Binary No More: The Transgender Challenge

My first transgender friend I met in 1976 when I was a graduate student at the University of Illinois. Formerly “Donny,” Lydia lived at the periphery of the campus community. For part of that bicentennial summer I dated a friend of hers. On one dramatic night, I talked Lydia out of killing herself when her boyfriend left her for a man.

The ambiguities of her life haunted me. Raised as a boy, but identifying as a woman. Wanting a husband, but living among gay and lesbian people.

Last year at the beginning of the semester, one of my students (with an officially male name) emailed me to let me know that she had begun the transition and wanted to be addressed by a female name. I recognized in myself some unexpected measure of discomfort with this ambiguity. My cisgender privilege and my unacknowledged investment in a gender binary became suddenly apparent.

These same ambiguities prevail in the arena of transgender health. As the Institute of Medicine’s The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding (2011) explained, transgender people are underreported in the research literature and underserved by health professionals.

Afraid of discrimination by health care providers, transgender people may be less likely to seek preventive or even acute health care. Precariously employed (transgender status is not protected in labor law) without adequate health insurance, transgender people who want body modification consistent with their gender identity (e.g., hormones or implants) may be more inclined to seek medically risky remedies.

A recent documentary film, Transgender Tuesdays: A Clinic in the Tenderloin (2012), provides an informed and informative first-person account of San Francisco’s Tom Waddell Health Center and the lives of its community. The tagline of the film announces, “They came for the hormones and stayed for the healthcare.” More aptly, the acknowledgements of the film’s website characterizes its participants as “Faces from the across the gender spectrum.”

Binary no more, but a spectrum.

Institute of Medicine. (2011). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: National Academies Press. Retrieved from

Transgender Tuesdays: A Clinic in the Tenderloin. (2012).

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Feeling Optimistic Today!

It’s the eve before leaving for the GLMA conference, and the second annual Nursing Summit. I have been excited for the conference for a number of reasons, including getting away from the early fall semester chaos and the dozens of faculty meetings we seem to need to get us jumpstarted after the summer break. But back to GLMA…the Nursing Summit, the launch of the Nursing Section, the number of nurses who are presenting workshops and posters is phenomenal. It seems like our time has finally arrived. We are more organized than ever before. We have a national organization and physicians and other healthcare professionals are lined up behind us in support. The time is ripe for us to demand to be heard in our own profession.

We seem to endlessly discuss the need for LGBTQ content in the nursing curriculum, but it seems like we never get beyond the discussing phase. My hope is that this will be the year that we develop a comprehensive document with supporting materials that can be handed over to curriculum committees at schools of nursing all over the world. Perhaps a book?

We (well, at least, I do) complain that our nursing professional organizations seem not to recognize us. Well, we have an Expert Panel at AAN and the Nursing Section of GLMA now. Let’s form an official alliance and push for policy change.

Our research shows how little practicing nurses and nurse educators know about LGBTQ health. Some of us have already begun to work on that, with continuing education programs and articles in our specific fields or areas. Some of us join, or run for, the curriculum committee at our schools. Let’s do more of that!

We started an LGBTQ nurse scholars mentoring program last year, but we have been pretty quiet in the past few months. Surely some of us have manuscripts that could use peer review, or ideas that we would like to throw out for discussion, or needs for collaborations to get us moving. Let’s use the resource this year and add to the growing number of articles on LGBT topics in our fields.

We have a growing number of allies in our practice, research, and policy work. How have we received this ally network? What can we do to be inclusive and encouraging of them? What kind of partnerships would help us move the discipline of nursing into near full inclusion and welcoming of LGBTQ nurses, nursing students, staff, and patients? Let’s foster and support our allies in a more formal way.

Finally, in preparing for the Nursing Summit, I was looking for images to jazz up my slides a bit. Do you know what comes up when you “google” for images of lesbian nurses? How can we address the sexualization of nurses in general, and lesbian nurses in particular? How can we blend feminism with our LGBTQ activism/theory to change the gender stereotypes and blatant sexism that still exists in the popular media about nurses?

I hope to see many of you in the next few days, and encourage others to join the Nursing Section of GLMA. Our day has come and we’ll have everything (and if you know what song that comes from, you are in my generation…we need to mentor the generation that will implement these changes!).

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LGBTQ Foster Kids

iSupportlgbtyouthFor this week’s blog posting, I want to bring attention to a report that was recently released by the UCLA’s Williams Institute. They received a federal grant to do a landmark phone survey of foster kids in Los Angeles, and they found that nearly 1 in 5 identify as LGBTQ. The report details how LGBTQ kids have more foster care placements, are more likely to be living in a group home and are three times more likely than straight youths to have been hospitalized for emotional reasons at some point in their lives. The study also found an overrepresentation of Latino or Black LGBTQ youth. Many of these youth enter the foster system either because they ran away from a home where their parents did not accept them, or because their parents kicked them out. It is distressing that a youth then enters a foster home where they experience more mistreated or are kicked out again.

The Los Angeles County Department of Children and Family Services has been conducting training for social workers and foster parents about how to work with LGBTQ youth. Also, organizations, such as Family Builders, work to connect LGBTQ youth in the foster system with accepting families.

A number of reports and publications have already highlighted the disproportionately high number of homeless youth who identify as LGBTQ, and thus it was not surprising to read the news from the UCLA’s Williams Institute. It gets tiring to read the reports of mistreatment of LGBT youth, at the hands of their own families, and I imagine I am not alone in this feeling. I hope this report is compelling enough for accepting families in California (and across the country) to approach their foster care worker and declare themselves as a welcoming home for LGBTQ youth.



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GLMA Nursing Summit Agenda – September 10, 2014

Join us if you can for the GLMA Nursing Summit to be held in Baltimore, Maryland on September 10, 2014!  Ifpo you cannot be there, watch the GLMA Nursing Section web site for full reports and information about the work we are doing to advance LGBTQ health in nursing and health care!  

Summit Goal and Learning Objectives:

The goal of the GLMA Nursing Summit is to bring together LGBT and ally nurses and nurse supporters to develop an action plan to improve critical LGBT issues in the nursing profession. 

Summit Learning Objectives  

  • Describe major recent accomplishments in nursing related to LGBT health.  
  • Report, evaluate, and build on progress toward a GLMA-sponsored action plan for LGBT health in nursing relating to: education and curricula, patient/clinical care, policy, research, and climate (including homophobia in the profession).  
  • Provide a forum of opportunities for mentorship, support, and networking for nurses and nursing students in the areas of research, academia, policy, and patient care.  
  • Assign leadership for fulfilling the goals of the action plan.  
  • Identify key areas for focus in strengthening nursing participation in GLMA.    

Here is the final agenda for this very important day! You can also download the agenda here.

2014 GLMA Nursing Summit Agenda 

7:30 – 8:30 am  –   Registration & Continental Breakfast 
8:30 – 9:00 am  –   Welcome & Announcements

Henry Ng, MD, MPH, GLMA President  
Hector Vargas, JD, GLMA Executive Director 
Laura Hein, PhD, MSN, GLMA Board Member at Large 
Sarah Fogel, PhD, RN, GLMA Board Member at Large 
Sarah Sanders, RN, Nursing Summit Planning Committee Chair  
Peggy Chinn, RN, PhD 

9:00 – 9:15 am   –   Recognition of Special Guests, Dr. Janet Allan and Dr. Bev Hall 

Peggy Chinn, RN, PhD 

9:15 – 9:30 am   –   Participant Introductions  

9:30 – 10:15 am  – Nursing Section Announcement & Special Recognition (Candidates for Section leadership will be asked to introduce themselves.  There will be an opportunity for floor nominations for those not already on the ballot)

Laura Hein, PhD, MSN & Peggy Chinn, RN, PhD 

10:15 – 10:30 am – Coffee Break & Poster Viewing 

10:30 – 11:00 am – Plenary #1: History and Current Landscape 

Sarah Fogel, PhD, RN 
Mickey Eliason, PhD 

11:00am – 12:00pm – Breakout #1: Action Planning Orientation 

Breakout Groups: Education and Curricula, Patient/Clinical Care, Policy, Research, and Climate 

12:00 – 12:45pm – Networking Lunch  

12:45 – 1:15 pm  – Nursing Section Business: Officer Floor Nominations & Elections  

Sarah Fogel, PhD, RN 

1:15 – 2:00 pm  –  Plenary #2: Breaking Down Silos: How Interprofessionalism Can Advance the LGBT Health Agenda 

Heather Young, PhD, RN, FAAN, Associate Vice Chancellor for Nursing and Dean and Professor, Betty Irene Moore School of Nursing 

2:00 – 2:15 pm  –  Election Results Announcement 

2:15 – 3:45 pm  –  Breakout #2: Action Planning Continues 

3:45 – 4:30 pm  –  Breakout Groups Report Back to Full Group  

4:30 – 5:00 pm  –  Next Steps, Wrap Up & Evaluations 

Sarah Sanders, RN 

5:00 – 5:30 pm  –  Optional: Poster Viewing and Networking 

5:30 pm – GLMA Welcome Reception 

Harborview Ballroom 

Continuing Nursing Education Credits

GLMA is approved by the California Board of Registered Nursing, Provider Number 16038, to provide nursing continuing education credits.  The GLMA Nursing Summit is approved for 8 contact hours.

In order to cover GLMA’s administrative costs, there will be a $30 charge for issuance of CE certificates.  Those attending and claiming credit for the GLMA Annual Conference will only pay the administrative fee once (for both the Nursing Summit certificate and the Annual Conference certificate).  Please see the Registration Desk for more information or to pay the fee.

GLMA would like to extend a special thank you to our sponsors

Sponsors_2014Thank you to the 2014 Planning Committee! 

Amy Wilson-Stronks, MPP, CPHQ , GLMA Vice President for Education 
Sarah Sanders, RN  – Chair, Planning Committee 

Rob Carroll, RN, ACRN 
Diane Bruessow, PA 
Mickey Eliason, PhD 
Sarah Fogel, PhD, RN 
Laura Hein, PhD, MSN 
Michael Johnson, MSN, RN 
Pamela Levesque, RN 
Alison McManus, DNP, FNP-BC 
Jose Pares-Avila, DNP, RN, NP-C 
Lola Pellegrino, MSN, NP-C 
Nicholas Sarchet, RN 
Mimi Snyder, MSN, RN 
Caitlin Stover, PhD, RN

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Gimme That Oldtime Religion: Stigma, Epidemic Disease, and Sexual Minorities

Few things evoke humans’ atavistic reactions as do natural disasters, including epidemics. The scale of epidemic disease and its elusive causes and treatments prompt us to revert to primitive prejudices and fears.

We saw this at work when a virus originating in Africa made its way to the Caribbean and eventually appeared in gay male and Haitian patients in the early 1980s. For many, especially religious fundamentalists, HIV/AIDS became a sign of divine wrath, a punishment for sexual or other sins.

Linking proscribed behaviors (homosexuality, IV drug use) with disease provided the grounds for this judgment.

This habit of thought has an ancient pedigree. In the beginning of both Homer’s Iliad and Sophocles’ Oedipus Rex, divinely sent epidemic plagues punish mortals, who must determine the nature of their violation and to offer propitiation.   

Now, what’s old is new again. The emergence of the most sustained and widespread occurrence of Ebola virus in Western Africa has evoked ancient atavistic impulses.

Liberian Christian leaders, including bishops of mainstream Roman Catholic and Anglican communions, have endorsed a joint statement that claims, “That God is angry with Liberia, and that Ebola is a plague. Liberians have to pray and seek God’s forgiveness over the corruption and immoral acts (such as homosexualism, etc.) that continue to penetrate our society. As Christians, we must repent and seek God’s forgiveness.” Many readers’ comments posted on the Liberian Observer’s website seem to agree.

Back in the United States, fundamentalist Christian radio personality Rick Wiles suggested that, “‘Now this Ebola epidemic can become a global pandemic, and that’s another name for plague. . . . It may be the great attitude adjustment that I believe is coming. Ebola could solve America’s problems with atheism, homosexuality, sexual promiscuity, pornography, and abortion,” according to an article in the Advocate’s online site.

Epidemic disease is terrifying, even in an age of remarkable health technologies and pharmaceuticals. We must always monitor and expose, however, the primitive impulse to blame stigmatized people.


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Cervical Cancer Screening for LGBTQ Women

RibbonWe know that some LGBTQ women do not utilize cervical cancer screening tests as often as heterosexual women do. Although a number of research studies have identified some of the reasons for lower screening rates among LGBTQ women, more data needs to be collected to design health interventions, programs, and services that are culturally sensitive and appropriate for ALL women, including LGBTQ.

If you identify as a LGBTQ woman and are between the age of 21 and 65, please visit our study’s website ( to complete a quick survey and/or sign up to participate in a brief telephone interview. Feel free to share the study’s website with any women you think might be interested, or with any LGBTQ groups. Also, if you want information postcards to distribute, please email me directly ( and I can send you some in the mail.

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Call for Papers

“The Intersections of Trans* and Lesbian Identities, Communities, and Movements”

A Special Issue of the Journal of Lesbian Studies

Genny Beemyn and Mickey Eliason, Guest Editors

Deadline for proposals: November 1, 2014

The Journal of Lesbian Studies, a peer-reviewed academic journal published by Taylor and Francis, invites essay submissions for a special issue on “The Intersections of Trans* and Lesbian Identities, Communities, and Movements,” guest edited by Genny Beemyn and Mickey Eliason.

Possible topics include, but are not limited, to:
• The identity development processes of trans* lesbians
• The experiences of trans* lesbians in different communities and societies
• Trans* lesbians in popular culture, the media, literature, or history
• Sexual and gender fluidity in the lives of younger people today
• Trans* and cisgender lesbian political coalitions
• Butch and FTM struggles and solidarities
• Efforts to include trans women in “women-only” spaces

Please send a 500-word abstract of the work you have written/would like to write to by November 1, 2014. The editors will respond to proposals by December 1. Completed articles of approximately 15-20 pages (5,000-7,500 words) will be due by March 31, 2015 (submitted articles will undergo a peer review process).

For more detailed information about submission guidelines, including copyright requirements and the preparation of tables, figures, and images, please see the homepage for the Journal of Lesbian Studies at =submit~mode=paper_submission_instructions

Please share this Call For Papers widely. Thank you!

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LGBTQ and Straight Professionals Working Together to Advance LGBTQ Health Care

Welcome to Theodora Sirota, who is now a contributor to our blog!  

As an advanced practice psychiatric nurse, I am aware that heterosexism has dominated most LGBTQ health care. Sexual minority communities experience health care disparities Sirotamainly due to homophobia and lack of appropriate education and /or interest in LGBTQ health care needs within the largely straight health care system. I am also aware that LGBTQ health care policy and initiatives have been spearheaded by LGBTQ professionals and it seems obviously appropriate that they should be taking the lead. However, as a straight ally interested in advancing LGBTQ health care, I want to be able to network and connect to others with the same agenda and especially to LGBTQ health care providers who can help extend and shape my own point of view.

Last year I had a very interesting and somewhat disturbing experience as I attended and presented some research at a conference related to LGBTQ health care. The attendees were LGBTQ physicians, nurses, psychologists and others with LGBTQ health-related clinical and research interests. Some, including myself, were straight allies interested in advancing LGBTQ health and human rights. In fact, as my career as a psychiatric mental health nursing clinician and nurse educator and researcher has progressed, LGBTQ health has become my primary professional interest and concern. This was my first conference experience where I knew I’d have the opportunity to meet and talk with prominent leaders and thinkers in the LGBTQ health care community. I was also excited and interested to attend presentations that would allow me to get more immersed in hearing LGBTQ professionals’ current perspectives on LGBTQ health care. Unfortunately, I believe most straight allies have too little direct experience listening to their LGBTQ colleagues and I really wanted to learn as much as I could.

However, at that conference, I experienced a kind of reverse homophobia, or “heterophobia.” It was immediately clear to me, as a straight woman, that I was part of a small minority attending the conference. That in itself was OK; interestingly, my brain isn’t geared to thinking of myself as being in a minority anywhere I go and this realization in itself was revelatory and instructive. But, although a few people did react warmly to me, I felt basically shunned, marginalized, ignored, and very much alone, even when I tried to reach out to interact with people who had been introduced to me. Honestly, at that conference I felt like I was wearing an invisible scarlet letter on my bosom: the big “S” for “straight”. This was a rather eye-opening experience; now I can say that I can truly understand what LGBTQ people must feel in a room filled with mostly hetero folks.

As a straight person who wishes to help eliminate health care disparities and is supportive of social justice for LGBTQ individuals and populations, I don’t intend to stop my scholarship or my clinical interest in advancing LGBTQ health care. However, my experience at the conference made me painfully aware of the fact that there remains a lot of suspicious skepticism and distrust among LGBTQ folks toward straight people who sincerely wish to share and advance their interests. From a historical perspective, I can understand why this is so. However, I would suggest that, at this point in time, not only do straight people need to continue to examine and adjust their homophobic attitudes toward LGBTQ people, but LGBTQ people also need to be more self-reflective about their feelings toward heterosexual allies and attempt to be less heterophobic around straight people who support them. Working on this is critical in a health care climate dominated by heterosexual professionals. Thorough, sensitive health care for LGBTQ individuals and communities cannot be realized until LGBTQ professionals and straight professionals conscientiously work toward forging alliances and mutual understanding that will benefit the advancement of LGBTQ health. LGBTQ professionals need to realize that not all of us are the enemy and not all of us have nefarious agendas. It is imperative that LGBTQ professionals and straight professionals form caring and collaborative partnerships to help end health care disparities faced by LGBTQ people.

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LGBT Cultural Competence Training: Will It Help?

I recently completed a qualitative study that examined the healthcare experiences of LBTQ women. Most of the women described experiences where their providers and/or nurses lacked knowledge about LGTQ specific care, used insensitive terminology, or had a discriminatory or prejudice attitude. The study reconfirmed what similar research has shown – more emphasis is needed on providing safe and welcoming healthcare environments for all LGBTQ individuals.

I asked all of the women in my study what they thought needs to be done to improve healthcare services for LGBTQ individuals. One of the women who lived in rural Oklahoma said that most healthcare providers and nurses want to provide the best care for their patients, and that few of them intentionally make their patients feel uncomfortable or unwelcome. Her response was very profound. As a society, I think there is phenomenon of wanting to “blame” someone or something for an error. The same holds true for the health and healthcare inequities of LGBTQ populations. Who should be held responsible for the uncomfortable and unwelcoming healthcare visits that the women in my study experienced?

I don’t think there is a simple answer to that question. We know that there are multiple factors at all levels of society (the person her/himself, communities, organizations, policies, etc.) that contribute to health and healthcare problems. So, how do we even begin to address the problem of uncomfortable and unwelcoming healthcare environments? Every woman in my study had the same answer – educate the providers and nurses. After all, the one woman said, they aren’t all intentionally making patients feel uncomfortable and unwelcome.

I agree with the women in my study. All healthcare providers and professionals need to be educated to provide appropriate care for LGBTQ patients. And the education curricula and cultural competency programs exist to help accomplish this (see So, the question becomes, how do we ensure that providers and nurses use the resources that are available to them? It is going to require upstream interventions, meaning that governing bodies, accrediting agencies, and professional organizations pressure (or require!) providers and nurses to take continuing education courses on LGBTQ patients, and for nursing and medical schools to include LGBTQ content in their curriculum. Until that happens, I urge everyone to educate your colleagues and students about providing care to LGBTQ patients.

I am going to end this post with a YouTube video that was created by the cultural competence program, Reexamining LGBT Healthcare.

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Gay College Presidents – Organizing for Change!

Last week “Inside Higher Ed” published an article that starts with the sentence “The number of gay college presidents has increased rapidly in the past seven years.”  What a revelation this is!  Even though I have spent my entire career in academia, I have never lgbtqpresidents_orggiven much thought to the life of the presidents of these institutions .. they seem so far removed from the day to day activities of teaching classes, advising students, working on research projects, planning curriculum.  And, the image of most college administrators, as in virtually all other corporate or institutional administrative circles, is laden with heterosexual messages … mostly men photographed with their wives at their side.

Of course I know that “we are everywhere” but somehow it came as a bit of a surprise to see this announcement.  The seven-year “increase” could simply be a function of the wave of “coming out” that has happened in our community across the board, but I suspect that it is also a real increase due in part to a greater acceptance, by those who influence the selection of folks in these positions, to someone who does not fit the heterosexual mold.  The organized group,  LGBTQ Presidents in Higher Education, has grown from 7 in 2010, to a current membership of 48! The nine presidents who formed the group included 4 women and 5 men .. a proportion of women college presidents that would be hard to find in most circles!

But the most exciting news is that this group of college presidents is hosting a conference next summer for LGBTQ academics who are interested in becoming college administrators!  The conference theme will be “LGBTQ Leaders in Higher Education: Shaping Our Futures.” It will coincide with the Chicago gay pride weekend June 25-28, 2015.

I suspect that most readers of this blog do not see themselves as prospective members of this group, or even as potential attendees in the conference.  But the fact that this group exists, and that fact of this conference planned for next summer, is to something major for our community!  We all benefit from the presence of these trailblazers, particularly in a field that has so great an influence in the lives of young people who are completing their education!  Even reading through the current list of members, and their affiliations, is an inspiring experience!  So here’s to yet another breakthrough for LGBTQ visibility, and influence!  lgbtqpresidents_org

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