GLMA LGBT Health Digest Update

Teaching DO Students LGBT Health
In this May 1, 2014, article in The DO, the author outlines common concerns faced by LGBT patients when accessing healthcare, including seeing a healthcare provider who is not aware of or comfortable with LGBT-specific health issues. The article notes the lack of LGBT health education providers receive. “There are too few health professionals who are trained in LGBT healthcare. And you cannot rely on physicians and medical students who are lesbian, gay, bisexual or transgender themselves to deliver all that care,” says Henry Ng, MD, MPH, clinical director of LGBT health services at MetroHealth Medical Center in Cleveland and President of GLMA. Sean Tai, DO student and recipient of the AMSA/GLMA Achievement Award, notes that sexual orientation and sexual practices fall under the osteopathic principal of treating the whole patient.

Henry Ng, MD, MPH, is the President of GLMA.
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Ongoing LGBT Health Disparities Addressed by Affordable Care Act
This April 2014 AAMC Reporter post details the benefits of the Affordable Care Act (ACA) for LGBT people, including increased access to insurance, provisions prioritizing cultural competence standards and training to improve LGBT health outcome and increased data collection. Additionally, the ACA has shifted more attention to how healthcare policy may contribute to negative health outcomes for LGBT people, notes Henry Ng, MD, MPH.

Henry Ng, MD, MPH, is the President of GLMA.


Trans Bodies, Tran Selves to Be Released Soon
As described in this May 1, 2014, Washington Post article, a new resource for transgender people is soon to be released. With 672 pages and “encyclopedic in scope,” Trans Bodies, Trans Selves is positioned to be the go-to resource for topics from health and law to history and politics. Reflecting on the book’s predecessor for women, Our Bodies, Ourselves, editor, Laura Erickson-Schroth, “At a time when over 90 percent of physicians were men ... it was an extremely daring and exciting thing to publish a book in which women taught other women about their bodies, their sexuality and their rights.” As the article notes, the goal of the book is to empower transgender people and provide them with a wealth of information about their lives.

Laura Erickson-Schroth is a Member of GLMA’s Board of Directors.


Defense Secretary Indicates Military Should Review Ban on Transgender Service As reported by ABC News on May 11, 2014, Defense Secretary Chuck Hagel has indicated the ban on transgender individuals serving in the US military "continually should be reviewed,” although not going so far as to indicate whether he believes the policy should be overturned. Hagel also said, "Every qualified American who wants to serve our country should have an opportunity if they fit the qualifications and can do it."

HHS Expected to Lift Medicare Ban on Gender-Affirming Surgery According to this May 8, 2014, Advocate article, the US Department of Health and Human Services (HHS) is expected to lift Medicare’s 1981 ban on gender-affirming surgeries, which claims the surgeries are “experimental” and denies any and all requests for coverage. Advocates argue the 33 year old ban is based on outdated science, which was reviewed by independent HHS panel formed last year.

Resource: SIECUS Releases New Edition of the State Profiles For ten years, SIECUS has “followed the money” to provide educators, advocates and policymakers with an annual snapshot of how federal funding is impacting sexual health education across the country. For the first time, the newly released publication, SIECUS State Profiles: A Portrait of Sexuality Education and Abstinence-Only-Until-Marriage Programs in the States, Fiscal Year 2012 Edition, also includes a State Profile At A Glance for each state, providing an overview of adolescent sexual health education state policies, data and federal funding. Click here to access the publication.


Resource: LGBTQ Organizations Release Intimate Partner Violence Community Action Toolkits The National Coalition of Anti-Violence Programs (NCAVP) in association with GLAAD, the National Center for Transgender Equality (NCTE), the National Black Justice Coalition (NBJC), the Gay and Lesbian Taskforce and Trans People of Color Coalition (TPOCC) announce the release of two community action toolkits that provide LGBTQ communities, survivors of intimate partner violence and advocates working on their behalf, resources to address intimate partner violence on the individual and community level. The toolkits are focused specifically on intimate partner violence in transgender and people of color communities and highlight the adverse impact of intimate partner violence on transgender individuals and LGBTQ people of color. Click here to learn more.

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Conference: 5th Annual Infectious Diseases Update Friday, June 13, 2014
1:00pm – 5:00pm
New York City, NY

This half-day course consists of five lectures by leading experts from the fields of infectious diseases. There will be ample time for audience participation and opportunities to engage the speakers in dialogue about current controversies in HIV management. This Weill Cornell CME activity is designed to lead to improved patient care. The program will strive to: Summarize the advantages and disadvantages of commonly used first line antiretroviral regimens, discuss three new technologies available in the clinical microbiology laboratory, review the epidemiology and diagnostic approach to malaria, summarize the approach to managing HCV infection in 2014 and three teaching points related to outpatient infectious disease cases. To register and learn more, click here.
GLMA’s LGBT Health Digest is an electronic newsletter with information and resources for health professionals concerned about the health of lesbian, gay, bisexual and transgender (LGBT) populations.

The Digest highlights issues, events, publications and other newsworthy items pertinent to LGBT health. Please feel free to circulate the Digest to your colleagues.

To sign up, send your request to digest@glma.org. Also, to submit an item to be considered for publication in the Digest, please send your request to Emily Kane-Lee at ekanelee@glma.org

New Intimate Partner Violence Report

Make Intimate partner violence a priority for LGBTIQ Health Week. Posted at keystothecloset.blogspot.com

"Why it Matters: Rethinking Victim Assistance for Lesbian, Gay, Bisexual, Transgender, and Queerhttp://www.bravo-ohio.org/Why%20It%20Matters.pdf

Victims of Hate Violence & Intimate Partner Violence"  A Joint Policy Report by the National Center for Victims of Crime and the National Coalition of Anti-Violence Programs is available at

This report makes recommendations and ultimately proposes collaboration between mainstream victim

assistance agencies and LGBTQ-specific anti-violence programs to increase the efficacy and equity of

services provided to LGBTQ victims of crime, particularly hate violence and intimate partner violence.

The recommended strategies will be effective only when supported by the necessary changes in laws and

policies to provide LGBTQ victims of crime with equal access to victims’ rights and services.

The National Center for Victims of Crime and the National Coalition of Anti-Violence Programs make the

following recommendations:

1. Build collaboration among LGBTQ anti-violence programs and mainstream victim assistance

providers to increase the availability of culturally competent services for LGBTQ victims of crime

by providing LGBTQ-specific training for criminal and civil justice system personnel and victim

assistance providers.

2. Assess and evaluate the implementation of state and federal protections for victims of crime and

implement policy and legislative changes to assure that LGBTQ victims have equal access to protections.

3. Increase public awareness of the extent and impact of victimization against LGBTQ individuals

and communities and on crime victims’ rights and services through national and local public

awareness, education, and outreach campaigns.

4. Increase state and federal funding for collaboration, training, outreach, services, research, and

data collection on the victimization of LGBTQ people.

About This Report

The National Center and NCAVP began this collaborative survey and report to gain a better understanding

of the victim services provided to LGBTQ victims of crime throughout the United States. The focus

of this joint policy report is on the crimes of hate violence and intimate partner violence against LGBTQ

people, because these are the crimes that are most reported to NCVAP programs. This report confirms

that gaps in services for LGBTQ victims of violence exist and shows the need for culturally competent

service provision through LGBTQ and mainstream service providers’ collaboration. These gaps in services

compromise the safety of LGBTQ individuals, families, and communities.

The Face of Domestic Violence in LGBTQ Communities

Intimate partner violence is a silent issue in the LGBTIQ community. Let's talk about it in honor of LGBTIQ Health Awareness Week.

This was originally published by the good people of Buckeye Regional Violence http://www.bravo-ohio.org/ and reposted here at http://keystothecloset.blogspot.com/

by Gary Heath, BRAVO’s Domestic Violence Program Coordinator

For most of us, images of Matthew Shepard, Brandon Teena, and Gwen Araujo, come to mind when we think about violence and the Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) communities. We often think of hate and bias crimes that are perpetrated upon us from outside our communities. There is however, another type of violence that goes unrecognized and undisclosed. This violence commonly referred to as domestic violence or intimate partner violence occurs every hour of every day within LGBTQ communities.Many are surprised to learn that domestic violence in LGBTQ relationships occurs at the same rate as in heterosexual couples — 25% to 33%. Thus you can imagine the scope of the problem in a community, such as Columbus, with large LGBTQ communities.

Buckeye Region Anti-Violence Organization (BRAVO) and the National Coalition of Anti-Violence Programs (NCAVP), of which BRAVO is a founding member, have recognized that our mission must include ending all forms of violence, both within and against LGBTQ communities. As a consequence, when it comes to domestic violence, our goal has been to educate both LGBTQ communities and “mainstream” communities as to the scope of the problem and the consequences of LGBTQ intimate partner violence. To begin, we have to understand what intimate partner violence looks like in LGBTQ communities. How does it differ from heterosexual battery and in what way is it similar?

We have all been acculturated to view domestic violence in the framework of a heterosexual male battering a heterosexual female. While this certainly depicts the vast majority of domestic violence (for reasons that clearly stem from the longstanding subjugation of women in male-dominated societies), it does nothing to explain the experience of same-sex abuse and makes it difficult for an LGBTQ individual to see oneself as the victim of abuse. As a result domestic violence programs have had to rethink these paradigms and get away from a gender based model that only looks at domestic violence in the context of a straight man abusing a straight woman.

For a start, a definition of domestic violence which makes no mention of gender may be very helpful. “Domestic violence is a pattern of behaviors utilized by one partner (the abuser or batterer) to exert and maintain control over another person (the survivor or victim) where there exists an intimate, loving, and dependent relationship.”

Another good definition is, “One individual systematically abusing another to gain power and control in a domestic or intimate relationship.” It is important to point out that one need not be physically harmed in order to experience domestic violence. It can present as a sustained and systematic pattern of abuse where one partner demeans, criticizes, insults, ridicules, and intimidates the other partner. It may take the form of one partner manipulating, coercing, and isolating the other. This abuse can of course escalate into physical violence including sexual abuse and murder.

LGBTQ people’s experience of domestic violence is compounded by social and internalized homophobia, where coming out or being “outed” by an abuser can further isolate a survivor from existing support networks and services, including family and friends, shelters, healthcare providers, and crisis agencies. The problem with homophobia and transphobia is that it is so pervasive and permeates our society at all levels. Such a barrier makes it extremely difficult for LGBTQ people to find programs and services that are appropriate and don’t re-victimize them. One of the components of BRAVO and NCAVP’s service delivery is to provide information and technical assistance to domestic violence programs, shelters, law enforcement, the courts, and other service providers. It plays an important part in dispelling myths people have surrounding LGBTQ people and LGBTQ intimate partner violence.

Other barriers to service include poor or inconsistent law enforcement responses, lack of non-criminal justice based safety options, limited access to civil court orders of protection, victims’ fears of being “outed” as LGBTQ and as a DV survivor, and victims’ hopelessness and/or fear of reprisals.

Another problem in service delivery for LGBTQ persons is that most domestic violence shelters predominately serve heterosexual women and as a result may not be particularly welcoming or appropriate when providing services to lesbians. Nationally and locally most shelters will not take in men, although some are beginning to provide private rooms or safe space off site. Nationally there is only one domestic violence shelter set up exclusively for men and some innovative programs across the nation provide a network of “safe homes.” Gay and bisexual men have few options and of great concern is finding caring and appropriate shelter options for those of trans experience.

For those programs that do provide domestic violence services to LGBTQ individuals it is extremely important that some type of screening tool be used during the intake process. Because we view domestic violence in terms that are gender neutral we have to do everything we can to assure we are working with the survivor and not the abusive partner. It is not uncommon for the abusive partner to contact a domestic violence program in order to access services or to try and find out if their partner has contacted the provider.

There are many issues facing LGBTQ communities and certainly domestic violence is one that is not commonly talked about in our communities. Obviously we want society to see our community in the most positive light. Some feel that talking about this issue is “airing our dirty laundry.” It is important to remember, however that intimate partner violence occurs at the same rate in LGBTQ communities as in the general population. It is important that we all confront the issue head on.

If you feel you are in an abusive relationship or would like more information about LGBTQ domestic violence feel free to contact BRAVO or NCAVP.