Ready for Mental Health Action Day – #LGBTWellness Roundup, Week of May 9, 2022

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Mental Health Action Day is May 19

This coming Thursday, May 19th, will be the second annual Mental Health Action Day. CenterLink is proud to partner in this initiative, which focuses on moving from awareness to action, given the serious mental health disparities that face LGBT communities (many of which have been worsened by a flurry of anti-LGBT and especially anti-transgender laws sweeping many states). Check out LGBT research and resources if you need support yourself or want to help spread the word on making for a better quality, more inclusive, and more affordable mental healthcare system. 

Honoring our LGBT Elders

Meanwhile, May 16th is recognized as National Honor Our LGBT Elders Day, an event started in 2016 as a way to honor the contributions that LGBT older adults have made to today’s LGBT communities. The event also draws attention to issues facing LGBT older adults, such as health, in which this population faces compounded disparities from decades of inequitable access to healthcare as well as discrimination. Resources include toolkits for various types of entities, including ways that healthcare settings can recognize the occasion and improve LGBT older adult health, and folks are encouraged to share messages and photos on social media with the hashtag #LGBTEldersDay.

Hidden Costs of Conversion Therapy

JAMA Pediatrics published a study that reviewed available scientific literature and found that, across various studies, conversion therapy for LGBT individuals was associated with higher rates of depression, substance use, and attempted suicide. In addition, they estimated that experiencing so-called conversion therapy – in which someone uses discredited means to try to change the sexual orientation and/or gender identity of another person – was assocaited with over $97,000 in financial loses, including the money spent on the “therapy” itself but also the costs of dealing with the fallout, as well as lost productivity over the lifecourse. On the other hand, affirmative therapy – in which a person’s LGBT identity is supported and the individual receives evidence-based care – was associated with cost savings compared with no intervention, as well as increased “quality-adjusted life years” and other benefits. 

Leaked Roe DRAFT Decision Raises LGBT Health Concerns

Gay City News published an analysis of concerns raised by LGBT advocates of a potential rollback in LGBT rights following a leaked, draft Supreme Court decision on reproductive rights. Not only does the leaked decision represent a seeming willingness to revoke previously-established constitutional rights – a frightening prospect in general for LGBT people – but it also specifically seems to erode the idea of a general right to freedom and privacy that have been key to decriminalizing same-sex sexual relations and establishing marriage equality. Abortion access is itself, of course, an LGBT health issue, with research finding that bisexual women were more likely than heterosexual women to need access to abortion services and that many gender minority people who became pregnant considered ending a pregnancy without medical support due to legal restrictions and stigma. It is important to remember, that the documents leaked are only drafts and do not represent and change in legislation or current access to care. Clinics should continue to provide life-saving reproductive healthcare and the community should continue to access it.

ICYMI: Exclusive “All of Us” Interview

Have you had a feeling this week that you were forgetting something? “Fear of missing out” creeping in? Maybe you missed our big interview last week with Dr. Anthony Pho, who is part of the team making the All of Us research program queerer and more fabulous. You can learn all about this important initiative, and how Centerlink and the Stanford University School of Medicine are helping to ensure it’s the most inclusive federal research program ever (and fill in lots of knowledge gaps on LGBT health along the way). Check out our summary here and, better yet, head to our podcast channel to hear the three-part interview yourself. 

Even More Happening on the Podcast

And speaking of our podcast, two weeks ago, we shared a study about promoting tobacco cessation among sexual minority women. This week, one of the study’s authors, Karen Caldwell, called into the podcast with some additional information on how they were able to use GPS technology to reach queer women who had been to specific locations where they wanted to prioritize outreach. If your work is featured here in the blog, or you are just a fan with thoughts to share or your own research to promote, you can send in your comments too using the “message” feature on our channel

How “All of Us” Can Improve LGBTQ Health – Special #LGBTWellness Podcast

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

This week’s roundup is all about the All of Us Research Program, a federal program aiming to gather health information on 1 million Americans so that we can better understand public health. The best part? All of Us has been working with Stanford University School of Medicine as their LGBTQ community partner to make sure we are counted. We sat down with Dr. Anthony Pho, a postdoctoral scholar with the PRIDE study and PRIDEnet at Stanford, to spill all the tea. You can listen to the full three-part interview on our podcast channel, or keep reading for the highlights. 

Meet Anthony

Our very special guest, Dr. Anthony Pho, is a “queer researcher doing queer research,” and we are here for it. Anthony went to nursing school and works exclusively with LGBTQ patients. “I was very passionate about advocating for my patients through LGBTQ research,” given the limited information we still have on LGBTQ health, Anthony says. He is currently doing a post-doc with PRIDE Study and PRIDEnet, which is how he came to be involved with All of Us. Anthony chatted with us about all things LGBTQ health, but one particular topic of interest was how genomics (or the study of genes) was being used as part of All of Us to match what we know about environmental and genetic factors for health. 

Recipe for Fabulousness 

“If genes are the individual recipes or instructions,” Anthony explains, then genomics are “all of these fabulous recipes that go into the genome cookbook and make you, you.” Understanding genomics helps us to understand and detect disease. “If we can detect things early enough, then we can maximize a plan to improve a person’s health and possibly even cure disease.” This also fits into the idea of “precision medicine,” which means tailoring care as much as possible to the individual, which we can do if we understand their genome and what it means for their health. “Environmental factors such as what we eat, the air we breathe, what medicines we take all can influence our gene expression, and so it’s important to combine both types of information.”

We’re Here, We’re Queer…

Why is it important for LGBTQ people to participate in this type of research? Well, because for so long, we have not been included (or at least not identified) in public health research, meaning we have huge gaps in what we know about LGBTQ health – and how to improve it. “The ability to actually show up in health research studies” is part of health equity, Anthony says, because it begins the process of addressing disparities. “For the first time, the federal government is really, at an incredible scale, recognizing that LGBTQ people have been underrepresented in biomedical research.” That’s why they have made inclusion of LGBTQ people a priority in this initiative.

So, Where Is This Going? 

Two CenterLink member centers, who are among the five working with All of Us to increase LGBTQ engagement, sent representatives to participate in the conversation. Evan Killingsworth from LGBT Detroit asked what some of the real-world applications of All of Us (and specifically its genomics component) might be for LGBTQ folks. Anthony provided examples such as using this data to inform guidelines for hormone therapy for transgender patients with more information on genetic risk for cancer, allowing clinicians to offer more and safer options to trans people seeking hormones and recommending screenings to assess potential cancer risks. 

What About the Haters? 

Kim Fountain from Center on Halsted asked if genetic testing could ever be used against LGBTQ people) and everyone else if protections healthcare access protections under the Affordable Care Act ever go away. Anthony says that while it’s not unreasonable to be concerned about the future, “I turn that concern into activism.” We can’t be forced to pick between advancing science and protecting our rights, so rather than hiding, we need to rise up and demand from our legislators that protections for those with prior medical conditions are here to stay. 

Let’s Talk Numbers

“We’re doing phenomenal” on LGBTQ recruitment to date, according to Anthony. He attributes part of that success to the way in which All of Us allows people to identify their sexual orientation and gender identity in a highly inclusive and engaging way. To date, over 42,000 LGBTQ individuals have enrolled in the program, the largest for any national research study. LGBTQ folks comprise about 13% of the overall All of Us participants (above our share of the population) and 9% of those doing the whole genome sequencing component. 

Want to Get Involved?

Anyone can sign up to be part of the initiative, share some info about their health, and contribute to what we know about LGBTQ health inequities (and how to end them). “We actually created a specific landing page for LGBTQ people” based on listening sessions with LGBT prospective participants, Anthony explains. “On that page you’re going to find more information that’s relevant specifically to our communities.” His final advice? “Read more, enroll, educate yourself, and advocate for this wonderful research program.” 

Get Ready for Something Exciting! #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Something Exciting is Coming Next Week!

Next week, we will publish a series of three podcasts featuring an interview with Anthony Pho, a postdoctoral fellow with the PRIDE study and PRIDEnet at Stanford University. Stanford University School of Medicine is the LGBTQ Community Engagement Partner for the All of Us Research Program, which is an unprecedented federal program aiming to gather health information on 1 million diverse Americans to improve research and healthcare. We spoke with Anthony about a variety of topics, including why LGBT health data is so important, how privacy is protected through this initiative, and how they are working to overcome mistrust among many in the LGBT community of public health and healthcare institutions. Be sure to sign up for our podcast here so that you don’t miss this special series, and you can learn more about the All of Us research initiative at joinallofus.org

What Do People Think About Anti-LGBT Laws?

The Washington Post published a detailed analysis of public opinion surrounding a variety of controversial laws and policies that some states are implementing to target LGBT people and their health. They found that polls differed wildly, depending on who was asking, who was being asked, and especially the wording of the questions. For example, Florida’s “Don’t Say Gay” bill was found to be popular when people were read the language of the bill, but less popular when it was explained to them, and even then, the complexities of the issue were not explored. Meanwhile, with respect to banning transgender athletes from competing on sports teams aligned with their gender, the population seemed fairly split on whether or not this should be prohibited. If nothing else, the results suggest that these types of laws are still not entirely clear to the general population, even as they advance in many states. 

Academy Publishes Puberty Book

NPR reported on a new book published by the American Academy of Pediatrics that seeks to teach youth about puberty in a way that is inclusive of all gender identities. The book seeks to teach youth to embrace and understand changes, rather than fear them or feel that there is one particular form of “normal.” The authors often discussed body parts without ascribing them to a particular gender, in contrast with traditional puberty lessons that divide boys and girls – often leaving out transgender and nonbinary students. The authors say that accurate, expert, and inclusive advice for youth is needed now more than ever, given the aforementioned wave of anti-LGBT youth legislation nationwide. 

Mental Health App for Youth Coming Soon

Also on the subject of LGBT youth, Q Chat Space announced a new mental health tool created with and for LGBT youth that will launch in June, just in time for Pride Month. A May 12th webinar will share more information for those hoping to utilize the app themselves or in populations they serve, while the website offers a sneak peak and a sign-up list to be notified when the app is available. The project is a collaboration with Hopeland and the It Gets Better Project. 

Recognizing National Minority Health Month

The U.S. Department of Health and Human Services celebrated April as National Minority Health Month with a campaign focused on advancing COVID-19 safety measures – especially vaccine booster shots – among minority communities, noting the disproportionate effect the pandemic has had on minority populations. Meanwhile, the CDC Foundation published a website on health equity to mark the occasion, including sharing resources and updates on how they are working to advance minority health. 

Smoking Cessation Program for Queer Women

Health Promotion Practice published a study analyzing a tobacco cessation campaign for queer women in North Carolina. The initiative utilized digital data such as location and marketing profiles to target ads over a four year period. This included adapting messages to address concerns related to COVID-19 risks among people who smoked during the pandemic. The campaign was considered effective and a potential model to use elsewhere, given ongoing disparities in tobacco use among the LGBT community. 

Providers Say No to Care Bans – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Providers Say No to Care Bans

The Journal of the American Medical Association reported that healthcare providers are speaking out against bills seeking to ban gender-affirming care, particularly for youth. They argue that this type of care is medically necessary and can save lives, and is being targeted for improper purposes. Additionally, they argue that it is stepping into the patient-provider relationship (and in some cases upending that relationship, where laws would require providers to “turn in” patients seeking to access this type of care). A new law in Arkansas and an executive order in Texas, both of which would issue bans on certain types of care, are both being blocked as courts investigate advocates’ concerns. 

Supplement Use High among Trans Men

Eating Disorders published a study finding that use of appearance and performance-enhancing drugs and supplements (APEDs) was common among transgengeder men, trans women, and nonbinary folks, but especially so among trans men, of whom more than 45% had used APEDs during their lifetime. Furthermore, among both trans men and nonbinary individuals, use of APEDs was associated with a range of health issues, including disordered eating and muscle dysmorphia symptoms. The results show the importance of this type of product being monitored by health professionals, especially when tied to one’s gender identity. The researchers used data from the PRIDE Study

VA Celebrates LGBT Health

The U.S. Department of Veterans Affairs celebrated LGBTQ Health Week with a post noting the importance of veterans (and all people) being able to openly discuss their sexual orientation and gender identity with their providers. Not only is self-identification a “basic right,” but there are positive health effects when healthcare providers know more about one’s identity and how to serve that patient, the post says. They also shared a series of fact sheets (for example, this one on nonbinary veterans) that delve into some of the specific needs – and strengths – of subpopulations within the broader LGBT community. 

Trans Care in New Zealand

Family Practice published a study examining the healthcare experiences of transgender adults in New Zealand. They found that the most commonly-reported supportive behaviors that trans people found with primary care doctors were being treated equitably and with competence and respect. Trans folks who had more negative experiences while seeking healthcare had higher levels of distress, self-injury, and suicidality, while those who had better experiences had lower levels of distress and lower likelihood of having attempted suicide in the past year. The results help to both highlight some common supportive behaviors that providers can practice, and the positive and negative health associations that result.

Contraceptive Use among Trans Men

LGBT Health published a study finding that trans masculine individuals were prescribed less oral contraception and less long-acting reversible contraception by healthcare providers than were cisgender women. On the other hand, trans masculine folks were more likely than cisgender women to have hysterectomies. There were also differences depending on whether public insurance (Medicaid) or private insurance was used by the individual. Researchers say that the results show the importance of access to knowledgeable, inclusive providers as well as comprehensive insurance coverage, as the differences may at least partially reflect barriers for trans individuals to access reproductive and sexual health services. 

Tough Conditions Await Immigrants

ABC News reported on the situation facing transgender immigrants who come to the U.S. seeking to escape violence from certain countries abroad, only to often experience discrimination and victimization in the U.S., as well. Those seeking gender-affirming care also find that while it is more available in the U.S. than it is in much of Latin America, there are still major barriers to receiving such care here in the States, and many jurisdictions are actively working to make it even harder. The reality for those coming to the U.S. to escape transphobia is that while some aspects of transgender rights might be more advanced here, and some services more readily available, the U.S. still has a very long way to go.

Queer COVID-19 Resources are Here, #LGBT Wellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Queer COVID-19 Resources are Here

CenterLink published a COVID-19 vaccine communication toolkit that provides resources for helping to reach and education LGBT folks on COVID-19 vaccination. The resources have been developed along with the School of Public Health at the University of Maryland, and were highlighted on an April 6th webinar. In addition to tailored resources like a customizable flier for those hosting vaccination clinics and conversation starters to get the ball rolling with clients, the initiative also includes a weekly newsletter to keep folks informed.

Delving into Vaccination Rates

Relatedly, the Journal of the American Medical Association examined COVID-19 vaccination among LGBT adults – and specifically, how things break down based on sexual orientation, race, ethnicity, and gender. While LGBT people on the whole are more likely to be vaccinated than are their peers, when looking at subpopulations, White gay men were most likely (with over 94% being at least partially vaccinated) while Black gay or lesbian women had the lowest rate (with less than 58% being vaccinated). The results suggest that more outreach is needed to certain groups – and especially Black sexual minority women – as public health officials and others in government try to get more of the country vaccinated. 

Anti-LGBT Youth Bills Continue 

Movement Advancement Project published a new report finding that 42 states considered bills that would make it harder for safe and inclusive education to be provided to LGBT youth over a two-year period, from 2020 to 2021. This means that more than 80% of U.S. youth live in states that have at least considered, if not enacted, such legislation. Additionally, a whopping 280 bills seeking to suppress support for LGBT youth or censor LGBT-inclusive content in schools have been introduced so far in 2022, which is more than the combined total from all of 2020 and 2021. They point to further research finding that the public debate around such bills negatively impacts LGBT youths’ mental health, even if the bill eventually fails to become law. 

Impacts of Negative Legislation

On that note, Fast Company analyzed some of the negative impacts that this type of bill can have. They include prohibiting teachers from using LGBT-inclusive lessons, but also blocking students from sharing their own identities (or having that information reported to their parent if they do). Both of those components can hurt mental health; for example, the author points to research finding that learning about LGBT historical figures was associated with lower suicidality among youth, and many LGBT youth rely on school as a safe place to get critical support that they lack elsewhere. 

New HIV Vaccine Trials Announced

NIH announced that it was beginning a Phase 1 clinical trial of three HIV vaccines that use mRNA in a way similar to that of multiple approved COVID-19 vaccines. Anthony Fauci expressed optimism that some of the scientific knowledge we have gained from fighting COVID-19 might translate into a vaccine for HIV, which remains an elusive goal more than 40 years after HIV was first reported in the US. (By contrast, companies developed COVID-19 vaccines in less than a year.) The study will begin with 108 adult participants, of whom one-third will get each of the three experimental vaccines. The trial is expected to be completed by summer of next year. 

Seeking (or Avoiding) Care in South Korea

LGBT Health published a study on the experiences of sexual minority adults seeking healthcare in South Korea. The study found that, after controlling for other variables, LGB adults who had high expectations of facing rejection related to their identity while seeking care had 1.38 times higher prevalence of delaying or avoiding care compared to adults with lower expectations of rejection. The results demonstrate how even the fear of not being treated respectfully can impact LGBT health, as those who skip care are likely to not have problems found when they are easier to cure or treat. 

Filling in Gaps on LGBT Health – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Filling In Gaps on LGBT Health

We at LGBT HealthLink will be publishing an exclusive podcast learning more about the All of Us research initiative, which is an unprecedented federal program aiming to gather health information on 1 million diverse Americans to improve research and healthcare. To create this podcast, we sat down with Anthony Pho, a postdoctoral fellow with the PRIDE study and PRIDEnet at Stanford University, the LGBTQ Community Engagement Partner for All of Us. We spoke about why this research program is important to learn more about LGBT health, what genomics is and how it could improve healthcare, and the issues that matter to LGBT community centers that are aiding the effort. You can sign up here for our weekly podcast so that you do not miss this special edition when it’s released, and you can learn more about the All of Us research initiative at joinallofus.org

More Health Centers Have SOGI Data

The American Journal of Preventive Health published a study finding that between 2016 and 2019, the number of community health centers with sexual orientation and gender identity (SOGI) data on at least three-quarters of patients increased from just 14.9% of centers to 53% of centers. Centers were more likely to have reached this number in 2019 if they were in non-metro areas and were located in the U.S. south or west, rather than east. While the results show that almost half of community health centers are still lacking critical SOGI data to identify and improve care for LGBT patients, they also represent a major improvement in a relatively short, three-year timeframe. 

Intersectional Analysis of LGBT Mental Health

LGBT Health published a study that looked at national mental health data through an intersectionality lens, that looked at sexual orientation, gender identity, and race/ethnicity. Among their findings were that generally, people with multiple forms of marginalization with respect to these identities had the highest levels of frequent mental health distress. The authors of the study suggest that this approach to analyzing data with an intersectional lens holds promise for better understanding the nuances of LGBT health. 

Get Ready for the U.S. Trans Survey

The 2022 U.S. Trans Survey launched a “pledge” feature that allows folks to sign up in advance to take the survey, once it is available. The 2015 version became the largest survey of U.S. transgender people in history, with 28,000 participants. As covered in previous Roundups, this new iteration of the survey has faced some delays, including with respect to the COVID-19 pandemic, but is almost ready to commence. The survey covers a wide range of topics around health, healthcare, safety, discrimination, and wellbeing. 

Expanding Gender-affirming Care

Transgender Health published a study looking at how to use a grassroots approach to improve gender-affirming care in areas where such services are lacking, and where there is not targeted funding or explicitly trained providers to fill the gap. They share their experiences with expanding care in this way, which involved a more than 600% increase in patient visits over an approximately four year period. The authors also discuss the importance of local partnerships when taking this approach. 

Recognizing National Native HIV/AIDS Awareness Day

HIV.gov recognized March 20th as National Native HIV/AIDS Awareness Day, including by sharing resources, videos, and toolkits designed to address HIV issues among indigenous communities in the U.S. These resources include a guide to improving access to PrEP among Native American communities, which could benefit LGBT people at risk for HIV infection, and a series of fact sheets that shine light onto the problem. For example, data show that more than half of new infections among American Indian and Alaska Native populations occurred in sexual minority men, a population that saw a 58% increase between 2012 and 2016.  

HPV Vaccination Higher for LGB Folks, But Still Low – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

HPV Vaccination HIgher for LGB People, But Still Low

LGBT Health published a study finding that gay and bisexual men and women were more likely than their heterosexual male and female peers, respectively, to both initiate and complete the three dose HPV vaccination, which can help prevent cancer. Sexual minority males were particularly more likely to have gotten vaccinated against HPV than heterosexual males, which might relate to the fact that programs traditionally targeted girls and young women, despite gay and bi men facing high risk. The bad news: overall rates of HPV vaccination were low across the population, with only about 10% fully vaccinated, 10% partially vaccinated, and 80% unvaccinated. 

Approaching Health Issues for Trans Individuals 

Pyschiatric Times published an examination of the health issues facing transgender and gender diverse individuals, including elevated rates of a variety of mental and behavioral health concerns. The researchers employed the Gender Minority Stress and Resilience Model (GMSRM) to understand these disparities as a result of encountering stigma, discrimination, and violence as a result of the individual’s gender identity. Traditional means of addressing a given health issue may not translate for gender diverse individuals, the authors say, because within this population the issue (for example, depression or disordered eating) may relate to how society has reacted to their identity. Instead, the systemic barriers and unique issues facing these patients – and their resilience as a trans or nonbinary person – need to be taken into account. 

Arizona Anti-Trans Bill Dies in Committee

NBC News reported that a bill in Arizona that would have banned transgender youth from accessing gender-affirming care was effectively killed when three Democrats and one Republican voted against the measure in committee. The Republican Senator broke ranks with his party, which had supported the legislation, after hearing testimony from trans youth and their families that such care had greatly improved their health and in some cases saved lives. Arizona has been the site of more anti-transgender legislation than any other state so far in 2022, with 15 such bills having been put forward in the past two months. 


Relationships, Sexual Partners, and Health

Body Image published a study looking at how being or not being in a relationship, as well as the number of past-month sexual partners, impacted body image and eating disorder issues among cisgender gay men. They found that those who were not in a relationship had greater “appearance intolerance” with respect to how they looked, and that a higher number of past-month sexual partners was associated with greater “drive for size” and use of various steroids and supplements. The results suggest that in addressing this type of issue among sexual minority men, considering their relationship status and sexual practices could be important.  

Limited Data on LGBT Incarceration  

LGBT Health published a study in which researchers sought datasets on LGBT people facing incarceration. They found that only five publicly-available, representative databases were available that included sexual orientation, and none were available that included gender identity – making it difficult or impossible for researchers to assess incarceration-related issues in the LGBT community. The data that was available showed that lifetime prevalence of incarceration was higher for sexual minorities (ranging from 18%-26%, depending on the database) than it was for heterosexual individuals (ranging 5%-21%), suggesting that the data is needed. 

Imagining an Equitable Future

Science Friday published a piece by former Surgeon General David Satcher examining what our healthcare system might look like if it was more equitable. He explains the history of the Healthy People reports, that led to the creation of new institutions and initiatives aimed at reducing disparities, but notes that even in areas where outcomes have improved overall (e.g., child mortality or HIV), huge disparities remain with respect to different races, ethnicities, sexual orientations, etc. Ending these disparities would mean greatly reducing the number of deaths among marginalized populations, but also improving lives and increasing insurance access. Dr. Satcher argues that we cannot address these issues without tackling the underlying social determinants of health, “including the public health system itself.” 

Spotlight on Policy – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

What’s the Evidence on Trans Youth Policies? 

Society for Research in Child Development published a review of the evidence on how policies impact the health of transgender youth – a timely piece given the wave of anti-transgender youth legislation making its way through state legislatures. Studies show that overall, transgender youth have higher rates of mental health problems than do their cisgender peers; however, these disparities are reduced or eliminated when students have access to gender-affirming care, receive support at home, and are able to socially transition at school and in the community. Policies that can bolster inclusion in schools include nondiscrimination policies, allowing name and gender marker changes, access to facilities and sports teams that match the students’ gender identity, and training staff to foster healthy conversation and provide support. In other words, banning trans students from accessing care, playing sports, or talking about their identities is (unsurprisingly to advocates) not the way to support youth. 

Interesting Factors Tied to Birth Outcomes

On the subject of policies impacting health, Columbia University shared new research finding that there was an association between risk for preterm births and decreased birth weights and what researchers called “structural heteropatriarchy.” They defined this by looking at whether an area had positive or negative LGB policies, good or bad reproductive health policies and funding, and relative equality or inequality on women’s socioeconomic opportunity. They found that in areas with negative policies and poor opportunity, there was higher risk for these negative birth outcomes, which can lead to lifelong health problems. Moreover, this was true regardless of whether someone felt personally affected by these issues. Researchers say this is evidence that a lack of social equality can impact health in ways that might not even be apparent to us on the individual level – and that everyone thus stands to benefit from inclusive societies. 

Nondiscrimination Rule on Deck (Again)

And in yet more policy news, WebMD reported that the Biden administration has proposed to require health insurers to not discriminate on the basis of sexual orietnation or gender identity in the benefits that they offer to patients. Such a rule had been included during the Obama administration before being removed by the subsequent administration. Some insurers have voiced concerns that the rule could prevent them from limiting coverage based on “evidence” and to limit costs, while advocates say it is necessary to prevent plans from not covering services for LGBT people that they cover for everyone else. 

Trans Woman Sues for Jail Assaults

Gay City News reported on a transgender woman who is suing the city of New York after being repeatedly assaulted in the men’s jail where she is being held. Corrections officers did not intervene to help her during the incidents, her suit claims, and while she was temporarily moved to a women’s facility, she was promptly moved back to the men’s prison because of “security concerns.” Violence against transgender people facing incarceration is sadly not uncommon, and the city and state of New York have faced scrutinity for conditions there. 

Incorporating Pleasure into Sexual Health Interventions

Plos One published a study that found fairly little research on incorporating considerations of pleasure into sexual and reproductive health interventions, despite pleasure being a major factor in sexual behaviors and decision-making. Most of the studies looked at higher risk populations, which generally includes LGBT individuals, and tended to measure condom use as an outcome for the intervention. Overall, the research suggests that including considerations of pleasure had a positive effect on higher use of condoms, which means that more interventions that take pleasure into account and measure its impact could advance sexual and reproductive health. 

Experiences of Trans Women in Brazil

Transgender Health published a study of transgender women in Rio de Janeiro, and found that prior experiences of discrimination and violence were associated with having had symptoms of depression. While not surprising, the result is disturbing – especially as a majority of participants had experienced violence and nearly all (96%) had experienced at least one instance of discrimination. Additionally, resilience seemed to not have helped with these experiences as much as one would hope. 

Major New Findings on Vaccination – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

Major Findings on Vaccination among LGBT Folks

The CDC published new findings providing the best evidence to date on COVID-19 vaccination coverage of LGBT adults. They found that gay and lesbian adults had higher rates of vaccination coverage when compared to their heterosexual peers, while transgender adults had roughly equal rates to their cisgender peers. Interestingly, gay men had higher rates of vaccination than did lesbian women, even though among the general population, women outpace men in getting vaccinated. The results are promising given that the CDC acknowledges LGBT people as being at increased risk for negative COVID-19 outcomes, but major gaps remain; for example, Black LGBT people – who likely face particularly high COVID-19 risks – were the subgroup least likely to be vaccinated. 

LGBT Youth Face High Rates of Homelessness

Trevor Project published a new study finding that 28% of LGBT youth had experienced homelessness or housing insecurity at some point in their lives. That number jumped up to 44% among Native/Indingenous LGBT youth, while Asian American / Pacific Islander LGBT youth had the lowest rate at 16%, and other subgroups fell in between. Rates were also higher amoung transgender and nonbinary youth than they were among other LGBT youth. The report also explores the challenges that LGBT youth face while experiencing homelessness or housing insecurity, as well as possible solutions and resources that they need. 

New Home in Arkansas for Youth in Need

Relatedly, the Arkansas Democrat-Gazette reported on the opening of a new home for LGBT youth in that state’s River Valley region. The home is now accepting applications from LGBT youth who lack a safe place to live. The founder, who also runs a social space for LGBT youth in the region, says that housing insecurity has been the main issue youth there are confronting, especially during the COVID-19 pandemic. The program will also help youth address physical and mental health issues that can often accompany housing insecurity, especially for those who faced an unwelcoming or unsafe environment at home as a result of their LGBT identity. 

Online Support Space Recognized 

And also on the subject of safe spaces for youth, Anthem Awards announced that Q Chat Space won a silver medal in its inaugural competition as selected by the International Academy of Digital Arts and Sciences (IADAS). The award recognizes Q Chat Space’s innovative creation of an online meeting place for LGBT youth to meet and chat with professional support. The need for such spaces – which can replicate and supplement the work being done by physical LGBT centers, which contribute to the project – grew exponentially during the COVID-19 pandemic, when youth lost many of the “safe spaces” in schools and communities where they could typically connect. Q Chat Space is an initiative of YouthLink, Centerlink’s youth program.

Dangerous HIV Variant Discovered 

NPR reported on a more transmissible and severe variant of HIV that appears to have been concentrated in the Netherlands. The variant seems to have been around for decades and to have already peaked, but was only recently discovered. The case highlights how (just as with COVID-19) HIV can still mutate and become more dangerous over time, underscoring the importance of ongoing surveillance and study. The good news: existing HIV medications still work excellently with this variant for those who are tested and get (and stay) on treatment. 

Med Students Lose Interest in LGBT Status Over Time

LGBT Health published a study that found, concerningly, that medical students were less likely to ask their patients about their sexual orientation and gender identity for every year that they were studying. By the end of their fourth year of study, only about half of students asked patients their sexual orientation and only about a quarter asked their gender identity. Most decided over time to only ask about sexual orientation and gender identity to when the patient complaiend about sexual health – despite the wide-ranging medical issues for which risk factors and needs vary for LGBT patients, and the fact that the vast majority of LGBT patients are happy to answer these questions.

LGBT Athletes at the Olympics- #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, brings you a round-up of some of the biggest LGBTQ wellness stories from the past week.

You can LISTEN to our Weekly Wellness Roundup podcast! Subscribe here: https://bit.ly/LGBTWellnessPodcast or where ever you podcast.

LGBT Athletes at the Olympics

Gay City News reported that there are 35 “out” LGBT athletes participating in this year’s Winter Olympics, which is more than double the number of LGBT participants when the competition was last held four years ago. Female-identified athletes make up the majority of that number, although LGBT men almost tripled their numbers from four in 2018 to 11 this year; meanwhile, Timothy LeDuc, a US pair skater, is the only nonbinary athlete at the games. The historic LGBT representation at the Winter Games comes at a time in which several US states have moved to ban transgender student athletes from participating in sports. 

New Report on LGBT Youth Equity

The National Academies Press published a report on reducing inequities among LGBT youth, based on a workshop convened last year by the National Academies of Sciences, Engineering, and Medicine. The proceedings covered challenges and opportunities across various sectors – child welfare, education, health systems, families, and communities – and included a focus on equity among LGBT students, of whom Black and Latinx students tend to face the greatest disparities.

Learn more about our YouthLink program, which was represented in the deliberations, here

In Florida, School’s Not “Out” 

On the subject of LGBT youth, CBS News reported that a bill is progressing in the Florida legislature that would ban discussion of sexual orientation and gender identity in elementary and middle school classrooms, as well as through support services offered by the schools. Proponents of the bill says that it would improve “parents’ rights,” while opponents say it will contribute to stigma and harassment facing LGBT students. Research has found that LGBT students in Florida face high levels of bullying, but that most have at least one supportive adult in their school – relationships that could be threatened by the prospective law. The bill is still making its way through the Florida senate, but the state’s governor says he supports it.

Environmental Justice and Queer Communities

American Journal of Public Health published a study exploring how the topic of environmental justice applies to LGBT communities, which face factors such as discrimination and socioeconomic inequities that are connected to elevated risk of negative environmental exposures. LGBT people tend to have higher levels and/or worse outcomes with conditions such as cardiovascular disease and cancer that can be in part attributed to environmental issues. Additionally, because LGBT people have underlying health inequities and unmet needs in the healthcare system, navigating the negative consequences of these environmental exposures can be more challenging. 

Want Who and What? Think Where, Why, How

LGBT Health published a study exploring how LGBT people feel about being asked their sexual orientation and gender identity by researchers. The found the most important factors for LGBT people to share this information was knowing why the questions were being asked – including, for example, to identify and address disparities – and feeling safe and supported in the environment where they were being asked. Research suggest that communicating more about the questions, as well as offering “environmental clues” that it is a safe space, could improve the quality of data we have on LGBT health by ensuring people self-identify to researchers who ask.

Gay, Bi Men Face Prostate Cancer Gaps

DocWire News reported that many medical providers who screen for and treat prostate cancer are not prepared to best serve gay and bisexual patients. The physical health problems that accompany a prostate cancer diagnosis and treatment – and the mental and emotional consequences that come with them – are similar but distinct for gay and bisexual patients. Additionally, data and research on the needs of this group are lacking. The article also highlights a first-of-its-kind urology program at Northwestern Medicine in Chicago that specifically serves sexual minority men and is exploring solutions to improve care. 

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