LGBT 101

An Introduction to Lesbian, Gay, Bisexual and Transgender Issues in Public Health

Agenda

      Common terms Issues unique to LGBT people Data and risk factors Challenges Strategies for interventions Conclusion

Presentation Objectives

 Participants will be able to define the acronym LGBT and each component.  Participants will be able to list at least two unique risk factors that exist for LGBT people.  Participants will be able to name two public health considerations specific to LGBT people.

Terms and definitions

 Terms are always changing  Self definition  LGBT

LGBT- An Umbrella Term

 Dissecting the acronym LGBT  Sexual orientation vs gender identity

Sexual Orientation

 Lesbian A woman or girl whose attraction is to the same sex  Gay – A man or boy whose attraction is to people of the same sex  Bisexual – A person whose attraction is to people of either sex

Gender Identity

 Transgender A term used to describe someone whose gender identity falls outside of the stereotypical gender norm

The Transgender Umbrella Defined

      Transgender Transexual Crossdresser Intersex Drag performers Gender bender, androgyne, gender queer

LGBT in the United States

 What images do people have?  What were you taught about LGBT people?  Not a monolithic experience!

 What can shape an LGBT person’s experience?

Coming Out

 What do you think it is like to come out?

 Who would an LGBT person come out to?

Feelings Behaviors

 Isolated  Scared  Anger  Stress  Relief  Uncertainty  Depressed  Leave home/ forced homelessness  Drop out of school  Increase drug and alcohol use/ abuse  Self inflicted violence  Suicidal ideation and attempts

In the Public Health Context

 Considerations for LGBT people

A Snapshot of LGBT People in the Medical Institution

 1869 The word “homosexual” is invented  1949: Hormone treatment for transsexuals  1973: Homosexuality is removed from the DSM  1996: Shock therapy, conversion therapy  2011: Gender Identity Disorder still in DSM

Health Disparities by Population

 Lesbian and bisexual women  Gay and bisexual men  Transgender people

Barriers to adequate healthcare

      Lack of legal protections Sporadic inclusive policies Invisibility Historic experiences Limited insurance coverage Lack of competent providers

Barriers continued

 Limited funding for improving LGBT outcomes  Inadequate data collection efforts

The silver lining

…  LGBT as a protective factor  Many LGBT people have high social capital  Visibility is increasing in medical/academic field

Acknowledgements

This presentation was designed in Spring 2011 by Curran Saile, Program Director of the Pride Center of the Capital Region done in partial completion of Masters in Public Health requirements at the University at Albany School of Public Health. The project would not have been possible without the support of Mary Applegate, Jennifer Manganello, Cheryl Reeves and the Pride Center of the Capital Region.

References

Bradford J, Ryan C.

The National Lesbian Health Care Survey

. National Lesbian and Gay Health Foundation, Washington, DC, 1988:76-85.

Centers for Disease Control. Cigarette smoking among adults – United States, 1997.

Morbidity and Mortality Weekly Report

18(43):993-996, 1999.

Cochran, S.D., and Mays, V.M. Relation between psychiatric syndromes and Behaviorally defined sexual orientation in a sample of the US population.

American Journal of Epidemiology

151(5):516-523, 2001.

Finlon, Charles. Health Care for All Lesbian, Gay, Bisexual and Transgender Populations.

Journal of Gay & Lesbian Social Services

. 2002, Vol. 14 Issue 3, 109 116.

Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual and Transgender (LGBT) Health

published by the Gay and Lesbian Medical Association\ and the National Coalition for LGBT Health in 2001: Fergusson, Hoorwood and Beautrais, 1999.

References

Makadon, Harvey J. Improving Health Care for the Lesbian and Gay Communities.

New England Journal of Medicine

. 3/2/2006, Vol. 354 Issue 9, 895-897.

Male-to-Female Transgender Individuals Building Social Support and Capital from Within a Gender-Focused Network.

Journal of Gay& Lesbian Social Services.

2008, Vol. 20 Issue 3, 203-220.

Schatz B, O’Hanlan K.

Anti-Gay Discrimination in Medicine: Results of a National Survey of Lesbian, Gay and Bisexual Physicians

. American Association of Physicians for Human Rights/Gay Lesbian Medical Association, San Francisco, May 1994.