#BWLBGTI Day 2 Post-Lunch: Revisiting sexual health

dwayne

Dwayne Steward 
LGBTQ Health Advocate
Columbus Public Health

After lunch at day 2 of the LGBTI Health Research Conference at Baldwin Wallace is all about sexual health. Historically this would have been the bulk of such a conference as this. As most of us know, pathology-focused research on homosexuality and gender diversity, along with the stigma associated with the HIV/AIDS epidemic forced LGBTI healthcare into a sexual health box for many years. It’s interesting to see that the pendulum is swinging back the other way in some ways as we as LGBTI healthcare workers/researchers are now having to convince certain communities that sexual health is still an important factor of the LGBTI health experience.

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Dr. Anthony Silvestre, professor of Infectious Disease and Microbiology at the Graduate School of Public Health at the University of Pittsburgh, opened with a lunch-time keynote on the history of sexual health research, reminding us how far we’ve come regarding the study of sex and sexuality in this country. He than joined Dr. Brian Dodge, Indiana University-Bloomington School of Public Health, for the “LGBTI Health Training” seminar track, which included a lively discussion on the changing landscape of HIV and intersectionality in public health research.

There was definitely a lot of talk about training program models in Indiana and Pennsylvania, but through the lens of sexual health research. Dr. Silvestre spoke on University of Pittsburgh’s LGBT health certificate program along with several other LGBT-focused specialized programs the university offers, including a post-doctorate program that specialized in MSM (men who have sex with men) healthcare.

Dr. Dodge made several interesting conjectures about the study of sexual health saying, much of the conversation regarding sexual health has been risk based. “We need to be including more about the actual pleasure of sex and begin taking a more sex-positive approach. It is okay for gay sex to be enjoyable,” he said. He went on to say that programs should take a more competency-based approach to better prepare students for their post-college endeavors.

My fellow Network for LGBTQ Health Equity scholarship recipients Heru Kheti (middle) and E.Shor (right).

My fellow Network for LGBTQ Health Equity scholarship recipients Heru Kheti (middle) and E.Shor (right).

Dr. Francisco Sy, director of the Office of Community-Based Participatory Research and Collaboration at the NIH/National Institute of Minority Health and Health Disparities (NIMHD), took a moment to educate the audience on the NIH grant process and how to best navigate their grant application process. But the day’s real winner was Dr. Erin Wilson’s presentation, “HIV Among Trans-Female Youth: What We Now Know and Directions for Research and Prevention.” Dr. Wilson, who is a former NIMHD Loan Repayment Program (LRP) recipient and research scientist currently with the AIDS Office at the San Francisco Department of Public Health, quickly (due to time constraints) spoke on her ground-breaking NIH-funded research on the social determinants of health that led to high HIV-infection rates for transgender female youth in Los Angeles.

The statistics Dr. Wilson reported were pretty staggering. She prefaced much of her presentation by saying her studies were very specific to L.A. and she had no research to show that this was reflective of the national transgender female population. She reported finding that transgender females in L.A. were 34 times more likely to contact HIV than the general population and at the time of her study nearly 70 percent of transgender female youth in L.A. participated in sex work. As a result of her work The SHINE Study was created, the first longitudinal study of trans*female youth that still continues today. Though nearly 40 percent of transgender females in L.A. are living with HIV only 5 percent are youth. “We have a great opportunity to get ahead of this disparity and create some real change,” she said.

That’s all for today my friends. Check back tomorrow for a full report on Day 3 of the Baldwin Wallace University LGBTI Health Research Conference (#BWLGBTI)!

#BWLGBTI Day 2: Perfect time, perfect place

dwayne

Dwayne Steward
LGBTQ Health Advocate 
Columbus Public Health

As I continue into the second day of the LGBTI Health Research Conference at Baldwin Wallace University, it struck me as pretty powerful that the BW’s president Robert Helmer opened the first day of seminars with the words “this is the perfect time and the perfect place for this [conference].” (BW Provost, Dr. Stephen Stahl also reiterated this sentiment just after lunch with saying, “this conference is at the core of founding values.”) This stayed with me throughout the morning as we heard from such innovative speakers such as Dr. Eli Coleman who, just through all of the heralding stories he shared, showed his longstanding impact on changing the American perspective on LGBTI health research. Dr. Coleman, who is currently the director of the Program in Human Sexuality at the University of Minnesota School of Medicine, also left me with a new mantra: “Without rights we will not have [good] health.”

Dr. Eli Coleman

Dr. Eli Coleman

After Dr. Coleman’s keynote address, the morning continued at a rapid-fire pace, with a revolving door of one prestigious presenter after another. Here are a few brief notes on the presentations I thought most intriguing.

  • During the “Translating Research into Policy and Heath Interventions” seminar track Kellan Baker, associate director of the LGBTI Research and Communications Project at Center for American Progress, gave a very interesting look at how political advocacy has led to inclusive research, highlighting the work of HIV/AIDS advocates during the 1980s. Baker went on to show that though there have been strides made concerning LGBTI political inclusion, there’s still so much more to be done. I found it interesting that between 2002 and 2010 there was absolutely no inclusion of LGBTI communities in any federal health research because of the change in presidential administration. This silence prompted the Gay and Lesbian Medical Association to create a sexual identity and gender identity specific companion report to the National Institutes of Health 2010 Healthy People report. Now in their 2020 Health People edition we see two LGBTI-focused reports because of such advocacy efforts.
  • Vivek Anand, Executive Director of Humsafar Trust in Mumbai, India, also took the stage during the “policy and health interventions” track and wowed myself an the audience with the grassroots, community-based research he’s been conducting in India, despite the country still criminalizing homosexuality. “On-the-ground work and community-based research is still crucial…if we are not out in the community and visible we will not be counted,” he said. Humsafar has fund-raised thousands of dollars and build several LGBT organizations in India, providing countless services and research for a nearly invisible community.
Vivek Anand

Vivek Anand

A brief break led right into a seminar track on “Sexual Orientation, Gender Identity, and Intersex Data at Population and Clinical Levels,” which I personally found rather enthralling. I was pleasantly surprised by the amount of evidence-based research that exists regarding adding sexual orientation and gender identity to medical forms and records.

  • Joanne Keatley, briefly detailed research from the Center of Excellence for Transgender Health at University of California-San Francisco that highlighted the groundbreaking work she was involved with to make the U.S. Center for Disease Control and Prevention start collecting transgender data in 2011. She also stressed the importance of including transgender female-to-males in HIV research, as much of their studies showed that this is an affected demographic, despite current perceptions.
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The many words for “transgender”

  • Karen Walsh, an intersex activist, detailed the importance of intersex research and how to include intersex information collection in an accurate and affirming fashion. I learned so much on the intersex community that I was not aware of, including most who are intersex receive some sort of surgical interventions as children but surgery is often medically unnecessary.
  • Dr. Jody Herman, of the Williams Institute at University of California-Los Angeles, and Harvey Makadon of Fenway Health’s National LGBT Health Education Center, also provided invaluable examples of specific language and formats that can be used on forms to capture sexual health and gender identity. If you are a healthcare provider that values inclusion I highly recommend visiting their organizations’ websites.

Stay tuned for more post-lunch recaps!

Out2Enroll: Getting LGBT communities connected to care!

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Network for LGBT Health Equity
Out2Enroll LGBT Communities 
 #GetCovered 
 
 
 

The Network for LGBT Health Equity, along with CenterLink: The Community of LGBT Centers would like to announce the roll-out of our #GetCovered ad campaign, highlighting the experiences of uninsured and underinsured LGBT folks and the barriers they faced accessing healthcare prior to the Affordable Care Act. We hope that it both educates and motivates people to visit Out2Enroll to sign up before the open enrollment window closes on March 31st, 2014!

Out2Enroll is a collaboration by the Sellers Dorsey Foundation, the Center for American Progress, and the Federal Agencies Project to educate LGBTQI communities about their options under the Affordable Care Act (aka “Obamacare”).

A study by the Center for American Progress discovered that a whopping 71% of uninsured LGBT people don’t know their options under the new healthcare act. LGBTQ people are less likely to be insured, and less likely to seek or be able to access preventative care. While the Affordable Care Act is in the beginning stages, this is the perfect opportunity to spread the word in our communities about the significantly expanded options available now, including:

– LGBT people and their families have equal access to coverage through the new Health Insurance Marketplaces in every state.

– Plans will cover a range of essential benefits such as doctor visits, hospitalizations, reproductive health, emergency-room care, and prescriptions.

– No one can be denied coverage based on pre-existing conditions.

– Financial help is available to pay for a health insurance plan, based on household size and income.

– There is family coverage that is inclusive of same-sex partners

Want more information? Check out this report or head right to Out2Enroll.org!

*And remember! In order to get health insurance coverage by January 1st 2014, you must enroll by December 15th 2013!

Check out the powerful images below, and feel free to download and share (Click to enlarge). This campaign will have a series of phases, with more photographs being posted to our blog and social media channels- so stay tuned!

O2E.1.ScoutO2E.2.RiaKikiO2E.1.Louis

O2E.1.DeNierO2E.1.DianeO2E.1.TexO2E.1.Ziggy

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O2E.1.Michael

 

 

 

 

 

 

 

 

 

 

 

We want to send out a huge thank you to the folks who shared their stories with us! Also a big thanks to the organizations that we have co-branded with- Center for Black Equity, Trevor Project, and GetEqual.

Would your organization like to co-brand with us on any of the above ads? Send us an email at lgbthealthequity@gmail.com!

Sunday Keynote: Cindy Stone

by e.shor

Cindy Stone = education and entertainment!

This afternoon Cindy presented a dynamic view into the Intersex Society of North America (ISNA) and her experiences with being diagnosed and living with an intersex condition. To quote ISNA, “Intersex” is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.” Cindy talked to us about the diversity of what this means…there are many different ways that this can manifest physically. Literally for some, this means having genitalia that do not look like a “traditional” penis or vagina (i air quoted tradition because I do not believe there is a TRADITIONAL set of genitalia out there), and for some this means having a seemingly “normal” external genitalia with internal anatomy that do not match the external (same goes for NORMAL). Sometimes the latter intersex condition can mean that someone with an external vagina may have testes internally and sometimes an XY chromosome. Here is a little video to help with the understanding…

I hope this is not confusing, because ultimately, what all of the discussions that I have had about intersex identities and conditions have come down to for me is this:

Every Body is Different. 

However, it is not that easy is it? It is not that easy because health care providers have been historically taking it into their own hands to prescribe gender to people at birth based on what genitals are between their legs…this is a problem when a doctor or a parent or a whoever decides to surgically alter a baby’s genitals to match some “traditional” allotment of gender. This surgery can harm or permanently distress a person’s ability to have sexual response. This surgery also brings up a whole host of ethical issues.

It is not easy because our health care system is not set up give access to people with bodies (or genders or sexualities) that are different. How do we increase access to proper, culturally appropriate care for intersex folks where the judgement and stigma about their bodies is not an issue. My only thought is to retrain our societal brain and then retrain doctor brains to reconceptualize “what the human body should look like.”

It isn’t easy because sex and gender are inextricably linked for a good portion of society. All of the stories of abuse of intersex folks, the surgery horror stories, the gender counseling, the putting of people in tidy boxes, it all comes down to gender liberation.