Conferences

BLACK HEALTH: FINAL THOUGHTS ON CONFERENCE ON LGBTI HEALTH RESEARCH

Dr Herukhuti-Lambda 2014

Herukhuti, Ph.D., M.Ed.

Professor, Goddard College

Founder and CEO, Center for Culture, Sexuality and Spirituality

“Are you sure, sweetheart, that you want to be well? I like to caution folks, that’s all. No sense us wasting each other’s time, sweetheart. A lot of weight when you’re well. Now, you just hold that thought…. Just so’s you’re sure. sweetheart, and ready to be healed cause wholeness is no trifling matter. A lot of weight when you’re well.” – Minnie Ransom in Toni Cade Bambara’s The Salt Eaters

The health and wellbeing of Black people. Who will take the weight of the wholeness and wellness of people who Europeans brought to the Western hemisphere as chattel slaves, marked as sub-human in scientific journals, made to live in dehumanizing conditions up to and including the present moment? In 1977, the members of the Combahee River Collective, stated, “We realize that the only people who care enough about us to work consistently for our liberation are us. Our politics evolve from a healthy love for ourselves, our sisters and our community which allows us to continue our struggle and work.”

The articulation of self-determination in Black communities has not been unique to Black women. Essex Hemphill, in his poem For My Own Protection, answered the question thusly, “I want to start an organization to save my life…. the lives of Black men are priceless and can be saved. We should be able to save each other. I don’t want to wait for the Heritage Foundation to release a study saying Black people are almost extinct…. I don’t want to be the living dead pacified with drugs, sex and rock-n-roll…. If we have to take tomorrow with blood are we ready?… All I want to know for my own protection is are we capable of whatever whenever.”

As we discussed the IOM report recommendations for research training, it became obvious that there is currently no research training center dedicated to LGBT health research run by Black people or even with Black people in significant positions of power and authority in the United States. Zero. The Conference on Current Issues in LGBTI Health Research, which the organizers characterized as an international conference and had presenters and attendees from Asia, Latin America and the United States, had one Black presenter.

Recommendation Six of the IOM Report made the following assertions:

“To create a more robust cadre of researchers in LGBT health, NIH should expand its existing research training framework for both intramural and extramural training. Three audiences should be targeted: researchers who are working with or considering working with LGBT populations, other researchers who may not be aware of LGBT health issues, and NIH staff.” p.304

“In its intramural training program, NIH should develop postdoctoral training opportunities in the area of LGBT research (for example, research on youth and families). Similarly, NIH should expand the curriculum of its postbaccalaureate NIH Academy to include LGBT-specific issues in addition to the racial and ethnic disparities that are currently studied within the program. To implement these research training activities, NIH should increase its capacity to provide on-site experts as mentors for researchers examining LGBT health issues.” p.304

“Within its existing extramural program, NIH should increase the number of individual awards offered to researchers studying LGBT health issues, including postdoctoral, graduate student, and career awards. In addition, the current loan repayment program should be expanded to assist students who choose to study LGBT health issues. In particular, the development of researchers of color who will study LGBT health should be encouraged.“ p.305

If these recommendations are to be implemented in ways that lead to tangible, material improvements in the health, wholeness and wellbeing of Black people, they have to be implemented in a different context than has been attempted previously. The Eurocentric and white-dominated systems, structures and mechanisms can not be the vehicles for implementation because they have proven to be ineffective in addressing the tangible, material conditions of Black people–despite the good intentions of well-meaning white allies.

It is time (as it has always been the time) for us to liberate and save ourselves. We need a national convening of Black lesbian, gay, bisexual, transgender, intersex, same-gender loving, and queer organizations, leadership and researchers to generate a health agenda that addresses our needs, realities, and aspirations. It will mean recognizing the areas of common experience as well as the uniquenesses that exists across Black folks who are lesbian, gay, bisexual, transgender, intersex, same-gender loving, and queer. It will entail our embrace of our indigenous knowledge of our communities (both grassroots knowledge and scientific knowledge) as well as considering the value of the work that has been conducted outside of our communities such as the IOM report. It will require the cultural confidence evidenced in the Combahee River Collective Statement and Essex Hemphill’s poem to believe that we can take the weight and the cultural sophistication to realize that we are the only ones who ever could.

Dr. Herukhuti is founder and Chief Erotics Officer (CEO) of the Center for Culture, Sexuality and Spirituality and editor-in-chief of sacredsexualities.org. He is also a member of the faculty at Goddard College. Follow him on Twitter and Tumblr and like his Facebook Fan page.

 

Conferences

INTERSECTIONALITY REDUX AND REVISED: DAY 3 AT THE CONFERENCE ON LGBTI HEALTH RESEARCH

Dr Herukhuti-Lambda 2014

Herukhuti, Ph.D., M.Ed.

Professor, Goddard College

Founder and CEO, Center for Culture, Sexuality and Spirituality

“Race and ethnicity—Concepts of community, traditional roles, religiosity, and cultural influences associated with race and ethnicity shape an LGBT individual’s experiences. The racial and ethnic communities to which one belongs affect self-identification, the process of coming out, available support, the extent to which one identifies with the LGBT community, affirmation of gender-variant expression, and other factors that ultimately influence health outcomes. Members of racial and ethnic minority groups may have profoundly different experiences than non-Hispanic white LGBT individuals.” – The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, Institute of Medicine of the National Academy of Sciences 2011

Saturday morning, we had  a very lively discussion of the Institute of Medicine (IOM) report on LGBT health. Drs, Walter Bockting, PhD, co-director, LGBTI Health Initiative, Division of Gender, Sexuality, & Health, NYS Psychiatric Institute and Columbia University,  Judith Bradford, director, Center for Population Research in LGBTI Health, Fenway Institute, and Rashada C. Alexander, special assistant to the deputy director of the National Institutes of Health (NIH) led the discussion with presentations on their work. Judith and Walter were members of the committee that crafted the report. Rashada, the only presenter of African descent during the conference, provided an important perspective on the way forward for people interested in using the IOM report to engage the NIH.

The committee recommended four conceptual frameworks “be applied to priority areas of research in order to further the evidence base for LGBT health issues:” minority stress model, life course approach, intersectionality and social ecology. Intersectionality is quite unique among the four in that its roots are in the radical activist traditions of Black feminist community organizers. The committee chose of the work Bonnie Thorton Dill and Ruth Zambrana, Emerging Intersections: Race, Class and Gender in Theory, Policy and Practice, as the basis for their understanding and articulation of intersectionality. But its history can be found as early as 1977 Combahee River Collective Statement, in which the women articulated,

“We are a collective of Black feminists who have been meeting together since 1974. During that time we have been involved in the process of defining and clarifying our politics, while at the same time doing political work within our own group and in coalition with other progressive organizations and movements. The most general statement of our politics at the present time would be that we are actively committed to struggling against racial, sexual, heterosexual, and class oppression, and see as our particular task the development of integrated analysis and practice based upon the fact that the major systems of oppression are interlocking. The synthesis of these oppressions creates the conditions of our lives. As Black women we see Black feminism as the logical political movement to combat the manifold and simultaneous oppressions that all women of color face.”

While the attention to an integrated analysis of the role of race, ethnicity, gender, sexuality and class in social life are the same, the tone, energy and politics of that statement are different than how the committee framed intersectionality in the IOM report,

“Intersectionality encompasses a set of foundational claims and organizing principles for understanding social inequality and its relationship to individuals’ marginalized status based on such dimensions as race, ethnicity, and social class (Dill and Zambrana, 2009; Weber, 2010). These include the following:

  • Race is a social construct. The lived experiences of racial/ethnic groups can be understood only in the context of institutionalized patterns of unequal control over the distribution of a society’s valued goods and resources.
  • Understanding the racial and ethnic experiences of sexual- and gender-minority individuals requires taking into account the full range of historical and social experiences both within and between sexual- and gender-minority groups with respect to class, gender, race, ethnicity, and geographical location.
  • The economic and social positioning of groups within society is associated with institutional practices and policies that contribute to unequal treatment.
  • The importance of representation—the ways social groups and individuals are viewed and depicted in the society at large and the expectations associated with these depictions—must be acknowledged. These representations are integrally linked to social, structural, political, historical, and geographic factors.

Intersectional approaches are based on the premise that individual and group identities are complex—influenced and shaped not just by race, class, ethnicity, sexuality/sexual orientation, gender, physical disabilities, and national origin but also by the confluence of all of those characteristics. Nevertheless, in a hierarchically organized society, some statuses become more important than others at any given historical moment and in specific geographic locations. Race, ethnicity, class, and community context matter; they are all powerful determinants of access to social capital—the resources that improve educational, economic, and social position in society.” p. 21

Dr. Herukhuti is founder and Chief Erotics Officer (CEO) of the Center for Culture, Sexuality and Spirituality and editor-in-chief of sacredsexualities.org. He is also a member of the faculty at Goddard College. Follow him on Twitter and Tumblr and like his Facebook Fan page.

Conferences

The Master’s House: Day 3 AT THE CONFERENCE ON LGBTI HEALTH RESEARCH

Dr Herukhuti-Lambda 2014

Herukhuti, Ph.D., M.Ed.

Professor, Goddard College

Founder and CEO, Center for Culture, Sexuality and Spirituality

“For the master’s tools will never dismantle the master’s the house. They may allow us to temporarily beat him at his own game, but they will never allow us to bring about genuine change. And this fact is only threatening to those women who still define the master’s house as their only source of support.” – Audre Lorde, comments at “The Personal and Political” Panel of the Second Sex Conference, New York City, September 29, 1979

What is the goal of sexual justice?

Of LGBTI health equity?

Are we seeking access to the privileges and status system that oppresses us and those we love? Or are we seeking to dismantle that system–to give birth to a new world?

Over and over again yesterday these questions emerged for me in the presentations and discussions that took place at the Conference on Current Issues in LGBTI Health Research. In a society of white supremacist, capitalist heteropatriarchy has been radical to study things related to lesbian, gay, bisexual, transgender, and/or intersex people. People have struggled to overcome professional obstacles and challenges to do that work. Many of them (some of whom were in the room) have sacrificed much.

But that work is not in and of itself the foundation for dismantling the system of oppression and the revolutionary transformation of the world. Studying the impact of our oppression (i.e., health disparities) without a direct link to the means to end that oppression (i.e., community mobilization and organizing, policy advocacy and social change) is useful for individual, personal professional mobility and advancement. It does not do the necessary work of dismantling the master’s house. Conducting and publishing research, leaving the anti-oppression work to “the community,” “activists,” or “advocates” is a convenient way to cultivate a sense of security and comfort.

For those of us who committed to dismantling the master’s house, it is a struggle to obtain resources for that work. Not only will the master’s tools not dismantle the master’s house, but also the master will not fund the dismantling of the master’s house. How do you fit revolutionary change in a grant proposal? What’s the research question for revolutionary change? If, as Gil Scott Heron declared, the revolution will not be televised, can we expect that it will at least be conducted on a grant?

Several conference attendees discussed the idea of working within the system as a subversive act. I am often curious as to how that works practically. My only reference for it in literature is Sam Greenlee’s novel The Spook Who Sat by the Door. In the novel, the protagonist used the knowledge obtained working with a government agency to teach, train, organize and mobilize members of the community in which he grew up with the same knowledge that used to oppress them. But that’s the only example of subversion that I have seen in detail. I’d love to have some of real-life subversives provide the details of their practice and how it has led to tangible, material advancement of the dismantling of the master’s house.

Dr. Herukhuti is founder and Chief Erotics Officer (CEO) of the Center for Culture, Sexuality and Spirituality and editor-in-chief of sacredsexualities.org. He is also a member of the faculty at Goddard College. Follow him on Twitter and Tumblr and like his Facebook Fan page.

Conferences

Taking a Breath: First Night at the Conference on LGBTI Health Research

Dr Herukhuti-Lambda 2014

Herukhuti, Ph.D., M.Ed.

Professor, Goddard College

Founder and CEO, Center for Culture, Sexuality and Spirituality

I awoke this morning feeling a familiar restriction in my chest. Asthma held at bay a part of the air I depend upon to breathe. My rescue inhaler, acquired from someone else, read fourteen more puffs of relief medicine. I haven’t had health insurance in nearly ten years.

Prior to Obamacare, also known as the Affordable Care Act (ACA), I received health care on a sliding scale at the municipal hospital–a place where waiting for service takes up the vast majority of the appointment. Since November, I have been on a long, arduous journey to obtain the promised affordable care of the ACA through my state’s health exchange. I live in a blue state so our exchange is fully realizing the vision of Obamacare.

But it’s a vision obscured by bureaucracy and tattered with holes that I struggle to not slip through in the process. Early in my attempts on the state exchange website, the system did not recognize me. Being Black, bisexual and male, I found the experience of being unrecognizable quite familiar. But I persisted. A couple of call center conversations led me to create several accounts–each an attempt to try a different suggested strategy. Finally, a call center operator told me I needed a state ID number through our Department of Motor Vehicles.

I don’t have a drivers’ license nor non-drivers’ ID but I used to have a learners’ permit. DMV told me the ID number attached to the permit was still associated with me but in order to obtain it I would have to file a form and pay a fee. At that moment, the no-fee sign-up promise of ACA disintegrated for me. I began a hunt for the old, expired permit among my papers. I didn’t find it but I did find the one and only receipt of my failed drivers’ test with my state ID number on it.

A final account registration with my no-cost, retrieved ID number granted me recognition and access to complete an application. I hurriedly did so, eventually finding out that the exchange determined me ineligible to obtain ACA-supported health insurance until they conducted an income verification. As a member of the contingent faculty class, my income does not fit into the neat little box of standardized, continuous employment.

I submitted the required documentation. A form letter response arrived requesting the exact same information. I resubmitted the required documentation. Another form letter arrived requesting the exact same information. I had my employer send a version of the documentation with the requested information. I waited for a response. Waited more for a decision on my appeal. Continued to wait. Without health insurance and with a depleting supply of asthma medication. I didn’t believe I could return to the hospital to receive a prescription on the same pre-ACA sliding scale.

On another call to the exchange call center to inquire about the status of the review, I asked if I would benefit from having a navigator assist me. The call center operator responded in the affirmative. Because I have worked with online systems and websites successfully for decades, I originally thought I didn’t need the help of a navigator. But my challenges weren’t located in the functionality of the website, they emanated from the system of policies, practices and procedures of the exchange.

I located a navigator–the only one to answer the phone when I called–who happened to work at our local LGBTQI health center. She immediately appeared competent, knowledgeable and experienced in navigating the system.

Now, I have someone who can work on the bureaucracy of obtaining my access to affordable health care while I attend events like the Conference on Current Issues in Lesbian, Gay, Bisexual, Transgender, and Intersex (LGBTI) Health Research hosted by Baldwin Wallace University (Berea, OH) with fourteen more puffs of relief medicine. I am here on special assignment for the Network for LGBT Health Equity writing about the conference.

The work of the ACA navigator on my behalf allowed me to sit a little more comfortably at Thursday evening’s reception hosted at the Rammelkamp Atrium of the MetroHealth Center here in Cleveland, OH. After opening remarks from conference co-organizer, Dr. Emilia Lombardi, assistant professor of public health at Baldwin Wallace University, Dr. Akram Boutros, CEO of MetroHealth, welcomed everyone and spoke about the progress MetroHealth has been making in becoming a workplace that is welcoming of sexual and gender diversity and a health care organization that effectively serves people of all sexualities and gender expressions with cultural competence. conference article1

Afterwards, I spoke with Dr. Henry Ng, who leads MetroHealth’s Pride Clinic serving LGBTQI people in the local community. He shared with me a significant challenge to the work of the clinic; there is no industry standard for creating space for people to self-identify as LGBTI on medical forms. In addition to the ways this present absence hinders efficient data collection on who clinics serve–data collection that can lead to tailoring and improvement of services–but it has a direct impact upon clinical service providing in that gender designations on third-party billing forms can limit the kind of care provided to someone. For example, a transgender man who has a cervix will require care regimes that not permitted by the billing procedures unless a doctor designates him as female or some other cumbersome workaround the service provider creates. Dr. Ng expressed significant interest in ongoing efforts to address, what I consider to be, the embedded and manifest heterosexism and cisgenderism within health policy and systems that make it possible for people to remain unrecognized and unrecognizable within the bureaucracy.

Friday’s schedule includes discussions about translating research into policy and health interventions; LGBTI health and population-level and clinical data; histories of LGBTI health research; and LGBTI health research education at the college/university level. Twelve puffs remain.

Dr. Herukhuti is founder and Chief Erotics Officer (CEO) of the Center for Culture, Sexuality and Spirituality and editor-in-chief of sacredsexualities.org. He is also a member of the faculty at Goddard College. Follow him on Twitter and Tumblr and like his Facebook Fan page