGBTQ people and families, and there are two online resources to help!

Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans is published by “Strong Families” and a host of LGBT partner groups. This guide provides information to help :

  • Evaluate your healthcare needs,
  • Navigate new insurance options and
  • Choose the best plan based on needs of LGBT families.

Out2Enroll is another resource specifically for LGBT individuals and families, offering guidance and assistance to get medical insurance coverage.

So if you do not have healthcare coverage, reach out to get the information you need and hopefully the coverage you need.  If you do have coverage, pass this information along to everyone you can reach in your local communities.  We all have friends and acquaintances who need this information and the least we can do is pass it along!

Posted in Affordable Care Act, LGBT Health, LGBTQ rights | Tagged , | 1 Comment