Lesbian, Gay, Bisexual Issues in public health

1. Lesbian, Gay, Bisexual Issues in public health

2. Presentation objectives • Participants will be able to define issues unique to lesbian, gay and bisexual people • Participants will be able to identify at least two ways to incorporate lesbian, gay and bisexual people in public health interventions • Participants will be able to describe reasons for health disparities within the lesbian, gay and bisexual population

3. Exploring sexual orientation • Climate assessment activity

4. Demographics • How many LGB people do you think there are? • Why might this be hard to discern? • Epidemiological challenges

5. LGB healthcare • Group brainstorm: • What are some health issues unique to LGB adults?

6. LGB healthcare • Hetero-centric healthcare • Welcoming environments

7. Barriers to healthcare • Invisibility • Historic experiences of bias, discrimination and stigmatization • Limited insurance coverage

8. Other issues for LGB adults • Marriage and partner rights • LGB parents • LGB aging issues • Mental Health • Substance abuse • Domestic violence • Hate crimes

9. Marriage and partner rights • Forms of partner recognition • Benefits linked to marriage State issues marriage licenses to same-sex couples State recognizes marriages by same-sex couples legally entered into in another jurisdiction Statewide law providing the equivalent of state-level spousal rights to same-sex couples within the state Statewide law providing some statewide spousal rights to same-sex couples within the state

10. LGB Parents • Parenting options • LGB parenting challenges • Family outcomes

11. LGB aging issues • Accessing aging services • Social isolation • Spousal benefits • Care giving, care receiving

12. Mental Health • Minority Stress • Prevalence • Suicidality

13. Substance abuse • Alcoholism and drug abuse • Cultural competency • Incidence • Bars as congregation spaces • Coping mechanism

14. Violence • Rates of intimate partner violence • Access to family court • Violence • Hate crimes

15. Identifying barriers • Discussion- applying what you have learned

16. 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.

17. References American Civil Liberties Union Lesbian & Gay Rights Project. “Too High A Price: The Case against restricting gay parenting.” ACLU, 2006. Badgett, M.V. Lee Lee and Ash, Michael, Separate and Unequal: The Effect of Unequal Access to Employment-Based Health Insurance on Same-Sex and Unmarried Different-Sex Couples (October 2006). Contemporary Economic Policy, Vol. 24, Issue 4, pp. 582-599, 2006. Available at SSRN: http://ssrn.com/abstract=1095935 or doi:10.1093/cep/byl010 Baker, Kellan and Krehely, Jeff. Changing the Game. What Health Care Reform Means for Gay, Lesbian, Bisexual, and Transgender Americans. Center for American Progress. March 2011.   Bockting WO, Robinson BE, Rosser BRS. Transgender HIV prevention: a qualitative needs assessment. AIDS Care. 1998;10(4):505-526. 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.

18. References 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. Gee, Royal. Primary Care Health Issues Among Men who Have Sex With Men. Journal of the American Academy of Nurse Practitioners. April 2006, Vol. 18 Issue 4, 44-153. 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. Kelleher, Cathy. Minority stress and health: Implications for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young people. Counseling Psychology Quarterly; Dec2009, Vol. 22 Issue 4, p373-379, 7p, 2 Charts Knauer, Nancy J. LGBT Elder Law: Toward Equity in Aging. Harvard Journal of Law & Gender. Winter 2009, Vol. 32 Issue 1, 1-58. 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. Mansergh, G. PhD, Data on MSMs and Methamphetamine Use CDC Division of HIV/AIDS Prevention, Conference on Methamphetamine, HIV, and Hepatitis, Salt Lake City, Utah, 2005.

19. References Nealy, Eleanor C., Public Testimony to the New York State Legislature; Standing Committees on Alcoholism and Drug Abuse and Health, New York City, January 7, 2005. New York State OASAS Data, 2004. 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. Stall, et. al. New York City Department of Health and Mental Hygiene, Community Health Survey, 2004.