Creating online communities

Posted on March 10, 2016 by Peggy L Chinn

As I see it, one of the most important factors in shaping the health of LGBTQ individuals is connections to supportive communities. Without doubt, many LGBTQ people face overwhelming loneliness and isolation, amplified by family rejections and friendships tLezDykeLogoBighat are shattered when these important people realize their loved ones’ sexual or gender identity.  Virtual or online communities do not replace important person-to-person relationships, or face-to-face socialization, but they can fill in a huge gap, and provide a literal life-line for someone who is struggling with isolation and loneliness.

Online communities can take many forms, and they do not necessarily require special skills — just a commitment to make it work! Often they start with just a handful of people who are connected in person, but who want to reach out to others in a specific geographic area, or who share a common interest.  Here are a few examples that might inspire you to start your own community!

Email lists have the advantage of managing various factors such as who can join, who can post, whether or not posts are screened (moderated) before posting, and members controlling their own personal information and preferences.  They are accessible to anyone with an email address.  The San Francisco Bay Area has several email lists that serve to notify people in the area of LGBTQ events, messages asking for assistance, rooms to rent, recommendations, etc.  The two that I subscribe to are BA-Sappho, hosted privately by Queernet.org – an organization that serves a host of LGBTQ communities – listed here.  The BA-Sappho list is described as a list for lesbians in the bay area, but I find that in fact it posts lots of information that could interest other queer groups as well.  Another email list I manage is LezDyke, focusing on promoting and encouraging social support in face-to face encounters among older lesbians.  We post information about events that are geared to the interests of older women, invitations to participate in more personal social encounters that are intended for friendship – not dating — reaching out to other women to meet for coffee, dinners, movies, etc.  BA-Sappho allows political and religious-type postings, whereas LezDyke does not.  Both lists allow limited discussion, but discourage hostile, protracted, and divisive interactions.

Facebook groups and pages have the advantage of being easily discoverable by a wide audience world-wide. A page is similar to an individual’s profile – it is a profile of a entity that exists somewhere (virtual or otherwise) and provides visibility worldwide – sports teams, businesses, clubs, professional organizations — and on and on. A celebrity, a sports team, a club, etc. might have a web page of their own, but also a Facebook page that can attract a broader audience.  People can “like” the page to get notices posted on their own Facebook new feed about the entity they are interested in.

A Facebook group, by contrast, is where people can actually join a group, and the group can post events, photos, documents and lots of information of interest to group members.  It is harder to stay connected to the group compared to an email list, and people have to have a facebook account to join and to get information on their news) or private (someone has to approve members before they can join). Facebook offers lots of advantages over an email list.  The LGBTQ Bay Area Group is a great example — this is a group to encourage and support the LGBTQ arts communities. If you search Facebook for “LGBT” (with or without Q), or “LGBT ______” (you fill in the blank), or any of your preferred LGBTQ-related terms, you are likely to find more than you thought existed.  If you don’t that is a clue to start your own!

So I encourage you to start interacting with other LGBTQ communities online. They are like any other group you join-  you can become involved a lot, only occasionally, or as a “lurker!”  But getting involved gives you a connection to people with whom you share something important, and at some point might become very important to you!  And if you can’t find exactly the right group for you, consider starting one!  It is helpful to have at least one or two “co-organizers,” which gives you a community of 2 or 3 who can share the responsibilities of the group and provide the kind of encouragement and support to carry on through the best and worst of times!

 

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Will you still need me, will you still feed me, when I’m 64?

Posted on March 2, 2016 by bowie21

The United States is experiencing its largest population of aging seniors, approximately one in five Americans will be over the age of 65 by 2030, according to a 2013 Centers for Disease Control and Prevention (CDC). In addition to a longer life expectancy, there are roughly 10,000 Americans celebrating their 65th birthday, every day, between 2011 and Gen-Silent.jpeg2030 (Pew Research Center, 2010). How does retirement and long-term care planning affect lesbian, gay, bisexual, and transgender (LGBT) seniors and their families? This is the first blog in a series about the unique health, economic, legal, spiritual, and social challenges LGBT seniors face when planning for quality and affordable long-term care.

Historically disadvantaged groups, including the LGBT community, are more likely to be living in poverty, and have higher levels of illness, disability, and premature death as compared to their heterosexual counterparts (National Institutes of Health, 2013 and CDC, 2013). Research suggests that LGBT people may not seek out health care or disclose their sexual orientation or gender identity to their health care providers due to real or perceived discrimination. This is particularly damaging for LGBT seniors who are more likely to need access to health care services due to age-related changes or increased incidence of diseases (National Institutes of Mental Health, 2013).

LGBT seniors are often single and estranged from their biological family and rely more on friends and their community members as their chosen families. When insurance and employment policies, hospitals and nursing homes, and state laws prioritize biological family members as the only parties able to make decisions about an individual’s health, it disenfranchises LGBT senior’s families of choice and same-sex partners. Louisiana State University Nursing Professor, Harlee Kutzen, M.N., ACRN, spoke to me about the importance of LGBT seniors planning for end of life care by identifying a close friend to be a medical surrogate before illness or placement in a long-term care facility occurs. Advanced planning is likely to ensure that you and your loved one’s wishes are followed, not those of an institution, be it a nursing home or hospital, or estranged family members.

Identifying local resources to aid you or your loved one in establishing a power of attorney or medical surrogacy may be needed. Local, grass roots organizations, such as the Louisiana-based Advocates for GLBT Elders (NOAGE), provide a model for organizing around LGBT senior issues. Jim Meadows, LMSW, and NOAGE Board Member, told me that the organization came about through a recognition that loneliness, due to social isolation, was a wide-spread problem among LGBT seniors living in New Orleans.

NOAGE is tackling many of the issues identified by national researchers as challenges for the LGBT senior population, including accessing competent health care providers and navigating legal hurdles in retirement. The organization is modeled on Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) and reaches out to the senior community through monthly coffee talks on relevant topics for seniors, such as health living and making friends outside the bar scene. NOAGE also offers free cultural competency training to health care professionals about working with LGBT seniors and is hosting a legal workshop for seniors, their families, and friends that addresses navigating state laws on medical power of attorney, living wills, and spousal benefits.

For more information on community organizing around LGBT seniors please listen to the following interview with NOAGE board members Jim Meadows and Jason Waguespack on 102.3 WHIV FM.

WHIV FM Interview with NOAGE

Non-governmental, national advocacy organizations, such as SAGE and the National Resource Center on LGBT Aging, offer training and resources for issues important to LGBT seniors and their families. These topics include information on Medicaid and long-term care, transgender aging, and social security. SAGE also has links to local organizations who advocate for and provide resources to LGBT seniors. Please find more information about these organizations below:

Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders

National Resource Center on LGBT Aging

Sources:

Centers for Disease Control and Prevention, 2013, “The State of Aging and Health in America 2013”, http://www.cdc.gov/aging/help/dph-aging/state-aging-health.html

Pew Research, 2010, “Baby Boomers Retire”, http://pewresearch.org/databank/dailynumber/?NumberID=1150

National Institutes of Health, 2013, “Health Disparities among Lesbian, Gay, and Bisexual Older Adults:

Results From a Population-Based Study”, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770805/pdf/AJPH.2012.301110.pdf

http://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health#10

SAGE and MAP, “Improving Lives of LGBT Older Adults”, 2010, http://www.lgbtmap.org/file/improving-the-lives-of-lgbt-older-adults.pdf

 

Posted in Join the discussion, LGBT Elders, LGBT Health, LGBT Services | 1 Comment

LGBTQ2SIA+ Healthcare: Moving Beyond Sexual Health

Posted on February 25, 2016 by Jennifer Lane

As a conclusion to my blog series on transgender inclusive practice, I wanted to explore the topic of sexual health and the potential for reductivity in regards to the delivery of care to LGBTQ2SIA+ clients. For gay men, it would appear that the primary risk is becoming HIV+. For gay women, it could appear that they aren’t at risk for anything given that they are the most unlikely subgroup of sexual minority women to have a care provider (Przedworski, McAlpine, Karaca-Mandic & VanKim, 2014). Due to gaps in the research, evidence on other LGBTQ2SIA+ communities is limited at best which creates another layer of marginalization for those who are unrepresented (Smalley, Warren, Barefoot, 2016). The harm in using the “T” in the LGBTQ2SIA+ as an umbrella for the diverse group of those who are gender non-conforming needs to be addressed (Smalley, Warren, Barefoot, 2016). Perhaps if gender identity and sexual orientation were addressed separately in the research, evidence would be produced that would provide insights into specific health risks of each subgroup which could then inform how healthcare professionals delivered care to LGBTQ2SIA+ clients (Smalley, Warren, Barefoot, 2016).

I personally find it interesting that LGBTQ2SIA+ healthcare is so often reduced to sexual health. Perhaps this is also due to the fact that gender identity and sexual orientation are variables that are not measured independently from one another. As long as they are not controlled for, it makes perfect sense that practice hasn’t evolved. I imagine evidence informed practice will remain reductive as long as research fails to produce evidence that exposes the many health risks of the LGBTQ2SIA+ communities. It remains no wonder why trans women, trans men and gender non-conforming people have the highest percentages of individuals who do not follow medical advice or failure to access any care at all (Smalley, Warren, Barefoot, 2016) insofar as their unique needs are not just misunderstood but instead they are most certainly completely misrepresented. Smalley, Warren & Barefoot (2016) suggest that future research should move away from sexual and substance abuse behaviours and begin to focus on personal habits of diet and exercise. They cite evidence to support this from their sample of transgender women who had the lowest rate of regular unprotected sex out of all gender groups studied however 50-60% of this group reported never or rarely exercising three times per week or eating five servings of vegetables (Smalley, Warren, Barefoot, 2016). Clearly our efforts in health promotion with the LGBTQ2SIA+ communities is missing the mark somewhere along the line.

It would appear that research into LGBTQ2SIA+ healthcare must start comparing the subgroupings if we are to produce evidence that will provide insights into the actual challenges that each subgroup faces (Smalley, Warren, Barefoot, 2016). For example, doing so could begin to teach us about the structural barriers that transgender women face as compared to cisgender women (Smalley, Warren, Barefoot, 2016) which would better control for the variable of sexual orientation. Results such as transgender men having higher rates of extra exercise as compared to transgender women could allow for new areas of investigation so as to gain new insights into challenges and risks to the health of LGBTQ2SIA+ subgroups (Smalley, Warren, Barefoot, 2016). Finally, incredibly important evidence such as stark differences between results on transgender groups as compared to gender non-conforming/genderqueer groups could be among the final arguments in the danger of assuming that the members of these diverse groups face similar challenges and/or the same behavioural practices (Smalley, Warren, Barefoot, 2016). It seems quite obvious however the evidence that current research is producing is not representative of this. What about members of the LGBTQ2SIA+ communities who identify as straight who apparently have the highest rates of many at risk behaviours (Smalley, Warren, Barefoot, 2016)? The lack of representation seems to be never-ending.

As a researcher, I’m fascinated. As a healthcare provider, I’m invested. As a member of the LGBTQ2SIA+ communities, I’m concerned. It would appear that healthcare must be delivered equally to all clients however this is an essentialization of the human experience that fails to address systemic inequity. Obviously all humans require adequate diet and exercise to have good health so this is a better starting point for LGBTQ2SIA+ clients than sexual health and substance abuse although in the absence of available evidence on how to proceed, it would appear that healthcare delivery will inevitably be limiting or reductive until the research begins to fill in the gaps.

Sources:

Przedworski, J. M., McAlpine, D. D., Karaca-Mandic, P., & VanKim, N. A. (2014). Health and Health Risks Among Sexual Minority Women: An Examination of 3 Subgroups. American Journal Of Public Health, 104(6), 1045-1047 3p. doi:10.2105/AJPH.2013.301733

Smalley, K. B., Warren, J. C., Barefoot, K. N. (2016). Differences in health risk behaviors across understudied LGBT subgroups. Health psychology, 35(2), 103-114.

Featured Image Credit: Niyazz via Shutterstock

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Trans Inclusive Practice – The Discussion Continues

Posted on February 24, 2016 by Jennifer Lane

This is the third post in my series about trans-inclusive healthcare. Given the content covered in the accessibility blog post, I thought it would be helpful to begin a conversation about what healthcare professionals can do to hold space with their LGBTQ2SIA+ (lesbian, gay, bisexual, transgender, queer, Two-Spirit, intersex, asexual, plus) clients during health encounters and while providing health services. I imagine it is important to follow-up inclusive medical spaces with inclusive medical practice. If heterosexism and homophobia is a problem when accessing healthcare services (Brotman & Ryan, 2001), then cissexism and transphobia must also be an issue for practitioners to consider. But how do we create spaces for LGBTQ2SIA+ clients, particularly trans and gender non-conforming folks, to feel that they can trust their care providers and gain access to appropriate healthcare? Brotman & Ryan (2001) cite cultivating an environment of safety and trust as immensely important when creating space for people to come out to their healthcare providers which, of course, significantly increases the satisfaction of LGBTQ2SIA+ clients. This seems quite obvious but how do we actually succeed in doing this?

Mandatory training and education about hetero/cis-sexism and homo/trans-phobia in academic programs and professional settings begin to address the harms around discriminatory practices when providing healthcare services that follow dominant models of medicine (Brotman & Ryan, 2001). Acknowledging that there are practitioners who will not change their negative attitudes about the LGBTQ2SIA+ community is achieved by creating a directory of practitioners in each community who provide affirming healthcare services (Brotman & Ryan, 2001). Acknowledging that well intended practitioners can still have an unintended negative impact on their LGBTQ2SIA+ clients is crucial. This requires gaining feedback from the LGBTQ2SIA+ communities about the impact of well intended actions and admitting that even if we are a member of the LGBTQ2SIA+ communities, this does not afford us a universal understanding of the diversity in lived experiences of those who also identify as LGBTQ2SIA+.

Communication is always a key factor. Using gender neutral language is important however conveying an understanding of the complexities around identity and the associated barriers is necessary to effectively open up spaces that may be experienced as harmful and hostile. This could be achieved by sharing with your clients an ongoing initiative in your practice to be inclusive of the many intersections of identity including (but not restricted to) people of conforming and non-conforming genders, people of colour and the many ways of identifying oneself along the continuum of sexuality (Brotman, & Ryan, 2001). It also includes using neutral language when referring to body parts, such as “monthly bleeding” in place of historically gendered terms that have potential for detrimental impacts such as “menstruation” (Vancouver Coastal Health, 2016). These are interventions that could begin to open up a space for those clients to embody their difference(s) during their health encounters. It is also suggested that practitioners convey an understanding to their clients that sexuality and gender can be experienced as fluid and that self-identified labels may change over time by acknowledging that previously articulated preferences may change over time (Brotman & Ryan, 2001). Asking clients to share their preferred pronouns as well as what terms they use to describe their gender and sexual identities while having an understanding and sensitivity about how age, ethnicity, race, class, ability and other intersections of identity (The Centre, 2006) can provide insight into how a person may interpret their individual context and understand their lived experiences. This will create an opportunity for an ongoing conversation (Brotman & Ryan, 2001) that could foster strong therapeutic relationships between clients and their practitioners.

Creating networks of support for LGBTQ2SIA+ clients builds capacity both individually and on a community level. Making referrals or reaching out to other practitioners who provide affirming healthcare services, validating non-traditional forms of family and offering to include them in the circle of care as well as advocacy in the form of systemic restructuring, policy change and collaborating with a diverse group of members from the queer community are all strategies to achieve the goal of capacity building (Brotman & Ryan, 2001). An awareness around the health concerns of different LGBTQ2SIA+ populations is important if practitioners wish to have a basic understanding of the unique needs of the members of each group. Qmunity (formerly The Centre) (2006) created a training resource that outlines specific health considerations for LGBTQ2SIA+ clients which begins on page 102 of the document. While I noted some outdated language in the document that is undoubtedly related to the age of its publication, it does serve as a good resource for healthcare practitioners to inform their care of lesbian, gay, trans, bisexual and Two-Spirit clients.

As a white queer healthcare professional, I have a unique combination of privilege and marginalization that can be used as leverage to inform future practice, change policy and challenge a structure thats operation relies upon systemic oppression and domination. This series of blog posts has provided me with a new understanding of the role I can play (and I imagine you too) by situating myself within the system to create networks of care that act to center members of vulnerable populations. It has challenged me to be uncomfortable and use my own experiences as a teaching tool and as a means to disrupt spaces that protect those who are more centered than myself. I am so privileged to be able to consider this as my future life’s work and will continue to develop a practice of solidarity throughout my career. I invite you to join me and together we can make this a mass based movement!

Sources:

Brotman & Ryan (March, 2001). Critical Issues in Practice with Gay, Lesbian, Bisexual, and Two-Spirit People. Retrieved from: http://www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2014/08/Critical%20Issues%20in%20Practice.pdf

The Centre (January, 2006). LGBT Health Matters. Retrieved from: http://www.rainbowhealthontario.ca/wp-content/uploads/woocommerce_uploads/2014/08/LGTB%20Health%20Matters.pdf

Vancouver Coastal Health (2016). Glossary. Retrieved from: http://transhealth.vch.ca/trans-101/glossary

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Student Resources page added to LavenderHealth Resources!

Posted on February 19, 2016 by Peggy L Chinn

We have listed a couple of resources for students on our “Other Resources” page for a while, but now they have a home of their own!  If you head on over to the “Resources” resourcessection on our main menu, now you will see the “Student Resources” page, where you can easily click to access these important resources.

Of course we wish there were more resouces like this one, but we expect this section to grow over time!  If you come across something that would be helpful to include here, please do not hesitate to let us know .. just use our handy “Contact” form, and we will add your information!

Posted in Education, LGBTQ youth, Resources, Students | Leave a comment