Missouri Case Study 11 – Reviewing LGBT Welcoming Policies in Rural Missouri Hospitals

andrew shaughnessyBy: Andrew Shaughnessy
Manager of Public Policy, PROMO Missouri

At the beginning of February 2015, LGBT advocates in Missouri began reviewing our second list of hospitals on their LGBT welcoming policies. Having successfully accomplished several LGBT policy victories during our first round of outreach, we began to tackle a new beast — rural Missouri.

Choosing 10 hospitals throughout the Mid-Missouri and Southeast Missouri region, we began our review. Reviewing rural hospital policies as an outsider can be difficult. Our researchers, however, presented themselves as regular patients that really only had one connection publicly* with these hospitals — their website. Herein lies several challenges to this research. Difficulties in the regular maintenance of a hospital’s website, problems with the lack of hospital organizational structure to allow for maintenance, and the years of slowly decreasing revenue adding to the lack of structure; could lead to possible inaccuracies from the data collected during the reviewing process. We, however, have not experienced any hospitals who have challenged our review.

How did we begin to review a rural hospital’s website?

  1. Identify hospital’s main website – for most rural hospitals this could be the website that their System had set-up, make sure to check both. If the hospital’s website links to the System network, then make sure to check the System website for their LGBT welcoming policies.
  2. Use search engine to identify key terms used by LGBT patients – this includes searching for terms such as “discrimination”, “sexual orientation”, “gender identity”, “visitation”, “patient rights”.
  3. Document and log policy research – in order to create the individualized reports, while also maintaining for your records whether policies do or do not exist before beginning our outreach.

Upon reviewing each hospital website, we concluded our findings and began to work on outreaching to those hospitals in hopes of sparking their interest in reviewing their policies. Next Missouri case study, find out the strategy used in outreaching to rural hospitals to spark their interest in LGBT welcoming policies.


Trans First World Problems

Pride Center Staff Photo


Bishop S.F. Makalani-Mahee

Minister. Performing Artist. Community Organizer





So I’m sitting in  this workshop at Philly Trans Health Conference entitled “Everything in Africa is Gendered”  given by  a south African trans woman of color, and before the workshop even begins she comes over to me introduces herself and tells me that she is living and working in rural South Africa as an out trans woman of color.  I am immediately sobered by the courage of her reality and share my thoughts as such with her; and her response to me was somebody’s got to do the work for those who come after her, so why not her and what I got in that moment is that as difficult as navigating a transgender experience in America can be, I am grateful to be doing so.


I and most of the trans folk I know have access to services like mental health and medical services, we have access to education, and most of us have access to food and community.  While our sister’s and brother’s in developing countries struggle to simply eat, find language that speaks their truth,  experience boundaries to accessing competent and lifesaving  medical  care, limited (if any) education, and they may not  have community for support.  Those of us that are employed, have access to care and community resources (like the ability to attend Philly Trans Health) may want to consider that we have trans first world problems and I would offer that we bare this in mind when wanting to fall out with each other or want to go to battle over things that really don’t matter; like young trans folk thinking older trans folk are stuck in the past and just “don’t get it”.


I would offer instead that we remember that there are trans people who wish they had other’s to relate to; and as we fight amongst each other about setting a trans agenda there are trans folk in our world just trying to stay alive.   We should find ourselves extremely grateful for what we have and the community we have, and if we recognize that even given the work yet to be done we are in a unique place of privilege that other trans people would perceive as the promised land, and we have a responsibility to do the work so that those that come after us have a promised land to enter into.


Continue To Walk In The Light, Redefine Your Faith, and Remember It’s All The Rhythm.

LGBT Policy · Presentations · Research Studies · Resources · Technical Assistance · Tobacco Policy

Tobacco Control In LGBT Communities: A journey through this valuable report

As I am sure you are aware on Tuesday Legacy released a new report: Tobacco Control In LGBT Communities. This report is another to hit the national stage to address the growing concern of tobacco use and the affect it has on LGBT people. The layout of this report is quite nice, first addressing Legacy’s role in the movement, but more importantly highlighting the prevalence rates, and the fact data collection efforts needs to continue so we can monitor tobacco use in our communities.fthfthutyu

While there are a lot of numbers folks who appreciate the data, sometimes the data does not truly share the full story. The report has a great section, Behind the Numbers: Tobacco and LGBT Communities. Which paints the story of why tobacco use is and continues to be an issues among our communities. It looks at Social Stigma and Smoking, the Bar and Club Culture, addressing health care disparities and the lack of access to health care our communities face. In addition they showcase tobacco industry targeting, and how smoking is normalized in our community in such a way that it has truly infiltrated our lives and LGBT culture overall. Additionally it goes in to the efforts the tobacco industry took in co-opting our community, and how tobacco companies were characterized as pioneers who stood in solidarity with our communities which is such a fascinating read.

We all know that there is a long standing history of LGBT people and tobacco. The report addresses some key points on what needs to be done moving forward with a set of actions public health and tobacco control organizations can take to counter tobacco in our communities:

  • Engage directly with the LGBT community to offer cessation and prevention services that are culturally competent.
  • Include questions on sexual orientation and gender identity in population-based studies and surveys of health status.
  • Develop better and more standardized questions about sexual orientation and gender identity so a better picture of LGBT populations can be drawn.
  • Conduct longitudinal cohort studies, which follow participants over long periods of time.
  • Include, at all levels, LGBT people in mainstream tobacco control efforts.
  • Develop tobacco control media campaigns targeting LGBT communities.
  • Help LGBT communities and organizations find alternatives to tobacco industry funding.
  • Include LGBT youth in all levels of tobacco control efforts.
  • Ensure that the leadership of LGBT tobacco control efforts represents all LGBT communities, including traditionally disenfranchised segments such as transgender people, lesbian and bisexual women, people of color, LGBT youth, and LGBT people of lower socioeconomic status.

In the second part of this report it showcases four case studies of past legacy grantees. Leave no Funds Behind, which was a project the Network created working on Bridging the Gap Between LGBT Organizations and Tobacco Control Funding. As well as, Delicious Lesbian Kisses: A Social Marketing Campaign with Staying Power, Crush: The LGBT Lifestyle Project, and 30 Seconds: Helping Health Care Providers Reach LGBT Tobacco Users were all highlighted.

I highly recommend you take a look at this report, and share both the report and the factsheet created by legacy:

Tobacco Control In LGBT Communities Report

Tobacco Fact Sheet: Lesbian, Gay, Bisexual, and Transgender (Lgbt) communities and smoking


October/November Updates from the Network

New Network Logo Short 3-2011

The Network started October with new data from the 2009-2010 National Adult Tobacco Survey, confirming the need for LGBT culturally tailored efforts in the tobacco control movement. The historic release of national surveillance data on LGBT tobacco use data was released in the American Journal for Public Health finding that 32.8% of LGBT people nationally smoke cigarettes; 12.2% smoke cigars/cigarillos/small cigars; 6.1% and 38.5% report using any tobacco.This means that LGBT people smoke cigarettes at rates 68% higher than the general population and that our overall tobacco use is 50% higher. It is clear that there is still a lot of work to be done in the arena in LGBT Tobacco Control and the Network is steadfast in working to reduce health disparities in our community. In addition to the release of the National Data, Puerto Rico released a report on Tobacco Use in the Puerto Rican LGBT Community highlighted both in English and Spanish on the Network blog.

As most of us can agree, data collection is vital, and we still do not have comprehensive data on LGBT people to showcase the true health disparities that exist within our communities. In an effort to assist the Network base in continuing to gather LGBT Health data we are proud to release a National Needs Assessment Data Collection Tool as free resource housed on the Networks Zoomerang site. Click here to view the Needs Assessment, and to gain further information about utilizing the tool.

The Network conducted a couple trainings and presentations over the past two months. First, Daniella and Gustavo presented: “Responsible, Relevant and Ready: Creating Smoke-Free Pride Policy” at the International InterPride Conference in Boston. In addition, Gustavo, Daniella, and Gabe Glissmeyer (Network Steering Committee Member), presented a webinar “LGBT Youth and Tobacco” to the Vermont Department of Education. The Network conducted a training with folks in Nebraska on working with the LGBT community, and forged a partnership to begin working on LGBT tobacco control efforts. Lastly, Scout had the pleasure of Speaking at the Southwest American Indian Rainbow Gathering held in Phoenix, AZ which was the first ever speaking engagement we have been invited to with our Native communities.


Scout was also in DC to film a video that Legacy will release on December 11th, during theirWarner Series Lecture: Tobacco Control in LGBT communities.  This collaborative event will take place at the Human Rights Campaign headquarters in DC at 4:00 pm est. The event is open to the public, and will be streaming via a live webcast for folks outside of the DC area. We encourage you to attend this highly anticipated event, click here for more details or email us at lgbthealthequity@gmail.com if you would like to join us.

2012-11-20_10-29-59_7191In honor of Transgender Awareness Week Network, Network staff participated in the filming of I AM: Trans People Speak video project, Spearheaded by the LifeSkills project of The Fenway Institute.  Scout and Daniella both attended the Video Release, collecting signatures and “I hope…” statements from event attendees about Trans issues that Dr. Scout presented to the White House at the Transgender Day of Remembrance event in Washington DC on Tuesday, Nov. 20th. Click here to read Dr. Scouts recap of the event.

In closing, over the past two months the Network celebrated National Coming Out Day and the Great American Smokeout. On National Coming Out Day we released a blog What We Owe to our LGBT Youth by Daniella Matthews-Trigg, reminding our community to remember our health as we celebrate and embrace our identity. For the Great American Smokeout, the Network lit up social media encouraging our community to quit tobacco for a day, to create a healthier tomorrow. To stay up to date on all of the Network activities and recaps on events click here to subscribe to the Network blog.