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Why Trans Folks Are Losing Sleep – #LGBTWellness

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Subscribe to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

TransWeedWhy Trans Folks are Losing Sleep

Researchers found that sleep loss was a common experience among transgender and nonbinary people in New York. 35% said they had trouble sleeping because of issues relating to their gender identity and accessing gender-affirming care, while 15% said mental health challenges were tied to sleep loss. 60% reported using strategies like prescriptions, over-the-counter sleep aids, and marijuana to help sleep.

 

National Black HIV/AIDS Awareness Day

The CDC commemorated February 7th as National Black HIV/AIDS Awareness Day, which this year had the theme, “We’re in this together.” The theme highlights the importance of engaging with families, partners, and communities, they said. This year’s resources included a variety of social media images and suggested messages, while fact sheets explain how Black gay and bisexual men are particularly impacted by HIV.

Beyond Sexual Risks for Black Men BlackMSM

On the subject of Black men’s health, the American Journal of Public Health analyzed scientific research on Black this topic, and found that 84% of literature focused on sexual health and sexual risk, mostly HIV. Almost non-existent was literature on sexual pleasure among Black men, regardless of sexual orientation suggesting a focus on negative aspects of sexuality. The limited body of research reduces the potential for sexual minority Black men “to develop healthy, emotionally intimate, trusting, and sexually pleasurable relationships,” and can be correlated to historical systemic racism and structural barriers to Black health.

Community Centers and Facebook

Researchers examined over 32,000 Facebook posts made by LGBT community centers, and found that using photos, videos, and direct engagement with the reader were all ways to boost posts. They also found that content related to topics including stigma and mental health played well – good news for centers hoping to address these critical health topics among the LGBT population nationwide.

TransYouth2Providers Speak Out for Trans Youth

NBC News reported that over 200 providers and other healthcare professionals in the South wrote an open letter opposing a growing number of pending state bills that would ban access to care for transgender youth. The letter says that there is strong medical consensus that such care is not only safe, but actually critical for the mental health and wellbeing of youth in need of such care.

Trans Women Say Healthcare Limited

A new study examined the healthcare experiences of a diverse sample of transgender women, and found that while mental and transition-related healthcare were priorities, participants struggled to find such care. They also found that sexual health was too narrowly focused on HIV and STIs, and that accessing sexual health education, broader support around dating, and other services were lacking.

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Special Report on PrEP Initiative – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Subscribe to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

ReadySetPrEP2

Special Report on PrEP Program Launch

HIV.gov hosted a webinar on January 29th to help launch its groundbreaking Ready, Set, PrEP program that seeks to bring this HIV prevention medication to those lacking insurance. The webinar delved into topics such as eligibility, applying online, and the critical role of health centers in implementing the new program. Listen to our full coverage of the event on our LGBT Wellness Roundup podcast – available from Apple or wherever you listen to podcasts.

Celebrating Black History Month

HRC published a piece celebrating the start of February as Black History Month. They point out that while Black LGBT folks have been at the forefront of the LGBT rights movement since its formation, they still face discrimination and disparities even within the larger community. They also discuss the importance of combatting issues like HIV, voter suppression, and violence that particularly impact Black LGBT individuals.

How Tobacco Campaign Reached LGBT Youth

Researchers evaluated the anti-tobacco campaign, known as This Free Life, which has been one of the largest LGBT public health campaigns in history. Findings determine the campaign to be overall successful in reaching its’ targeted markets and receiving positive opinions of its’ content. It also found that reactions to the ads varied based on identities within the LGBT community, highlighting the importance of working to reach diverse subgroups.

Policies Counter Public Health BannedTransCare

Axxios reported on a troubling trend in which states across the country are considering banning various types of gender-affirming care for transgender minors, including some that would impose criminal penalties on healthcare providers. The article also explores research that has found gender-affirming care to be a lifesaving intervention for youth, making these policies dangerous for the trans community.

Nurses Need Training on LGBTQ Issues

Researchers found that home healthcare nurses wanted more training on LGBT health before they could feel comfortable discussing topics like sexual orientation and gender identity with their patients. They said that while they wanted to provide quality care to all, and to document LGBT identities, that there were challenges in discussing these topics and that more training was needed.

U=UUnpacking U=U

The Body published an op-ed exploring the downsides of using Undetectable = Untransmittable (U=U) to promote people achieving an undetectable HIV viral load and thus no longer being at risk of transmitting the virus. The author says that the message puts pressure on people living with HIV to achieve an undetectable viral load – a goal that is out of reach for many based on health, income, and structural factors – and that it could be stigmatizing populations such as LGBT people of color who face the biggest barriers.

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Puberty Blockers, Queer Identities, and More – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Subscribe to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

HormonesPuberty Blockers Could Save Lives

Researchers found that among 20,000 transgender adults, 16.9% wished they had access to puberty blockers (hormone therapy that delays puberty during adolescence), while only 2.5% actually accessed the treatment. Those who did use puberty blockers had much lower odds of ever having considered suicide – highlighting the potentially lifesaving importance of hormone therapy for youth.

HIV Agency Says Health Not a PrivilegeUNAIDS2.JPG

UNAIDS announced at the World Economic Forum in Davos that world leaders should be doing more to ensure healthcare to vulnerable populations, such as LGBT people, women, and immigrants. They say that nations need to invest more spending in healthcare, which should be a right and not a privilege of the rich, if health problems such as HIV are to be overcome.

QueerUmbrella.JPGWho Identifies as Queer?

NBC News reported on new research finding that while “queer” is the primary identity of only 6% of LGBTQ people, it is particularly popular among young adults aged 18-25, with more than three in four queer-identified adults falling into that age range. 83% of queer individuals were identified as female at birth, and they expressed more diverse sexual attraction than did gay- or lesbian-identified individuals.

Measuring Internalized TransphobiaTransphobiaFlag.JPG

A study tested a new measure of internalized transphobia, which used four dimensions to explore this theme with transgender individuals: pride in their identity as a trans person, interest in “passing” as a cisgender person, alienation from the transgender community, and shame with being transgender. They found the measure to be reliable, meaning that it could be helpful in further research on the impact of internalized transphobia as a form of minority stress.

Online Training for UK Doctors Rainbow UK

Digital Health reported on a “first-of-its-kind” online resource for UK general practitioners that aims to train them on providing quality care for LGBT patients. The program, which was created by a leading professional association and the government, has six modules on topics like creating inclusive environments, improving mental health, and properly screening transgender and nonbinary individuals.

StopHIVTogether.JPGShare Your HIV Story

The CDC called for applicants to help share their stories with HIV prevention or treatment as part of the Let’s Stop HIV Together campaign. The goal of the campaign is to prevent HIV infection by encouraging use of services such as PrEP for HIV prevention, and they are looking for real people to share their stories as a way of encouraging others. Selected applicants will be contacted in the coming months as the campaign develops.

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YouTubing Your Way to Good Nutrition – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

RainbowYouTube

YouTubing Good Nutrition

A study explored how transgender folks used YouTube videos to share information about nutrition. Use of the social networking medium was widespread on topics like diet and exercise philosophies, dietary supplements, and the nutrition impacts of hormone therapy. The researchers believe that YouTube could thus be key for providers engaging with the trans community and providing accurate information for those seeking it.

RSPrEPEvent Set for Landmark PrEP Initiative

HIV.gov announced a webinar to help launch the new landmark initiative called Ready, Set, PrEP that aims to bring the HIV prevention treatment to 200,000 people over the next decade. The webinar will help explain the program, the online tools it offers, and how it can be integrated into new or existing efforts to provide PrEP at the community level. It will take place on January 29th at 2:00pm EST. Subscribe to our podcast for further coverage of this event in the coming weeks!

How to Develop a Trans Health Program

Researchers outlined the steps that a primary care practice can take in order to provide care to transgender patients, a population that currently faces a dire lack of access. The steps include conducting a community needs assessment, gaining commitment and assignment roles to leadership and staff, creating protocols, and fostering a generally welcoming environment.

Preventing Gender Violence in Middle School MiddleSchoolKids

A new study examined a novel program to address gender-based violence at the middle school level, to preempt this form of violence that disproportionately impacts female-identified and gender-nonconforming individuals. The program targeted male youth through school athletic programs and went beyond typical “bystander training” to challenge gender norms at the heart of the problem.

New Resources for Addressing HIV

The CDC released new resources for those working to end the HIV epidemic, including information on coinfections that impact people living with HIV such as Hepatitis C (affecting 21% of people living with HIV) and Tuberculosis. Other resources include strategies for addressing the epidemic through testing, treatment, and prevention and an overview of the nearly 38,000 new diagnoses of HIV in 2018.

YouBelongStudents Push for Binder Coverage

The Daily Pennsylvanian reported on an effort by the student assembly at the University of Pennsylvania to have the school’s insurance policy cover the cost of chest binders for transgender and nonbinary students who use them. Gender-affirming medical supplies like binders are typically not covered by health plans despite being a key part of care for many transgender men, in particular. The students were inspired by a similar change that recently occurred with Cornell’s student health plan.

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Landmark Study on Eating Disorders – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

First-of-its-kind Study on Gay Men and Eating Disorders Pride Study2

Researchers found that among cisgender gay men, about one in five (21.4%) reported concern about their physical shape and one in ten (10.5%) reported concern about their weight specifically. In addition, 19.8% reported dietary restraint within the past four weeks while 10.1% reported excessive exercise within the same time. Almost all eating disorder research has focused on women, making this study unique – and one made possible by the groundbreaking Pride Study on LGBT health.

LezMomsNP Fellowship Focuses on LGBT Health

Nurse.com reported on a new nurse practitioner fellowship, set to launch at Callen-Lorde Community Health Center, later this year. The landmark fellowship will help prepare healthcare professionals to serve the estimated 11 million-plus LGBT people living in the U.S. who often find healthcare services lacking. It will cover a wide variety of topics from HIV care to cardiology to reproductive health.

Tweet Opens Mental Health Dialogue

LGBTQ Nation reported on a Tweet regarding LGBT mental health that went viral and that they say is inspiring queer people worldwide. The Tweet says that while LGBT people have to hide their true selves as youth, this presents a “gift in disguise” as one goes on a journey of self-discovery later. The article notes that challenges remain on mental health access, especially for low-income people and people of color.

Cigarette Packaging Has Power to Attract

A new study found that changing the design of a cigarette package to include subtle or even explicit targeting of LGBT populations had the intended effect, and made LGBT folks more interested in the product (regardless of safety). The results suggest that preventing the targeting of LGBT folks, through marketing ploys, could be important in reducing the high tobacco use disparities the community faces.

TheSourceCC.JPG

Center to Fight Opioid Addiction

Your Central Valley reported that The Source LGBT Center in California received a $50,000 grant to fight opioid addiction among LGBT people of color. This population has faced higher penalization for using drugs such as opioids, the article says, and has faced trauma in accessing the healthcare system – with community organizations such as LGBT centers therefore having a key role to play in education and care.

Find out what your local LGBT center is up to using CenterLink’s interactive directory.

NY Offers In-home HIV Testing HIVTestKit.JPG

Gay City News reported on a New York program that provides in-home HIV test kits to people connected to participating community-based organizations or who apply online. The program has reached a racially diverse group that includes 35% Latinx and 17% Black individuals, but has so far been used mostly by cisgender men, with only up to 5% of each round’s participants being transgender or nonbinary.

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News from Around the World – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast.

STDChatApps Up Health in New York

NBC News reported on how a health clinic in Brooklyn is using LGBT apps to not merely advertise their sexual health services, but to actually engage in dialogue and education through chats. Their outreach has focused on gay men and transgender women of color, who face disproportionate rates of HIV and often face stigma and other barriers in accessing services. The role of social media in HIV prevention was also in the news as Facebook removed ads that some say were causing undue fear about PrEP.

 

Pakistan Issues Trans Health IDs

ABC News reported that Pakistan will begin offering “transgender” as a gender marker for their national health ID cards, a move they say is designed to ensure health access for trans people. The move comes as transgender Pakistanis have reported being denied care when providers do not know how to classify their gender or into which gender-segregated ward they should be admitted.

Minnesota Makes Medicaid More Inclusive

Vice voiced that more states should ensure that their Medicaid programs include coverage of gender affirming care for children. They note that services like puberty blockers and hormones can be life-saving for transgender youth facing discrimination and seeking to have their identities affirmed. The story comes as Minnesota recently joined a minority of states in explicitly covering such services.

Germany Banning Conversion Therapy for Youth GermanHealthMinister

Gay Nation reported that Germany will kick off 2020 by banning so-called conversion therapy for minors, while also cracking down on advertising of the service and disclosure of risks for adults, as well. Germany joins just a few countries in banning the discredited and harmful practice nationwide; a growing number of U.S. states have also done so.

LGBT Health Services Grow in LA

The Pride reported that the Los Angeles LGBT Center – already one of the largest LGBT health centers in the country – is expanding with a new branch in South LA to open this week. The new center will focus on serving young LGBT people of color with free or low-cost services like HIV testing and PrEP, but also things like mental healthcare, help with housing, and a safe drop-in space.

Did you know? CenterLink can help you find an LGBT center in your area with its interactive directory.

CDCGlobalShigella and HIV in Georgia

A CDC study examined cases of Shigella – bacteria that can cause diarrhea and about which little is known – in the state of Georgia. They found that men living with HIV, of whom the majority were sexual minority men of color, were at significantly higher risk for infection. They say that providers should be aware of this relationship among patients, regardless of HIV diagnosis.

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Wishing You #LGBTWellness Now and into #2020!

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast. 

Keeping Well During the Holidays

Holidays2019.JPGOutSmart shared strategies for staying well during the end-of-year holiday season, which they say can be a difficult time for LGBT people who may be estranged from families or communities. They share tips for setting boundaries and having a plan to exit unhealthy situations, as well as leaning into existing support systems and exercising self-care.

 

$4.5 Million for Trans-led Organizations TransFlags.JPG

Metro Weekly reported on a $4.5 million fund started by Gilead to support work being done by transgender-led organizations across the country. Many of the recipients described efforts to broaden HIV prevention and treatment among transgender people by looking at issues such as housing, community, and employment instead of just access to medication.

HIVCoMorbiditiesUnderstanding Comorbidities and HIV

Researchers examined the importance of comorbidities in the continued fight to end the HIV epidemic. They explain, for example, that people living with HIV are more likely to have issues with cardiovascular, kidney, and liver health, as well as develop cancer. These issues cannot be solved merely with antiretroviral therapy, they argue, and more research is still needed.

transhealthflagConnectedness Generally Good for Health

A research review found that community connection among transgender folks was associated with a variety of positive health outcomes, including better mental health, greater connection to care, and more knowledge about gender transition issues. One downside: sometimes such connectedness made transgender women in particular feel less comfortable going to sexual health clinics, where they feared facing stigma from community members.

MexicoSrCenter

Mexican Senior Center Sets New Standard

The Week reported on a groundbreaking LGBT senior center in Mexico City founded last year by an 87-year-old transgender woman. Its clients say the space helps fill a social gap for those with limited family relationships and shrinking social circles. They also provide services like internet access, shared meals, counseling, and help working through instances of discrimination.

Cancer Screening and Gender-affirming Surgery LGBTHealth

Researchers examined the usefulness of screening for anal cancer among transgender women undergoing neovaginoplasty, at least when those women have elevated risk factors such as HIV or HPV infection. They explain the case of a transgender woman who had a mass discovered while receiving surgery, and note that there are not currently guidelines for this type of screening.

CenterLink and LGBT HealthLink wish you a Happy and Healthy 2020!

2020

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“They” Makes Word of the Year – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast. 

Young Queer Men Lack Health Access

A new study found that adolescent sexual minority men largely perceived themselves to have only low-to-moderate healthcare access. Only 29.2% reported that their provider had asked about their sexual orientation, while a slim 15.6% had spoken to a provider about using condoms with male partners. Younger adolescents, those in rural areas, and those in the South reported even higher barriers than others.

They

“They” Makes Word of the Year

ABC News reported that “they” was named the Word of the Year by publisher Merriam-Webster, in recognition of the fact that more and more people are using it as a pronoun alternative to “he” or “she.” They say that searches were up 313% percent for the pronoun from last year. Advocates said broader recognition of nonbinary pronouns is key for the wellbeing of those who use them.

Advocates Warn on Ads

Washington Blade reported on a call issued by LGBT health and HIV advocates warning about Facebook ads that may mislead people on PrEP. They say that the HIV prevention treatment is being misrepresented as unsafe by law firms seeking to sue drug companies – and that it may prevent LGBT and other folks for starting treatment despite standing to benefit.

Unpacking Substance Use Disparities

Researchers found that among sexual and gender minority adolescents, those who were assigned male at birth had higher prevalence of substance use than did those assigned female at birth. They also found that transgender adolescents reported substance use at a higher rate than their cisgender peers, suggesting a need to look within subgroups of the LGBT population to address substance use issues.

Supporting Friends with Substance Use Issues RainbowHeartSupport

On the subject of substance use, Queerty explored how LGBT folks can support friends with substance use issues. While every person is different, some tips include: do not try to lecture the other person; offer to spend non-judgmental time with them; and try asking them about what issues they may be avoiding resolving through healthier means.

Human Rights and HIV

UNAIDS marked Human Rights Day by discussing how human rights are essential to ending the HIV epidemic worldwide. They note that the virus has disproportionately impacted those whose rights are often violated or suppressed – including LGBT people and others – and that the marginalization of these populations makes it difficult to address their health needs.

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#LGBTWellness News: Ready, Set, PrEP!

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast. 

ReadySetPrEPReady, Set, PrEP to Launch

The U.S. Department of Health and Human Services announced that a landmark program is launching to provide access to PrEP nationwide. The initiative, titled Ready, Set, PrEP, will make HIV prevention medicine available for free at 21,000 pharmacies or by mail order. Costs have been a major barrier to higher uptake of PrEP, especially among LGBT people of color. 

HIV Infections Remained Stagnant

Relatedly, the CDC found that the number of new HIV infections per year remained statistically unchanged between 2013 (with 38,500 new infections) and 2017 (with 37,500), with researchers saying that more needs to be done to meet the goal of ending the epidemic in ten years. Only 18.1% of those with indicators for using PrEP to prevent HIV were currently taking it.

Novel Study on Alzheimer’s and Decision-making LGBTAlzheimers

Regenstrief Institute announced a new study that will delve into the wellbeing of LGBT adults with Alzheimer’s and specifically the challenges facing their surrogate decision-makers. They note that in addition to facing discrimination which surrogates must help them navigate, LGBT older adults are more likely to live alone and not have children, factors which likely complicate care and decision-making for LGBT folks with Alzheimer’s.

High Interest, Lower Use of LGBT Clinics

Researchers found that only 13% of sexual minority adults have utilized an LGBT-specific healthcare clinic, with proximity to such a facility among the main factors for whether or not someone has done so. Additionally, 52% of LGB people expressed interest in utilizing an LGBT clinic in the future, demonstrating an unmet demand for queer health services.

Family Support Associated with Lower Bullying

A UK study found that having a supportive family was associated with reduced likelihood of being bullied for sexual minority youth, with a 25.6% decreased likelihood among young women and a 31% reduction among young men. Coming from a supportive family was also associated with less workplace bullying, but at lower 4.6% and 12.5% risk reduction for LGB women and men, respectively.

SexEd2California Advances Inclusive Health Ed

Vox reported on California’s implementation of a recent law requiring LGBT-inclusive health education at schools, with students exploring topics like LGBT identities and inclusion. They say the change has been controversial, even in a generally LGBT-friendly state, and note that only 17 states even require sexual health education to be medically-accurate, much less inclusive.

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World AIDS Day and More – #LGBTWellness Roundup

Each week LGBT HealthLink, a Program of CenterLink, and researcher and blogger Corey Prachniak-Rincón bring you a round-up of some of the biggest LGBTQ wellness stories from the past week.

Now you can HEAR your Weekly Wellness Roundup, too! Listen to our weekly podcast here: https://apple.co/2lzs5Ti or where ever you podcast. 

WADCDC Marks World AIDS Day

The CDC recognized December 1st as World AIDS Day by highlighting actions being taken by the U.S. at home and abroad to help end to the HIV epidemic. In addition to discussing the Ending the HIV Epidemic plan, which aims to reduce HIV rates in the U.S. below an epidemic level in 10 years, they discuss PEPFAR’s work to support HIV efforts around the world.

 

Spotlight on Empowerment

Meanwhile, UNAIDS commemorated World AIDS Day with the publication of a new report called “Power to the People.” It explores how individuals can play a critical role in addressing the HIV epidemic, as well as how programs that empower people – like increasing access to PrEP, addressing stigma, and reducing gender inequity – are all vital to the goal of ending HIV.

Identities and Disparities among Queer Women

Researchers  found that women who identify as “mostly lesbian” versus “exclusively lesbian” or “bisexual” reported higher levels of hazardous drinking and more identity uncertainty. Mostly lesbian and bisexual women also had several health disparities compared to exclusively lesbian women, including with respect to both mental and physical health.

Tweet Inspires Trans Action TransClothing.JPG

Mashable reported on an Ohio nonprofit organization that helps transgender youth access clothing that corresponds with their gender identity – and it was all inspired by a tweet about creating opportunities for trans youth. The founders of Transform want to help youth and their families who are ready to transition but lack the resources to buy a new wardrobe.

How One Counseling Center Made a Difference

University Herald reported on a new  examining an outlier in LGBT mental healthcare – an LGBT counseling center in Philadelphia that provided affirming care in the 1970s and 1980s. In lieu of having research or data on how to be LGBT-affirming, they practiced what the author calls “clinical activism” based on their ethics and experiences, and became a model for inclusive mental healthcare.

RainbowCouplesSame-sex Marriage Challenges Remain

Center for American Progress analyzed some remaining inequities facing same-sex couples with respect to marriage that may complicate their rights and role in child rearing. For example, while different-sex spouses have traditionally had a presumption of parentage over children, the rule generally does not apply for same-sex spouses who cannot gestate. Children born to same-sex parents abroad also face issues with respect to their citizenship.myhl-500-300

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