LGBT Health Education Blog
- After a long struggle, a New Jersey transgender woman finally received reimbursement from her health insurance company for her mammogram. The insurance company relied on language in their plan that excluded from coverage costs related to the woman’s change in gender status. The Transgender Legal Defense and Education Fund intervened and ultimately convinced the company that the exclusion should not apply to the mammogram, a procedure that had nothing to do with changing sex characteristics. Such an overbroad interpretation could have led to denial of many claims for medically necessary care, such as treatment for breast cancer. This is just one of many examples of how trans women and men are denied access to care based on their transgender status. The TLDEF’s press release is here: link.
- A study (link) in the most recent issue of the Journal of Homosexuality finds that people whose parents react negatively to their coming out are at higher risk for depression and substance abuse. The authors looked at data from a Massachusetts population-based survey and also found that lesbian and bisexual women who had not come out to their parents experienced worse health outcomes than those who did.
- The New York Times reports (link) that Robert Spitzer, MD recanted his 2001 study on reparative therapy (therapy directed at making gay and lesbian people straight). The study is often used to advocate for the validity of reparative therapy. The American Psychiatric Association and the American Psychological Association formally oppose this form of therapy, which can lead to increased depression, anxiety, and suicidal ideation.
- California may become the first state to ban reparative therapy, reports the San Francisco Chronicle (link). If passed, the legislation will become prohibit sexual orientation change therapy on minors, and require adults to provide written consent for the therapy.
- San Francisco State University’s Family Acceptance Project released multilingual versions of a booklet, entitled Supportive Families, Healthy Children. It educates parents about how to support LGBT children (link). The U.S. government-supported Suicide Prevention Resource Center (link) recognized the booklets as a suicide prevention “best practice”. The booklet is available in Spanish, Chinese, and English.
- The Agency for Healthcare Research and Quality (AHRQ) recently published its 2011 National Healthcare Disparities Report (link), which for the first time recognizes and tracks LGBT health disparities. The report’s LGBT-specific sections focus primarily on transgender disparities. AHRQ is a federal agency charged with improving quality, safety, efficiency, and effectiveness of American health care.
[This post was originally published on the Fenway Health Fenway Focus blog, here. Fenway Health is one of the National LGBT Health Education Center's parent organizations.]
Looking at other Women’s Health Week resources, I found the same general health advice: eat healthy, exercise, seek routine preventive care, avoid unhealthy behaviors, and foster good mental health. Yes, these are all vital to maintaining health, but hasn’t almost everyone heard this advice at least 100 times? And shouldn’t people of all genders aim to practice these healthy behaviors? Of all the extremely important women’s health issues, this is what we focus on during a week dedicated to women’s health?
Many lesbian, bisexual and transgender women feel uncomfortable talking about their sexual orientation or gender identity, preventing them from getting the care they deserve.
I was ready to give up on this post when I was inspired by some simple words from my mother. She was a single mom who returned to college when my sisters and I were in elementary school. Despite having three daughters to raise alone, she managed to excel in school and eventually complete a graduate degree.
My mom is a fighter, and she fought for her health and the health of her children. She disagreed with healthcare providers if she was unsatisfied with their diagnosis or treatment plan. We lived in poverty, went through periods of being uninsured, and had limited access to competent healthcare providers. Yet, my mom always advocated for the best possible care. And, believe me, we got it.
I spoke to my mom a few days ago and we discussed some health problems she has been experiencing. She said to me, “Christina, why don’t doctors listen to their patients? I know my body better than anyone.” As we talked about her plans for seeking further care she told me that, “it always helps to be assertive."
Check out the rest of the post at the Fenway Focus blog.
The LGBTQ Policy Journal at the Harvard Kennedy School recently published a study entitled, A Gender Not Listed Here: Genderqueers, Gender Rebels, and OtherWise in the National Transgender Discrimination Survey. The paper (link) evaluates health care and other experiences of people who do not identify as being one or the other gender using data from the National Transgender Discrimination Survey (link). The survey gave respondents the option to write in their self-identified gender rather than choose from predefined male/female/both categories, and 860 of the 6,450 respondents did just that. Compared to respondents who did identify a gender, respondents who chose to self-identify their gender were more likely to be unemployed, suffer physical assaults, and forgo health care due to fear of discrimination. The respondents who self-identified their gender were also more likely than transgender respondents to have attempted suicide (43% vs. 40%); both numbers contrast starkly to the rate of suicide attempts in the general population, which is less than 2%.
This study and the survey data from which it springs only begin to describe the health disparities transgender and gender non-conforming patients face in health care and other aspects of their life. Hopefully these scholars will continue their important work, and inspire others to do the same.
Look for our staff and faculty next week at the National Health Care for the Homeless Council’s National Conference in Kansas City. Further information, including how to register, is here. Providers and advocates from around the country will gather for the conferences many accredited workshops, professional networking, and inspiring plenary sessions.
Our program on Optimizing Care for LGBT People in Health Care for the Homeless Programs will be presented by Education Center Faculty Joanne Keatley, MSW, Ralph Vetters, MD, and Harvey Makadon, MD on Wednesday, May 16th. JoAnne Keatley is Director of the Center of Excellence for Transgender Health at the University of California, San Francisco. Dr. Vetters is Medical Director of the Sidney Borum, Jr. Health Center, which is a program of Fenway Health, our parent organization. Hilary Goldhammer, MS, our Manager of Curriculum Development, will moderate the panel discussion.
Also check out our booth at the conference which will feature giveaways, including a drawing for a copy of The Fenway Guide to LGBT Health, along with a variety of LGBT health information. We would love to discuss how we can be helpful to your health centers.
We are excited to be included in this conference and look forward to additional collaborations with the NHCHC. Check out our calendar, here, for additional NHCHC collaborations in Tennessee and Seattle.
Check out Urbanite Baltimore's noteworthy profile of openly lesbian health care provider Tonia Poteat, PhD, who was recently appointed Senior Technical Advisor for Most At Risk Populations by the Office of the U.S. Global AIDS Coordinator. As a physician assistant at Chase Brexton Health Center (a LGBT-focused health center in Baltimore) Dr. Poteat cared for at-risk transgender patients at Poteat's coming out story was told in the 2007 documentary For The Bible Tells Me So, which profiled Christian families’ struggles to accept lesbian and gay children. Dr. Poteat also did a stint with the CDC and the World Health Organization monitoring and evaluating HIV treatment programs in sub-Saharan Africa. It is inspiring to read about a provider so dedicated to reaching the most vulnerable populations.
Chicago’s LGBT health center, Howard Brown Health Center, doubled the size of one of its primary clinical locations, as reported by ChicagoBusiness.com. The larger storefront location will increase Howard Brown’s visibility and allow them to expand services to include older patients and infants.
Whitman-Walker Health, a LGBT-focused health center in Washington, DC, recently announced that they have increased their patient population by 20% since 2010 and now care for over 15,000 patients. Their patient base has nearly doubled since 2006. Whitman-Walker also reported an operating gain for the second year in a row, marking a nearly $7 million turnaround in five years.
In Colorado, Boulder Valley Women’s Health has begun offering care for transgender patients. The Daily Camera reports that it is the first Boulder clinic to reach out to transgender patients. Executive Director Susan Levy got it right when she said, “We…don’t make assumptions about our patients…their sexual habits or who their sexual partners are, any of that. That's not our job as a healthcare provider." The clinic worked with transgender individuals and community organizations to find out what services were needed.
Our director, Dr. Harvey Makadon, was the keynote speaker at the third annual LGBT Health Student Symposium, a gathering of medical, nursing and social-work students from around the country. The symposium was organized by Howard Brown Health Center, Center on Halsted and the University of Chicago Medicine. The Windy City Times reported on the conference.
Dr. Makadon stressed the importance of asking patients about their sexual orientation and gender identity, and discussed transgender health care in depth. Speaking about how transgender patients may seek health care providers’ assistance to transition, he stated, "Someone once said, 'The source of identity is in your soul.' It's not so much a transition, but an affirmation of what has always been."
Also at the conference, representatives from Chicago Black Gay Men's Caucus (CBGMC) discussed the disparate impact of HIV on Black men who have sex with men (MSM). Other speakers discussed stigma and discrimination; transgender health; LGBT inclusion in medical school curriculum; and LGBT mental health.
The Health Resources and Services Administration (HRSA) will host a Webinar on Transgender health on Tuesday, May 8, 2012 at 1:00 pm EDT. Register here. Among the panelists are members of the National LGBT Education Center's Faculty and Advisory Board: JoAnne Keatley, MSW (Director of the Center of Excellence on Transgender Health at University of California San Francisco), and Walter Bockting, PhD, (University of Minnesota).
In March, the Veterans Health Administration clarified a portion of its 2011 policy on respectful delivery of health care for transgender veterans. (The National Center for Trans Equality issued an excellent fact sheet about the directive.) The original policy stated that an individual must provide official documentation in order to change their name and gender in VHA medical records. Some VHA staff incorrectly interpreted this to require documentation of sex reassignment surgery. The VHA has now clarified that to change the gender on the patient’s VHA medical records, a veteran must simply provide a physician’s letter certifying that the veteran has changed genders and has had appropriate clinical treatment for gender transition. The physician’s letter need not certify that surgery, or any particular medical procedure, has been completed. Since many transgender individuals do not undergo surgery or other medical treatment, this policy clarification is very important to helping them receive culturally sensitive care. One important way health care staff can create a welcoming environment for transgender patients is by using the individual’s preferred gender, pronoun, and name.
The VHA is among the largest healthcare providers in the U.S., with over 275,000 employees. It provides care to thousands of women and men who have served in the U.S. military.