Guest Blogger

Each Step Is a Step of Affirmation

Filed By Guest Blogger | April 01, 2011 2:00 PM | comments

Filed in: Living
Tags: Fenway Community Health, Institute of Medicine, IOM, LGBT health

Editors' Note: Guest blogger Henia Handler is the Director of Government Affairs for Fenway Health.

HeniaHandler.jpgFor more than a decade the national community of lesbian, gay, bisexual and transgender (LGBT) researchers has remained true to illuminating our knowledge on the factors that affect the community's health. This week the Institute of Medicine (IOM) released a historic report on the state of research addressing the health of LGBT populations. Recommendations from the report will shape future research and research training by identifying gaps and targeting LGBT health disparities. Research to date has been hampered by the absence of LGBT inclusion in large national and state surveys which has made this population largely invisible in the eyes of many researchers and policy makers.

The IOM report follows a series of steps undertaken by the US Department of Health and Human Services over the past 12 years to increase LGBT inclusion in federal health surveys and priorities. In 1999 the IOM sponsored a conference that highlighted the omission of lesbians within the growing arena of women's research. In 2000, Healthy People 2010 spoke to the disparities experienced by LGBT persons in accessing primary medical, mental health and substance abuse treatment, it presented precise data on the burden of smoking, obesity and alcohol consumption across the LGBT community.

In the last year, there have been even greater efforts to recognize and include LGBT people.

President Obama issued an executive order in April, 2010 on hospital visitation rights for same sex couples. In July of last year, the White House issued a National AIDS Strategy with a specific focus on reducing HIV infections in gay and bisexual men and transgender people. Then in December, the federal government released Healthy People 2020, the blueprint for national public health prevention and policy goals for the next decade, had historic inclusion of LGBT populations.

These gains have been important, but lack of good data on the needs and experiences of LGBT people is still a challenge. As recently as January 2011, the CDC MMWR report stated that efforts to address disparities are thwarted in the absence of good data, highlighting the seriousness of the "data gaps in two critical disparity domains - disability status and sexual orientation and identity."

The recommendations in the IOM report lay a foundation for the collection "good data" related to sexual orientation and gender identity. The objective should be inclusion on national health surveys, access to these data sources, and publication and dissemination of new knowledge. This investment to address the gaps in research will ultimately provide the researchers the opportunity to dissect the underlying causes of health inequities affecting LGBT persons.

Recommendations in the IOM report include:

  • Researchers must engage LGBT people in health studies and collect data on these populations to identify and better understand health conditions that affect them.
  • Federally-funded surveys should proactively collect data on sexual orientation and gender identity, just as they routinely gather information on race and ethnicity.
  • Information on patients' sexual orientation and gender identity should be collected in electronic health records, provided that privacy concerns can be adequately addressed.
  • The National Institutes of Health (NIH) should support the development of standardized measures of sexual orientation and gender identity for use in federal surveys and other means of data collection.
  • The NIH should provide training opportunities in conducting research with LGBT populations and encourage grant applicants to address how their studies would include or exclude sexual and gender minorities.

Increased data collection on LGBT people will not only help us to address specific healthcare needs and health disparities, but will also provide an opportunity to explore the social factors that strengthen the community, what has contributed to its resiliency and hope, and what enhances the community's power and presence to defy stigma and shape its good health. Despite a historic lack of culturally competent programs and support, LGBT families are thriving and their children are well and achieving in all the ways that children do. Seniors are forging their way to lives of dignity and respect as people who are "out and about", increasingly vocal and demanding equality within the environments they fill and services they access. More and more LGBT people of all backgrounds are living open and fulfilled lives.

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As a native of Massachusetts I wish Fenway health would drop the use of transgender and the automatic assumption that all T people live in the LGBT community. It is an umbrella term that is damaging and unrealistic to think it is fair to trap all TS identified people under it or with the LGB community.Those that are LGB all have sexual orientation in common those who are labelled transgender in various segments really have no common ground with the other subgroups under transgender only the implied implication that they do. Find a new word that covers only those associated with the LGB or just drop Transgender all together.Seriously this is no April fools joke it is a sad reality of just one more unecesary hurdle and false association that I have to cross.

1. Thanks, Henia for this post. It's always affirming when powerful straight allies who work in the business of affirming LGBT and other lives speak out in ways that reach us and others we might not attract. Thanks, as always.
2. To Amy's comment, while we who are LGBTQQI2S-lmnop, including transsexual, believe we are all special and different in our own special ways -- and we are -- those who oppose us don't like many or any of us.

Yes, we have people who have the luxury of living stealth -- until the first woman has prostate cancer and needs health intervention, until the first man has female-organ or female-body-associated medical needs.

While political preference of distinction is easy to state and stand for, human reality hits differently and takes work to defend, in my humble view and extensive experience as an LGBT health access expert.

Folks like Henia (and myself and many others) have been doing the work on the medical reality side to permit the room for political preference.

I urge us all not to assail our allies who have influence and power while they're doing work on our behalf. It doesn't make sense or gain ground, and anyone saying "I'm not assailing" when they are, trying to re-define by re-shaping messages is no defense. Just don't do it, please. Diego

It's like the song that calls for Latina unity and lauds "Boriqua, Morena, Colombiana, Dominicana, Boriqua, Morena, Cubana, Mexicana."

To people who don't like Latinos, Latinas, Hispanics -- we're all just 'damn fer'ners' or "Spanish" (which we're not, not that we have anything against Spaniards) no matter where we were born or what we have contributed. Es la verdad - no matter how we see ourselves. Facing facts helps navigate reality. Punto. Diego

Diego I don't see anyone who is trying to force people into the LGB or transgender boxes as allies. Instead I see them as unrealistic political juggernauts with an agenda.Whether you care to admit it or not the word transgender has been misused to marginalize already marginalized enough groups. It is time for people like you to realize it is not your right to attach unwanted and unneeded derogatory terms like transgender on people. Nor is it your right to attach them to a group with a totally different needs Sexual orientation. The house of cards you guys have built is coming crashing down and rightly so.You can either realise this and through your own choice quit using the word transgender to entrap people or you can be forced to the choice is yours but it is going to happen.

Aren't we self-defined? No one is "forcing" me into any box. I am proud to be a woman of transexual history, proud to call myself transgender, and happy to have LGB and straight allies. We have common cause because there are powerful people who want to prevent equality for all of us. I will speak up for my individual needs, seek common cause with others, and there are times when I will be disappointed when others don't support my needs. But I define myself.

Jill as long as the LGBT is pushing the unwanted and unneeded assertion that all transsexuals identify as transgender they are forcing my inclusion into the LGB. It disallows me to self identify as non LGB or Transgender.Also the assertion that the majority of transsexuals are okay with being shoved under the transgender umbrella is bunk as the majority of transsexuals are heterosexually self identified. Also many lesbian identified transsexuals are realizing how the term is labelling them the sex they were born as not the sex they truly are. Here is an interesting link to read it might help you to drop the transgender self identity: