Tuesday, April 5, 2011


April 5, 2011

LGBT Americans have experienced many advances in recent months -- including the impending repeal of Don't Ask, Don't Tell and polls showing a majority support for marriage equality -- but their health remains a serious concern as homophobia and transphobia are still debilitating forces in their lives. This past week, a series of new studies on LGBT health show that persistent stigma is taking a heavy, if unseen, toll on lesbian, gay, bisexual, and transgender Americans. Revving up their social conservative base, Republican presidential hopefuls have nonetheless been spouting anti-LGBT talking points as if it were still the late 1980s, but it is this very rhetoric that could have the gravest consequences for LGBT health, both mental and physical.

POOR UNDERSTANDING OF LGBT HEALTH NEEDS: Last year, the National Institutes of Health charged the Institute of Medicine to report on LGBT health research, expecting a report on the gaps in LGBT health; however, upon reviewing the existing literature, "the committee found that the existing body of evidence is sparse and that substantial research is needed." What they did find (and compiled for the first time) are health concerns across all age groups of LGBT people, including elevated risks for attempted suicide, depression, and substance abuse. It also found a dearth of health-care providers knowledgeable about LGBT health needs, and severe social isolation for LGBT elders. While the report's call for implementation of an LGBT-focused "research agenda" with extensive data collection does not make for a sexy headline, such a commitment to LGBT health could revolutionize understandings of this undeserved population. Indeed, the Department of Health and Human Services incorporated the report into a series of recommendations to improve LGBT health and well-being. The Affordable Care Act provides opportunities to address some of the "unique health disparities" of the LGBT community, but as a new Center for American Progress study outlines, the need for health care reform is still great, including preventing discrimination in health insurance exchanges and supporting LGBT families.

COMPOUNDING STIGMA: Another study released last week from the UCLA Center for Health Policy Research shows how the impact of anti-LGB stigma compounds over time. Older lesbians, gays, and bisexuals reported higher rates of high blood pressure, diabetes, physical disabilities, and psychological stress. The study also stressed the need for "increasing cultural competency and sensitivity among health care providers," particularly as the number of LGB older adults rapidly increases. A 2010 study by the Movement Advancement Project already confirmed that LGBT elders have higher rates of poverty, homelessness, and depression due to the inequities of marriage inequality, sexism, and a lifetime of stigma. The spate of high-profile suicides among bullied youth has raised awareness about the need to minimize the stigmatizing language still prevalent in our schools, with President Obama even declaring that bullying is not "just a harmless rite of passage," but that it can have "destructive consequences for our young people." Transgender individuals experience "Injustice at Every Turn," facing high rates of poverty, unemployment, housing discrimination, homelessness, discrimination in healthcare, harassment by law enforcement, and attempting suicide at 25 times the rate of the general population. Meanwhile, HIV continues to ravage the gay community at infection rates far exceeding the general population, which seems to be as ill-informed about the disease as ever.

FANNING THE FLAMES: Despite all the new information available about LGBT health and inequitable access to healthcare, prospective GOP presidential candidates are catering to social conservatives with their favorite homophobic rhetoric. By reinforcing these anti-LGBT ideas, some of which are 40 years behind social science, these candidates are reinforcing the very stigma that impedes LGBT health. Haley Barbour, Tim Pawlenty, and Mike Huckabee all want to reinstate Don't Ask, Don't Tell. Just yesterday, Newt Gingrich defended his donations to the American Family Association, refusing to disavow harmful repudiated ex-gay therapies and claiming the group's anti-gay positions were "allegations" he couldn't "check," despite having just agreed with many of them on Bryan Fischer's radio show. The RNC's new fundraising page repeatedly attacks President Obama for his support of LGBT rights. An important question for all candidates will be whether they would allow these LGBT health studies and initiatives to continue under their administration. Regardless, as the body of research on LGBT health grows, it will become more and more evident that as social conservatives try to limit the liberty of the LGBT community, they are diminishing the very life of that community as well.