Got a supervisor, elected official, or other authority figure you want to persuade to adopt more LGBT-friendly policies? The Gay and Lesbian Medical Association (GLMA) has compiled a tool that you may find helpful.
Their newly-updated “Compendium of Health Profession Association LGBT Policy & Position Statements” compiles information on and links to LGBT-related policy statements made by 11 different health care professionals’ groups ranging from the American Academy of Family Physicians to the American Public Health Association (apparently no health care professional association is going to start its acronym with anything other than “A”).
A short article on Barbara Warren, Beth Israel Hospital’s Director of LGBT Health Services, discusses some of the issues she is facing in implementing LGBT cultural competency training and including sexual orientation and gender identity in electronic medical records. The article also notes that she has gotten a small grant to do a wellness series called “Ask the Docs” at SAGE’s senior center, the LGBT Center, and Gay Men’s Health Crisis. You can find the article at http://nypress.com/longtime-lgbt-advocate-pioneers-new-health-services/
The place of transgender and gender variant people in American society is rapidly changing. Another marker of this change was issued this summer by the American Psychiatric Association (APA). The APA formed a task force on the treatment of gender identity disorder (GID) – the psychiatric label the APA assigned to transgender people in 1980 – to “perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA.” Continue reading
Wondering what the federal government has done for the LGBT community lately? A good place to start getting answers is an 11-page-long report that the U.S. Department of Health and Human Services (HHS) published last month, available at http://www.hhs.gov/secretary/about/lgbthealth_objectives_2012.html
The report goes over nine 2012 objectives. Those most relevant to LGBT aging issues include:
- Releasing a report that “identifies the gaps and oppportunities in its portfolio in light of the recommendations that the Institute of Medicine made in its 2011 report entitled, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.“
- Funding five pilot studies to reduce obesity in lesbian and bisexual women.
- With the Centers for Disease Control and Prevention, assessing the impact of new chronic disease prevention programs on LGBT populations;
- Conducting a comprehensive review of LGBT cultural competency training curricula and improving training for programs delivering integrated health services to LGBT clients; and
- Through a partnership between the Centers for Medicare and Medicaid Services and the Administration for Community Living, “release a training video to educate long-term care ombudsmen, surveyors, healthcare providers, and state and local government officials about LGBT older Americans, the impacts of the social stigma on this community, and the rights of consumers in nursing homes, hospice, and health care. The video will highlight best practices, identify resources to support LGBT older adults, and give instruction on what to do if one becomes aware of discrimination based on sexual orientation or gender identity. In addition, CMS will clarify its rules governing nursing home visitation rights, which are already in place and apply equally to those with same-sex domestic partners.”
The report also notes that the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Administration on Aging has issued five grants focused on improving behavioral health services and on suicide prevention among older people. Two of theswe grants — to the Jewish Family Service of Los Angeles and the Montrose Counseling Center in Houston — specifically target LGBT seniors.
The National LGBT Cancer Network recently announced a major expansion of its directory of LGBT-friendly cancer screening facilities, including offering a starred designation for facilities that have trained all staff on transgender issues and reached out to their local transgender community.
“LGBT people are at increased risk of cancer, not due to any physiological differences, but behaviors, many of which result from the stress of living as sexual and gender minorities in this country,” Liz Margolies, Executive Director of the National LGBT Cancer Network, explained. She noted, for instance, that “Gay men have very high rates of HPV, the virus that can lead to anal cancer. In fact, anal cancer rates in this population are 40 times higher than in the general population. A simple screening procedure, an anal pap smear, can test for precancerous changes, but too few men are aware of the need for or existence of the test, or out to their provider who could then recommend it.”
In addition to their searchable directory, the National LGBT Cancer Network also offers an automated Electronic Prompt that can help you keep track of when you are due for another screening, and a risk assessment tool to help you pinpoint where you may be at increased risk of various types of cancer. The directory, electronic prompt, and risk assessment tool are all available through the Natinoal LGBT Cancer Network’s homepage, at http://www.cancer-network.org/ An article on the expansion of the directory is available at http://miamiherald.typepad.com/gaysouthflorida/2012/04/national-lgbt-cancer-network-adds-300-facilities-and-transgender-friendly-designation.html
Last week’s Supreme Court decision upholding the constitutionality of most of the provisions of the Affordable Health Care Act (popularly known as “Obamacare”) left in place upcoming changes to Medicaid that will particularly help low-income LGBT people.
The new law permits states to expand Medicaid coverage to all Americans under the age of 65 who make less than $15,000 per year (the Supreme Court struck down the provision that would have withheld ALL Medicaid funds from states that refused to do so, making this now a truly optional program). This provision could provide care to an additional 16 million currently uninsured people, including many LGBT people, who on average have less income than non-LGBT people. The provision also extends Medicaid coverage to people living with HIV earlier in the course of the disease, again affecting a disproportionate number of LGBT people.
A blog post on this topic, written by two health policy analysts for LGBT Progress, is available at http://thinkprogress.org/lgbt/2012/06/28/508590/how-medicaid-expansion-affects-gay-and-transgender-communities/
The U.S. Supreme Court has just decided to uphold most of the Affordable Care Act, also known as “Obamacare,” a move that is extremely helpful for LGBT people. Some of the most important provisions related to LGBT people:
- Pre-existing conditions will no longer be a barrier to getting health care insurance, a provision that is especially important to transgender people, who are sometimes excluded from coverage because “gender identity disorder” is ruled a pre-existing condition;
- Making private insurance policies available to small employers and individuals who make between $15,000 and $43,000 per year;
- Non-discrimination provisions covering sexual orientation and gender identity;
- The collection of data to better understand LGBT health disparities, which sets necessary groundwork for future programs to improve LGBT persons’ health;
- Improved coverage of preventive care for Medicare beneficiaries; and
- Much more.
Here are two more places to consult to find out more about LGBT people’s health and the Affordable Care Act at:
The Gay and Lesbian Medical Association (GLMA), in conjunction with Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, is offering what appears to be a free, 4-part series of webinars on the health care needs of LGBT people.
The sign-up page for the first webinar, to be held Tuesday, June 19, 2012, from 3:30 to 5:00 p.m. EST, says of the series: “The webinar series is an education program open to anyone interested in learning about the healthcare needs of LGBT people. This cultural competence four-part series will explore the health concerns and healthcare of LGBT people. We will review the social determinants that influence how LGBT people seek and receive care and the impact those influences have on health. We will virtually follow the experience of LGBT people and those of us who care for them to better understand how we can create healthcare environments that are welcoming and can help minimize the existing disparities experienced by this population. We will delve into the clinical concerns specific to LGBT persons- both in terms of physical health and mental health- so we can better understand how to create comprehensive systems of care that support positive outcomes and experiences for LGBT people and result in high quality healthcare.” To sign up, go to: http://www.glma.org/index.cfm?fuseaction=Page.viewPage&pageId=1025&grandparentID=534&parentID=940&nodeID=1
Do you know what a health disparity is? How about health equity?
Simply put, a health disparity is the poorer health one group has compared to another. LGBT people have more depression and anxiety than non-LGBT people, when you compare the groups’ averages. African-Americans and Latin@s are far more likely than white people to contract HIV/AIDS. An important aspect of health disparities is that “[f]or people who belong to mulitple communities that experience health disparities, these disparities do not simply add up: They multiply.” Thus, African-American LGBT people, on average, have poorer health than either white LGBT people or African-Americans who aren’t LGBT.
Health equity is the opposite concept: rather than focusing on the differences, health equity focuses on where we want to be: attaining the highest level of health for all people. A good short article on these concepts, with multiple links, is available at http://thinkprogress.org/lgbt/2012/04/27/472826/health-disparities-lgbt/
What happens when you’re transgender and living in the middle of rural America and need specialized medical care?
The patient at the center of this story is only 20 years old, but his story, written up in The Daily Iowan on April 4, 2012, is instructive. Like many transgender people — one study says the figure is 50% — he had to educate his health care providers about transgender health care. Luckily, it worked. Not only did he eventually get the health care he needed, but activism by him and his colleagues is beginning to change the climate in Iowa City. For a more recent story that indicates there are still problems — but also that even more efforts are underway to correct them — see the Iowa City Patch article here.