Ending Exclusions Under Obamacare

Andrew Shaughnessy, Manager of Public Policy for PROMO

By: Andrew Shaughnessy
@andrewshag

For the LGBT community health is a complicated matter. It is further complicated when health insurance companies deny or exclude certain forms of coverage that for some are basic health needs. For LGBT folks seeking gender-affirming health care coverage barriers exist at every turn — until the Affordable Care Act. Or so we thought…

Section 1557 of the Affordable Care Act prohibits discrimination on the ground of race, color, national origin, sex, age, or disability under “any health program or activity, any part of which is receiving Federal financial assistance … or under any program or activity that is administered by an Executive agency or any entity established under [Title I of ACA]….” To ensure equal access to health care, Section 1557 also applies civil rights protections to the newly created Health Insurance Marketplaces established under the Affordable Care Act.

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Upon researching a complaint raised to us by a Missourian, who qualified and enrolled in a federal marketplace plan, we concluded that exclusions still exist under ACA plans that inhibit transgender patients from getting the basic care they need. Under certain Federal marketplace health insurance plans exclusions have been put in place that state “sex change services and supplies for a sex change and/or reversal of a sex change.”

A real life example of how this affects transgender patients was raised to me, “I had a large cyst on my ovary that had to be removed a several years ago. I hadn’t started transitioning, so my insurance company didn’t blink when I claimed the surgery to remove it. Fast forward to now. If I had the same problem and walked into the doctor’s office with a beard and “male” on my documents, the insurance company can (and would absolutely) deny my claim.”

The State of Missouri’s, along with several states’ ACA exchange, is administered by the federal government and is governed by this rule, however this exclusion is a clear violation of Section 1557. Transgender patients who rely on marketplace coverage for health insurance are forced to censor their own health management for fear that marketplace plans will deem any healthcare on a transgender body excluded from the plan.

I along with the support of hundreds of Missourians requested that the Department of Health and Human Services investigate these claims and make efforts to remedy any claims of sex discrimination in health insurance plans under the Affordable Care Act.

If you are or know someone who is affected, please consider making a request to the Department of Health and Human Services to investigate these claims.

Upcoming! Sixth Annual Genderevolution conference, Salt Lake City UT

Sixth Annual Genderevolution 2014 Conference: Love Your Queer Body

Saturday, November 15th, 2014

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The purpose of the Genderevolution is to:

  • Foster community building among trans* folk and allies alike, to help create a strong and safe space to push gender boundaries in the Salt Lake City area.
  • Educate employees, cisgender/non-trans* folk, trans* folk, health and mental care providers, and allies about the myths and realities of gender.
  • Celebrate trans* identities in an inclusive, healthy and positive way.utah-pride-center

At the 6th Annual Gender Conference, over 400 attendees are expected, and aims are to deconstruct gender mythology, explore the implications of socially constructed gender norms, and integrate our many intersecting identities.

We are all members of various communities, how do these memberships affect each other? How does our experience with gender intersect with our experience of race? Of class or sexuality or relationship styles? How about religion, physical dis/ability, or political ideology? Maybe we won’t find clear answers to these questions, but in asking them perhaps we can come to understand ourselves—and each other—just a little better.

 LGBT HealthLink is the official sponsor of the 2014 Wellness track! The track will include sessions on:

Trans 101 in Spanish
Surgical Outcomes for Vagioplasty
Trust & Resonance in Relationships (by the LGBTQ Affirmative Therapists Guild of Utah)
WPATH (World Professional Association for Transgender Health): What you need to know
Fitness & Transition
Gynecology for Trans* Patients
Smoking out a Deadly Threat (by our very own steering committee member, Gabe Glissmeyer)

Keynote:

The keynote speaker is Pat Manuel, a trans/off-binary boxer and transmasculine fitness advocate.
Pat Manuel

Pat Manuel

Pat Manuel, also known as “Cacahuate(Peanut)” is a transmasculine QPOC who has shaped his masculine identity in boxing gyms around Los Angeles, CA. A 5x national amateur champion, Pat was a participant in the first ever Women’s Olympic Boxing Trials and was the only vocally out queer fighting in the history of USA Boxing’s Olympic Box-Offs. Medically disqualified after the first fight of the tournament, Pat struggled with ways other than visibility to aide his community. Since joining the Brown Boi Project in 2013, he has decided to use his knowledge as a trainer and athlete to empower other through physical fitness. Pat created Buffbutch.com, a website intending to fill the void of queer fitness interests. When he isn’t training, Pat is usually fond of enjoying cookies and dreaming of becoming a giant robot pilot.

“It’s Your Time To Shine!” 2014 LGBTQ Youth Regional Retreats Recap

Motivational-Inspirational-Life-Quotes-2243National Youth Pride Services recently hosted it’s 2014 “It’s Your Time To Shine” Regional Retreat series in Detroit, Michigan (Midwest), Columbia, South Carolina (South) and Washington D.C. (East) thanks to sponsors CenterLink, Lambda Legal, 3LW TV, South Carolina Black Pride, Palmetto AIDS Life Support Services and Al Sura. The retreat was designed to uplift, inspire and motivate the black LGBTQ youth communities in a way that had never been done before. Below, the retreat facilitator and participants recap the events of the three retreats.

In 2014 NYPS changed it mission and vision to be MORE uplifting, positive and empowering; to focus on the positive and less of the negative. We believe that people who are self-confident are more willing to help lift others. After All, winners help others win. Many people are looking for hope, and may just not know where to find it or how to get there. “One Shinning Moment” is our nationwide effort to uplift and inspire our target population. There is much to be said about all the negativity in our communities. This video, shown to all attendees, highlights some of the negative opinions about our community, but we feel this is our #OneShinningMoment to come up with solutions and move to the next level.

The goals of the retreats were to make sure each participant would leave the weekend knowing how to:

Live your life on purpose.

Not on “default.” Be Proactive. Make conscious and deliberate choices. When you don’t choose, circumstances choose for you and you are never leading: you are following or catching up—or worse, living in “default” mode.

Utilize your full potential.

Give what you’re doing your best and fullest attention. Be here now. Even if you’re not where you want to be, giving it half of your effort doesn’t move you forward. Master what you have at hand, for the sake of mastering it, and something will shift.

Live in the question.

There is nothing you cannot be, do, or have, so do not impose limitations on yourself. Instead of saying you can’t get there, ask “How can I get there?” Live in the affirmation of possibility rather than the declaration of negativity.

There is always a way, and it is being presented consistently, but you have to live in the question to be on the lookout for the answer.

Learn to say “No.”

To live your best possible life, you need to learn how to say no to the things that aren’t serving you. The best barometer to measure this by is: if it isn’t a “hell yeah” (Yippee, so fun, can’t wait!), then it is most probably a no. If you have to talk yourself into it, it’s a no.

Once you get comfortable saying no, everything becomes a matter of choice. Living a life of choice is a living a life of freedom.

Know your own value.

Others may be more educated, skilled, or talented in one or another area, but there is something magnificent and valuable about what you have to offer this world that, in comparison, is equal.

Do not allow yourself or anyone else to diminish it. You have a learning disability? So did Dr.King, and that’s what makes him the most powerful speakers. Joe Vitale came from homelessness. Look at him now. Stop idolizing anyone else’s gifts and dismissing your own.

The Midwest version (June), the largest of the three, was held in conjunction with FIERCE, a national program working towards LGBTQ youth of color liberation and located at the Allied Media Conference at Wayne State University. Andrew Rahme, attended the Midwest Regional and based on his experiences and interactions during the weekend, actually became a member of NYPS. Here are some of his thoughts on the Detroit even which had a greater focus on community building and activism:

10383485_10203476696491931_6806017940715506034_nCreation, connection, and transformation are the words that come to mind when thinking about the Midwest Regional at the Allied Media Conference (AMC). Being a queer or trans person of color, it is reality that you have to constantly create solutions for yourself in order to live happily, and successfully. We create walls, stories, identities, spaces, and sometimes we even create realities different from the ones that we are confined to. At the AMC networking gathering, we had a chance to come together as QTPOC and identify the current issues to implement change in our community. Through games, laughter, relationship building, and amazing food, we discovered things about ourselves and about each other that allowed us to grow in ways we didn’t expect.

A very large focus of the network gathering at AMC was surrounded around connection. Connection to each other, to the world around us, and to our personal selves. We mapped out where our interests of change are and brainstormed what steps we can take to implement that change. We connected in ways we didn’t expect through common interests, experiences and the sharing of our wants, needs, hopes, and realities. Many of us began combining different realities and solutions in order to produce ideas for the most effective change.

The end result was inspiring and truly transforming. We got to be first hand witnesses of the beauty that comes out of organizing with QTPOC youth. Ideas as well as lasting relationships were created and strengthened, and to see what change these new alliances will create is exciting to watch for.

The South version (August) was held in Loft’s at The Claussen’s Inn. On Friday night all participants watched the video on the State of The Black LGBTQ Community. Some in the room agreed with some of the statements made, but the majority felt that there were some things that could be done to change the perception of what it is like to be black and LGBTQ.

On Saturday, the first session focused on a common theme in the video: “Status Anxiety”. This is the constant comparing of yourself to others. We looked at how the people you surround yourself with can be stressful and a few ways to get rid of status anxiety. Other issues touched on were: “Later Never Comes” (procrastination), Self Respect, Self Esteem, How Not To Care What Others Think About You as well as our other Life Development Series for Black LGBTQ young adults: “Dollars and Good Sense” and “Born To Win”.

Brandon Berry, of Orlando, FL gives his thoughts on the south retreat:

Brandon Dykes served as a facilitator for the South Region Retreat, as did Brandon Berry.

Brandon Dykes served as a facilitator for the South Region Retreat, as did Brandon Berry.

It was the epitome of comfort, which was a pleasant surprise to me. Imagine walking into a beautiful inn, rich with its area’s history and augmented tall ceiling including a large glass window clearly displaying the beautiful sky. Imagine a two-story loft for a room with all of the space necessary for yourself as well as any of your guests and fellow attendees. One would think no real productive work would be done. Contrary to that thought, we spent a majority of our days with each other having deep, lengthy and intelligent conversations. One of the highlights of this weekend is that great work took place in the comfort of our own rooms. It was a great experience.

I not only met strong and intelligent Black men of distinction, but I got to get personal with them and discuss life and goals and our journeys to our respective unfolding greatness. We held discussions on how to be an effective leader, things to remember when inheriting a leadership position from someone else, and other miscellaneous subjects like the Quality of Education from HBCUs vs PWIs.

Overall the conference was great, and the experience was even greater.

The East version (September) was held at the Akwaaba, a luxury, African inspired house in LGBTQ friendly DuPont Circle. Like the south version, on Friday night, participant’s gathered to watch the video and discuss it. They were more aggressive in their defense of the black LGBTQ community and pointed out how no one in the video took any personal responsibility.

The East Region participants, not only went over all of the same Life Development series topics covered in the South Region, they were able to

Jabbar Lewis facilitated the "Selfies" series in DC.

Jabbar Lewis facilitated the “Selfies” series in DC.

preview parts of our new series: “Choices”: Whether you believe it or not, everything up to this point in your life that has or has not happened to you is because of the choices you have made. Every aspect or our life when examined a little closer can be traced back to a series of choices we have made.

In addition, each participant was given a section of each series to study and then present to the group.

The East Region allowed participants to live together for 3 full days in a fully furnished house, similar to a reality show. This dynamic might have made the East Region one of the best experiences out of the three, so much so, we are looking to hosts future retreats in a luxury house setting. The South and East Regions are also where we tested out having each participant follow each presentation on their tablet/laptop or mobile devices instead of the traditional power points and projectors. They now will be able to relive each session on their mobile device at any time.

Here is a  complete list of all Life Development topics, related videos and handouts from the retreats.

Missouri Case Study 10 – Making LGBT Health Matter in Missouri Hospitals

Andrew Shaughnessy, Manager of Public Policy for PROMO

Andrew Shaughnessy
Manager of Public Policy, PROMO Missouri
@andrewshag

This year has proven to be a monumental year for LGBT Missourians. Those monumental steps have been the recognition of out-of-state marriages by the State of Missouri, and the leadership of nearly 47 Missouri hospitals, who have included 105 new LGBT welcoming policies to their core values. As an LGBT Missourian it certainly gives me relief to know that I can access health care facilities and be me: my authentic self.

In 2013, only two Missouri Hospitals, Children’s Mercy in Kansas City and the VA in St. Louis, qualified as leaders in the Human Rights Campaign Care Equality Index (HEI). In the coming days the health sector will see the launch of the 2014 HEI, where several of Missouri’s top hospitals have been reviewed on their lesbian, gay, bisexual and transgender (LGBT) welcoming policies.  This year, Missouri will see several hospitals both in rural and urban areas that have been working to ensure their facilities are welcoming to all.

To learn more about the policies of Missouri Hospitals, click here for a map detailing their LGBT welcoming policies.

We have truly made LGBT health matter among Missouri’s top hospitals, but the work of the LGBT health policy project does not stop there. Through the technical assistance of Dr. Scout, Director of LGBT HealthLink, we will continue to work with health and social services organizations in Missouri to ensure that we are creating spaces free from discrimination. Through our collaboration with Sherrill Wayland, Executive Director of SAGE Metro St. Louis, we will be training Missouri’s health and social service professionals to understand the unique needs of LGBT patients.  And we will continue to advocate for the health of LGBT families and our families of choice.

As we begin to look at the legal future for the LGBT community, we must be concerned with the growing disparities we find in LGBT health. Our next frontier is on the borders of health and making sure that we are a strong and healthy community. I’m humbled to be a part of this work. Having experienced discrimination in a health care setting myself, I assure you your voice is not going unheard.

 

LGBT Wellness Roundup: October 5

As published on Huffington Post’s new LGBT Wellness blog, see original at: http://ow.ly/DhVNO

Each week HuffPost Gay Voices, in a partnership with bloggers Liz Margolies and Scout, brings you a round up of some of the biggest LGBT wellness stories from the past seven days. For more LGBT Wellness, visit our page dedicated to the topic here. The weekly LGBT Wellness Roundup can also now be experienced as a video — check it out above.

The Black Bisexual Experience Presentation at Out on the Hill Conference

faith cheltenham

Faith Cheltenham, President of BiNet USA

Blogging from the National Black Justice Coalition’s Out on the Hill Conference.

On the 2nd day of the NBJC Out on the Hill Conference I was honored to present one of the very first presentation/panel discussions on the black bisexual experience from inside Capitol Hill’s Hart Senate building.

faith bi icon

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

Members of NBJC, BiNet USA, Alliance of Multicultural Bisexuals (AMBi) of Metro DC and Center for Culture, Spirituality and Sexuality all contributed thought leadership into the PowerPoint presentation I presented on The Black Bisexual Experience. Following my presentation we had a 30 minute panel discussion featuring Black LGBT and bisexual icon, ABilly S. Jones-Hennin and Shervon Laurice a D.C. based bisexual psychologist.

faith bi platform

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

Charles Blow’s recent piece for the New York Times surrounding the launch of his book was also shared with attendees of our workshop thanks to the quick actions of Out on the Hill organizers.  Blow has written a stunning memoir of growing up black and bisexual, something I myself also aim to do. Having Blow’s piece shared with OOTH attendees helped emphasize the national conversation that is taking place surrounding bisexual community issues of disparities and resiliency.

faith intimate partner violence

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

For black bisexual people these conversations are especially important for sometimes it feels like the best way to be brave in the face of a disparity is to be knowledgeable about it. Many bisexual disparities are based in our own hearth and home, whether it be the staggering rates of sexual/physical violence or the higher rates of mental health issues including depression, suicidality, self-injury, and PTSD that bi people often report.

When looking closely at data provided by the CDC on the lifetime prevalence of sexual violence as experienced by certain minority groups we see something interesting. Both bisexual and multicultural (non-Hispanic) people report high rates of experiencing intimate partner violence. They also report higher rates of rape and sexual violence.

faith bi violence

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

One question I posed during my Out on the Hill presentation considered whether bisexual and multiracial people have similar issues and vulnerabilities, not being fully in one world or another. It may indeed be the case that the higher levels of physical/sexual violence disparities reported by both are due to fewer multicultural or bisexual specific resources.

faith bi info

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

As conversations continue about the violence perpetuated upon black communities we must strive to consistently remember how that stress affects the health of black people. When people have more than one identity like black bisexual folks, the multiplier factor only increases meaning that if we wish to care about the health of black bisexual people we need to truly design interventions that target both communities.

faith infograph

From The Out on the Hill Black Bisexual Experience Presentation, click here to download it.

References:

  1. Out For Health, Healthy People 2020 Bisexual Fact Sheet (link)
  2. Walters, M.L., Chen J., & Breiding, M.J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Findings on Victimization by Sexual Orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (link).

Putting the I in LGBTQI

 

e.shor

 

E. Shor, MPH

Wisconsin Population Health Service Fellow through UW-Madison

 

Blogging Live from: the LGBTI Health Research Conference

 

This has been a jam-packed day so far and it is only half over at the LGBTI Health Research Conference. There have been speakers addressing data collection on sexual orientation and gender identity, addressing the necessity of doing more research around intersex identities, policy changes and implications of those changes, transgender health, history of research in LGBTQI communities, and so much more.  My brain feels full of things to think about.

 

Here a few things I thought were interesting:

 

  • From a historical perspective, Kellan Baker of the Center for American Progress, described a historical paradigm shift that has been happening in the lat 15 years. He mentioned that in the 2000s public health work highlighted health disparities, and in the 2010s the lens has shifted to health equity and health in all policies. This paradigm shift has really emphasized that equity is justice in the form of public policy and changing systems.

 

  • Thus far there have been a number of speakers highlighting experiences of groups who often face high levels of invisibility, including people who are intersex, and who are transgender. There have been great strides in methodology around collecting data in transgender and gender non-conforming communities. The two-step question method outlines questions to ascertain “sex at birth” and “current gender identity” to affirm a participants gender identity and create understanding about potential clinical needs and biological implications. However, it was very interesting to engage in dialogue about the fact that this two-step method may not be effective for people who are intersex, and that there is great need to build and test questions that capture intersex experiences and conditions.

 

  • Here are some thoughts on where to go and what we need to do to continue doing good work around LGBTQ health and research…

 

  • e.shor lgbt health con