Ack, this isn’t fresh news!
That’s right cause we changed our name so we’ve changed our blog name.
But it’s still the same great stuff… so come on visit us at
See you there!
You may recall a recent Network webinar: State and Cities: New Webinar – 411 on Including LGBT Disparities in CTG Proposals: Resources. Well here are some resources from that call!
Powerpoint Presention: States & Cities: New Webinar – 411 on including LGBT Disparities in CTG Proposals 6/13/2011
We also have the Presentation and recording from our 6/2/2011 Call:
How to advocate for LGBT inclusion in Community Transformation Grants Webinar 6/2/2011 http://lgbttobacco.org/files/CTG%20Webinar%20Final%20For%20Website.pdf
Audio recording of 6/2/2011 Call: Conf_recorded_on_Jun__2_2011__2-50PM
Praise where praise is due!
Sure, we have a tendency to point out when health policymakers leave LGBT people behind… but never let it be said we don’t praise inclusion just as loudly! (if a little belatedly). Well, I’m very pleased to say the U.S. Substance Abuse and Mental Health Services Administration has done an outstanding job at including the LGBT population in every level of their new strategic plan. LGBTQ (questioning) people are mentioned a whopping total of 50 times throughout the document and there’s plenty of toothy initiatives to show it’s not all fluff. Including a brand spanking new action item on enhancing tobacco cessation efforts for LGBTQ folk with mental health or substance abuse issues. Weeha!
Gold star to SAMHSA’s administrator, Pamela Hyde, and special thanks to the many stalwart allies there, including: Larke Huang, Ed Craft, Nancy Kennedy, and Sylvia Fisher. Special thanks also to Barbara Warren from Hunter College and the Trevor Project folks for being some of the key community advocates (along with us) who kept helping them shape this inclusion. Great job SAMHSA! We say, A+!
Panel 3: Future Research and Policy
It was really exciting to sit in on the afternoon session of the Intersectionality Working Group meeting of the LGBT Population Research Center. There was a fantastic conversation on intersectionality among several researchers discussing bisexuality in public health research, LGBT communities of color and domestic violence, and transgender inclusion in data collection.
First, Dr. Wendy Bostwick (of Northern Illinois University) spoke about her expertise in bisexual research. Particularly she addressed the need to look at the bisexual community as different than gay/lesbian. Some of the specifics she raised in her conversation were:
“What does bisexual stigma mean for public health?”
“Considering comparison of lesbian and bisexual women with gay and bisexual women, how does that affect health outcomes?”
The answer to the latter question may be less availability of social support for bisexual people than for gay/lesbian folks. There may be a common assumption that bisexual people are much more privileged than gay/lesbians in social and healthcare settings. Contrary to that assumption, health outcomes of bisexual people are actually worse in many areas, so perhaps there are psychological barriers that affect bisexual health disparities unknown to us at this time.
Second, Shawn McGuffey (Boston College) shared the intersectionality of race, sexuality, class and domestic violence (DV). From media to academia, there is a public narrative about how you do “gayness” but there is no sexual script for bisexuals. Even when those sexual scripts are narrow, at least there is some sort of roadmap for gays/lesbians. Furthermore the script for LGBT People of Color (POC) is even weaker and our knowledge of DV in these communities suffers.
From studies we know domestic violence is the same for gay/lesbian couples as heterosexual women. Given that, how do we account for this and how do we consider the phenomenon of race and class. There is much more mutual violence in gay/lesbian relationships then the general population, so how do we provide services if we can’t understand it?
With sexual assault, conservative rates reveal 14-18% prevalence of rape experience among LGBT people. Therefore the intersectional benefits are so important as they consider switching from “why” versus “how”. Prevalence of interpersonal violence has good data but we don’t know how it happens, under what conditions, how to prevent it and how to better serve. We need to move from a gender to a power model, and we need to understand intersectionality of race, class since LGBT POC have more interracial relationships than any other group.
One of the most important practical considerations to take home is:
Which policies help all LGBT communities and which do not?
Finally our own Scout talked about some of the policy issues impacting intersectionality research right now. First he strongly encouraged the researchers at the table to add gender identity to their studies and surveys because by excluding it we tell national surveys and other researchers not to include gender identity in their surveys. Scout talked Jessy Xavier’s Gender Variance Model as one way to consider how sexual orientation and gender identity overlap in the field, and how what we label as homophobia might actually be gender discrimination.
Scout emphasized that for LGBT health and intersectionality overall, we’re at a time of real opportunity. It’s really a time where we as researchers should loose ourselves from the constraints of “what we were allowed” and think “what is just”? Then, we need to speak out when we see discrimination against us as researchers, because now is a time when people are trying to change that history. For instance, Health and Human Services (HHS) officials are asking us, “where at the National Institutes of Health (NIH) is there a problem accepting LGBT research”? One researcher in the room brought up an issue with NIH review forms, which don’t allow an option to say the study focuses on transgender people, only male or female. That’s a good example of what we can give feedback to HHS about. Scout also talked about the importance of mentoring researchers, and for intersectionality research, we might need to find ways to mentor before the graduate school level, because too many promising students have their prospects cut short before graduate school. For example, he noted he’s one of only two or three transgender PhD level health researchers in the country. And of course, Scout talked about the lack of data and prospects for changing it. Scout noted the most likely source of LGBT of color data, according to the researchers assembled for the LGBT of Color Sampling Methodology report, is consolidating data across several state’s Behavioral Risk Factor Surveillance System (BRFSS) surveys. So, one local advocacy opportunity is to work with your state to ensure LGBT measures are added to your BRFSS.
As you know the Network has been advocating for these inclusions through some of our Action Alerts. Another way the Network has done this is by advocating CDC to include health disparities (specifically LGBT) in new RFAs. Also be sure to check out some of our other policy papers on data inclusion, such as the one prioritizing datasets to add LGBT onto, and the overview briefing paper about methods. If you want to get alerted about LGBT health advocacy opportunities directly email email@example.com and put “Advocacy” in the subject line.
The last hour or so of the day was spent brainstorming followup and possible joint projects by the participants. We’ll let those unfold when they do. The closing comments again showed just how much the participants really appreciated this opportunity to get together and share. Many people were effusive about how valuable the meeting was, if anything the biggest refrain was “more time!”
Congratulations to Judy Bradford and Aimee VanWagenen at the The Fenway Institute’s LGBT Population Center for convening this fabulous meeting, to Ilan Meyers and all the others who helped organize it, and to Phoenix Matthews for standing up and saying we needed it. Job well done all!
Panel 2 – Methodology for Intersectionality Research
Kimberly Balsam starts by laying out some challenges in each stage of the research (sampling, measurement, analysis, interpretation). She talks a bit about two different research projects she’s been finishing, the Rainbow Project and the Rainbow Women’s Health Survey. At least one study is still being published so I won’t talk about the findings as much, but instead focus on her methods. First, each study was mixed methods, combining a few strategies to get to the people they wanted to recruit. Respondent-driven sampling was used (one of the shiny stars of rare population research) as well as targeted sampling. There was an interesting subdiscussion here on interviewing, one researcher talked about a project where they used community members instead of graduate students to do the interviews, then even further, allowed the participants to choose their own interviewers. They found that most of the participants (all Black), chose sex and race matched interviewers. But African and Afro-Carribean interviewers were more likely to request white interviewers. Another research project was brought up where Black men in prison were being interviewed, and while they presented as heterosexual to the heterosexual interviewer, it all changed once the gay researcher got in the room. Everyone agrees, the researcher affects the data, but we don’t have enough information on how.
Next we get to see some advance results of Juan Battle’s national LGBT of color survey, named Social Justice Sexuality project. Like Kimberly, he used mixed methods for his sampling: quota sampling, venue sampling, snowball sampling, respondent driven sampling, the internet and partnering with a “whole host” of community based organizations. He worked for a year and a half to set up the partnerships. Then, they went to every different type of event imaginable, festivals, parties, special events, prides, rodeos, dinner parties, the choir directors caucus at the National Black Baptist Convention, everything they could find. Face it, “mixed methods” hardly describes the breadth of the methods, seems like it’s more like “every method you’ve ever heard of”. The result? Over 5,000 respondents. So what about findings? Well, I won’t say any results because they’re still coming out. But he brought up an interesting methodological point. Usually when you ask about importance of racial identity v. sexuality you get 90% of your sample saying, “no real diff”. So he approached this question differently, he asked “how important is your sexual identity?” in one part of the survey, then in a very different part “how important is your racial identity?” Fascinatingly, suddenly most of the sample said either race or sexuality was more important.
Now onto Mignon Moore, who I gotta give a big shout to because she was one of my dissertation advisors, w00t! She’s done a series of research studies on Black lesbians that are coming out in a new book very soon, Invisible Families: Gay Identities, Relationships, and Motherhood among Black Women. Again, what’s our theme? Mixed methods! Not only in recruitment but in data collection too. She talked about the particular value of surveying all of her sample but supplementing it with in-depth interviews for half, allowing greater exploration of the survey results. She has an interesting (and time saving) take on researching intersectionality: instead of comparing across race or gender categories, analyze the experiences of the people who live at those intersections. She asked questions about primacy of identity like Juan did and that brought up some interesting information: one identity can be used for self-definition, but a wholly different one can be used as a status that helps a person stick with a particular group.
The panel was rounded out by Brian Mustanski, who’s been working on a project with LGBT youth of color in Chicago. He’s really interested in the question of whether resiliency about race can be transferred to become resiliency about homophobia, but of course explores a lot of intersectionality on the journey to that goal. Again our theme, the study used mixed methods. They started with a survey (using the Race Coping Measure), added psychiatric interviews, mental health self reports, then specifically added open ended qualitative questions both at enrollment, and then again at one year followup. His discussion of the analysis was interesting, to integrate the different types of data collection, they ended up using a qualitative coding scheme for the whole project, to try to bring up themes across the different datasets. And he brings us right back to our theme from the first session, it’s all about context. When they asked about race they heard about neighborhoods, when they asked about neighborhoods, they heard about race, so in some cases, context really defines the issue.
Lisa Bowleg sums it up: “To do intersectionality research, you really have to do mixed methods research”. She challenges us to go further, incorporating more disciplines in the research braintrust, go to the economists to see what neighborhoods to study. But mostly, don’t get stuck on methodological limitations. We really are pioneering some interesting research strategies as each of us draws from our different resources to create our own particular mix of methods.
David Chae rounds out the discussion by bringing up the elephant in our room… we need more general population surveys to include measures of sexual orientation and gender identity. Hear hear, we don’t count until we’re counted!
The Fenway Institute has another really cool project (in addition to ours), the LGBT Population Research Center. This is the first federally funded population research center that focuses on us. It’s a really fascinating concept where the Center works to help convene and support LGBT population researchers to share information and grow new collaborative research projects. I’m lucky enough to be a faculty member, so I get to go to those cool meetings that bring the researchers together to confab and plan. I’ll tell you, they’re always valuable, there’s nothing like an occasional face to face to really jump ideas forward. So now, how does that lead us to today? Well, at a recent population center meeting Ilan Meyer and our own Steering Committee member, Phoenix Matthews, both started talking about the issues related to LGBT research on race and ethnicity. This germ of an idea has now grown into a specially convened meeting on Intersectionality. So now we’re here in the room with about 25 LGBT researchers who’ve specialized in research on LGBT race, ethnicity, or other facets of intersectionality. You know we’re all about sharing information here at the Network, so let me see if I can speedtype and try to give you a birdseye view of the meeting. Excuse these longer than usual posts, but there’s an amazing amount of expertise in the room and this is a too rare type of gathering to let the discussion float off into the ether.
Just a note, within the first twenty minutes alone it was clear the meeting was exceptional, the excitement was palpable. In the words of one researcher “I’m literally choking up because I’m so happy I’m not the only Black researcher in the room.”
Caution High Gobblygook Ahead: While we tried to translate into plain language, there’s no escaping this was a dense scientific meeting.
Panel 1: Theoretical Conceptual Issues for IntersectionalityPanelists: Lisa Bowleg, Hector Carrillo, David Chae, Margaret Rosario, Bianca Wilson
The day kicks off with a rapidfire panel asking “What is Intersectionality?” “Who should be involved?” “How does it help us think about LGBT health?” Perfect for me, because I think I’m a bit weak on question 1, what is intersectionality? David Chae gives the definition below. He notes that it’s traditionally been interpreted as being the study of the intersections of race and gender.
Intersectionality: Traditionally used to describe a structure of interlocking oppressive systems.
Lisa Bowleg frames it up fast, “We’re not interested in identities alone, we’re interested in social justice and power.” “And so often, data we get doesn’t help us. I’m looking at the Census tables and I’m looking for intersections, and I just get the table on Blacks or on women. That doesn’t help me.” As David says, intersectionality is really about disentangling that “Matrix of Oppression”, in some cases social identities may be more important than others and intersectionality between them may be more or less relevant.
David points out that identity is both internally adopted and externally ascribed. There’s some evidence that the externally ascribed identity might impact people more than internally ascribed for both race and sexuality. (In plain talk: what folk think you are might affect you more than what you think you are.) “Disease emergence is a socially produced phenomena” -Paul Farmer. David has some great graphics showing how socially oppressive systems, group identity and discrimination all feed into health outcomes.
Margaret Rosario uses an interesting term, she asks “How are identities arranged? Does this give us information about their health?” Some people arrange their identities hierarchically. They are usually ranked in importance by a few factors: “salience or likelihood of being activated by others”, individuals own subjective basis, or temporal grounds. What are temporal grounds? That might be something that is designated in certain contexts, like a researchers deciding “you may not identify as ____, but I think you belong in that group.” Now we can consider identities as intersecting, like in a venn diagram, but we could also consider them as nesting, so we need to explore intersectionality as one possible model.
Bianca Wilson talks about how she sees intersectionality as potentially three different constructs. She’s done a lot of work exploring these contexts with black lesbians. First, it’s the Matrix of Domination (I want to get that slide). Where the “holy trinity” of oppressive factors (race, sex, class) interact with other factors like fat-based sizeism, and heterosexism. All stand alone, plus potentially interact with each other, each independent unit or interaction flowing into the total health of a person. There where some interesting discussions here about a threshold effect in discrimination. There have been studies showing white people react more poorly to adverse incidents than people of color, the hypothesis is that experiencing something more routinely raises your threshold of tolerance. But what other effects does it have? Second, intersectionality represents interlocking sources of socialization. You are both socialized and trained by the different communities you’re affiliated with, that socialization often builds resiliency and sets standards for what is “routine”. Third, intersectionality represents multiple community affiliations, the different current social experiences you have continue to build your health context all throughout your life.
Hector Carrillo talks a bit about the potential pitfalls of intersectionality. According to him, as we explore this we run the risk of essentializing the sexuality of the people we’re studying. He worries that essentializing the sexual culture within these communities is the same phenomena that has led to the ‘othering’ of LGBT people of color too often. (cripes he talks fast) He also says, when we study the multiple lines of oppression, we run the risk of exaggerating their overall impact. We know people display amazing resiliency, that’s hard to measure. He cautions that to use intersectionality as a frame, we need to not only look at oppression, we need to really look at the different contextual factors. He’d like to suggest that we can approach research and programming not by directly asking about identities, that we instead ask about their lives, and look at the emphasis areas, then do the analytical work to see what is relevant to them in different contexts. Juan Battle heartily agrees “I really like the idea of adding intersectionality on the back end, because otherwise, it’s kinda like asking a fish to describe water. You can’t do it because you’ve never been out of it.” Lisa Bowleg also concurs, “The onus is really, really on the analyst for intersectionality. Data do not stand on their own, they have to be interpreted. The analyst has to have a voice in this work.”
Margaret really sums it up, “The body and the mind remember, we may forget the many insults to us, but the body and mind remember, and those memories can be activated when they get to a certain threshold.
Whew, and that’s it, time for a break. Back with more later!
The Network would like to take a moment and highlight our Fabulous Program Associate, Emilia Dunham.
On Friday, March 18th, Campus Progress released their List-Down: 15 Inspiring Young Female Activist with our very own Emilia Dunham making the list.
With March being women’s history month, Campus Progress wanted to take a moment and recognize amazing women who are inspiring work today, rather than great leaders in the past. While there have been some amazing women who have truly shaped our history, I really liked their approach in recognizing the women of the future!
With this recent news we wanted to take an opportunity to showcase Emilia and all of her amazing accomplishments.
As you know Emilia has been working with the Network for the past year, but before she came onboard she had been shaping the future for herself and her community years. Before joining the Network Emilia worked as an intern performing quality control on multi-site clinical HIV prevention trials at Fenway Health our parent organization. Additionally she is the chair of Youth Kicks!, a social marketing campaign of the National Youth Advocacy Coalition focused on LGBTQ youth tobacco control. She is also the Policy Committee Co-Chair for the Massachusetts Transgender Political Coalition.
One of her biggest accomplishments took place as an undergraduate student at Northeastern University, where she spearheaded a successful Gender Neutral Housing campaign. After a few years of advocating, collaboration, and protocol development, Emilia along with other worked with the administration to pilot Gender Neutral Housing in 2009, which continues to thrive today.
Additionally, while at Northeastern University, she served as President of the LGBTQ student group NU Pride where she planned LGBTQ focused activities such as Pride Week, Day of Silence, AIDS Week and numerous other events. Last April, she presented a paper on Feminism and Transgender Activism at the New England Sociological Association Annual Conference.
She’s also been involved with a number of other jobs and activities in areas of social justice, women’s health and LGBT equality and will continue to amaze us all.
If you would like to join me in congratulating Emilia on this amazing accomplishment, click here to send her an email directly.
Click here to view the article: Inspiring generations, Emilia Dunham listed as one of 15 Inspiring Young Female Activist.
Dear Fellow Blog Readers,
As you may have seen we have started posting mini activity reports to our blog outlining some of our work over the past month. The reports are generally posted the third week of the month so we can share some of the Network’s current efforts with you all. We will continue to send out Newsletters every other month and we will have one coming out soon, but in the meantime here is our March 2011 Activity Report.
March 2011 Activity Report:
The Network has been extremely busy this past month. We started off the month with Scout presenting on LGBT Health Policy to a huge crowd at the 32nd Annual Minority Health Conference at University of North Carolina. From there we went to Puerto Rico, where we trained local advocates on our LGBT Cultural Competency Training, held a two-day Strategic Planning Retreat with our Steering Committee, and participated in two local events, the first ever LGBTT Health Summit and Puerto Rico’s Tobacco Conference. (In Puerto Rico, they use LGBTT because they say transgender and transexual.) The events were all a huge success. The Strategic Planning Retreat brought new ideas, direction and clarified identity for the Network as we grow into our new name. The LGBTT Health Summit was more popular than we could have imagined, organizers finally cut off registration at 130 people. Steering Committee chair Francisco Buchting presented on surveillance and as one of the main sponsors, our Director Dr. Scout actually managed to give a short welcome speech to the crowd in Spanish. But the real stars were the local organizers, who assembled an amazing program. Attendees were so enthusiastic about the event that many planned to continue meeting about LGBT health issues. Overall, Puerto Rico is a Dream. They already have some of the most comprehensive tobacco free laws in the country (you can’t even smoke on the beaches or in cars with kids), now we learn that local advocates have been successful in getting them to add LGBT questions to both their quitline and BRFSS survey. The Network for LGBT Health Equity was even listed as a main sponsor of their tobacco conference. In preparation for our Puerto Rican journey we also our proud to report four newly translated Spanish language resources: our brochure, a smokefree air factsheet, the Sharing our Lessons HIV booklet, and our Quitline Poster. After Puerto Rico Scout moved onto Washington D.C. to attend the New Beginnings Initiative convening of LGBT policy organizations from across the country. Attendees reviewed the LGBT gains at a federal level and created a priority list for future years coordinated policy priorities. Spurred by this meeting, Scout wrote to HHS officials about policy gaps. Initial information shows the communique was circulated up to Sebelius’ office and well received, more on that effort as we know it. To round out the month, Scout presented on nutrition and exercise at the Missouri Checkout Advisory Committee meeting.
New Institute of Medicine Report on Healthy People 2020 Has LGBT Inclusion
So HHS asked the prestigious Institute of Medicine to come up with leading health indicators for Healthy People 2020 and their report just came out today. We’re poring over all 87 or so pages now but wanted to give you the heads up LGBT people figure prominently in the document.
First, the Institute of Medicine recommends 12 Leading Health Indicators, or measures of the overall nations health be used. These include things like “Proportion of the population with access to healthcare services” and of course our favorite “Proportion of the population using tobacco”.
Then they suggested 24 objectives from all of the many in Healthy People 2020 that are very related to the Leading Health Indicators. Now this is where it gets interesting to us, they noted that 12 of those objectives were particularly relevant to LGBT health disparities.
The 12 Most Important Health Objectives for LGBT People
(The garble at the beginning refers to what HP2020 chapter they are in.)
- AH 5L: Increase the educational achievement of lesbians, gay men, and bisexual and transgender adolescents and young adults.
- AHS 1L: Increase the proportion of lesbians, gay men, and bisexual and transgender persons with health insurance.
- AHS 5L: Increase the proportion of lesbians and transgender persons with a usual primary care provider.
- HIV 17L: Increase the proportion of condom use among gay or bisexual males aged 15 and above who are sexually active with other men or women.
- MHMD 4L.1: Reduce the proportion of gay, bisexual or questioning males and females aged 12 to 17 years who experience major depressive episodes (MDEs).
- MHMD 4L.2: Reduce the proportion of lesbian, gay men, bisexual, and transgender persons aged 18 years and older who experience major depressive episodes (MDEs).
- NWS 10L: Reduce the proportion of lesbian and bisexual female adolescents who are considered obese.
- SA 13L: Reduce the proportion of lesbians’, gay males’, bisexuals’, and transgender persons’ past-month use of illicit drugs.
- SA 14L: Reduce the proportion of lesbian, gay males, and bisexual persons engaging in binge drinking of alcoholic beverages.
- TU 1L: Reduce tobacco use by lesbian, gay men, and transgender adults.
It’s great that they have identified priority objectives for LGBT people, but they even went further, they talked about data!
The Call for LGBT Inclusion in Health Surveys!
“A major difficulty in examining LGBT health relates to the availability of data for analysis. According to the Healthy People website,11 “Sexual orientation and gender identity questions are not asked on most national or state surveys, making it difficult to estimate the number of LGBT individuals and their health needs.” Therefore, the committee believes HHS should focus on improving and developing datasets that will facilitate analysis of disparities in LGBT health, thereby leading to action that can improve the quality of life and well-being of LGBT populations.” p. 43.
Hear hear, we agree heartily. And face it, if one more government policy doc comes out suggesting LGBT data inclusion, it’s going to be pretty hard to keep excluding us!
Read the whole report on the Institute of Medicine website.