The Network

for LGBT Tobacco Control

Big News! Report on the National Center for Transgender Equality Survey

Emilia Dunham, Network Program Associate

by Emilia Dunham

Program Associate, reporting at Creating Change

As you may know, we’re thrilled for the report of the largest ever national survey on transgender people. We are proud to have been involved in the development on inclusive of questions on tobacco and alcohol, but more than that, it’s great to finally have some sort of national data on transgender people at many levels. The information in this survey involves a myriad of issues and the National Gay and Lesbian Task Force just released factsheets on those results. You may have seen the data on the October 2010 study but this report deals with what can be done and what this data means.

As you might imagine, there is discrimination in virtually all areas which I will share a little below.

Education: 59% bullied by teachers attempted suicide, which is ridiculous as teachers should be the ones supporting and protecting students. Some were even expelled for their gender identity.

Employment:  For those trans people who have jobs, 90% were harassed or mistreated which is such an astounding number. Many are fired, denied access to bathrooms. We experience extreme poverty with 4x more likely to earn less than $10,000.

Housing: 20% refused housing. Only half as many of us own homes as compared to general population. Many are also denied housing.

Public Accommodations: Half of trans people have been assaulted in public spaces. 1/5 denied government equal treatment.

ID Documents: 40% were harassed when presenting IDs and many are unable to update government ID records.

Health: ½ have had to educate providers just basic Trans 101. Many do not have insurance and experience discrimination. HIV, alcohol, tobacco rates are much higher in trans populations. 41% suicide rate (compared with 1.6% of general population; general population of depressed people only have 20%)


I’ve talked a lot about some absolutely chilling horrifying facts, but it’s important to know there are positive aspects and things we can do about these disparities. Despite high discrimination and harassment, 78% who transitioned at work felt better. Many return to school after transitioning and trans people actually have more education than the general population.

What can we do? Recommendations:

  • We all have a role to play (health providers, employers, police, general public, etc).
  • Policy changes are vital at all levels
  • Research: the data is available online for folks to analyze
  • Share the information with ourselves, our coalitions
  • Keep all areas of our society accountable in whatever you way you can!

For more information on these documents:

“Injustice at Every Turn by the National Gay and Lesbian Task Force and the National Center for Transgender Equality (NCTE) **Newly released**

National Transgender Discrimination Survey Report on health and health care by the National Center for Transgender Equality and the National Gay and Lesbian Task Force

Go to for more information on this study, its uses, the data and implications.

February 5, 2011 Posted by | Creating Change, Creating Change 2011 | 3 Comments

Anti-LGBT Bias Violence and Reporting

Emilia Dunham, Network Program Associate

by Emilia Dunham

Program Associate, reporting at Creating Change workshop: National Reporting and Data-Driven Advocacy: Ending Anti-LGBTQ Violence with the NCAVP

Today I attending a workshop on a familiar subject: LGBTQ biased violence. At Northeastern, I was involved with our Campus Center on Violence Against Women, realizing how little resources and information was provided and known about LGBTQ survivors. Fortunately I was able to work with the supportive program to raise more awareness and create more support for us. After taking an LGBTQ inclusive course on family violence. However after this workshop I realized how seldom this knowledge is available. Below I want to share the reality of the picture and what can be done.



  • In recent years, even with more calls to the police from LGBTQ survivors there are high rates of police misconduct (harassment) and false arrests (arresting both partners).
  • Of anti-LGBTQ hate crimes, 79% were against people of color, 50% of those murdered were transgender women
  • Despite enactment of Matthew Shepard Act, there were still significant cuts to anti-violence LGBT programs
  • Law enforcement, prosecutors, general violence programs don’t work with LGBT violence programs.
  • 84% precincts reported no kinds of hate crimes at all (even race), so we shouldn’t focus on prevalence so much as whether these crimes exist
  • Coincidences of LGBT bias hate-crimes with national LGBT news (national conversation on LGBT issues like marriage)



  • Collect more expansive and exhaustive demographic information
  • To collect different types of violence: sexual violence and pick-up violence (against sex workers)
  • Organizations are the ones doing the reporting
  • Data is the story: organizations collect quantitative and qualitative data

What can be done? (effective suggestions)

  • Use data to show need for funding to support this great work
  • Get LGBTQ inclusion in the Violence Against Woman Act grant. With that hope, LGBTQ anti-violence programs may receive more funding and allow training.
  • Legislative visits (Lobbying, protocol shifts)
  • Grants and education (statements of need, demonstrate national coalition work and services provided for funders)
  • Training and education (numbers and reports needed, present models of promising practices)
  • Promoting policy change and shifts (illustrate how policies contribute to and are sources of violence with specifics, show how increased funding can make a difference, show evidenced-based practice)
  • Community organizing (compelling statistics can be used for promotion/media, awareness-raising campaigns)

February 5, 2011 Posted by | Creating Change, Creating Change 2011 | 2 Comments

Sodomy to Fare Evasion: Evolving LGBT Criminal Defense and Health Effects


Emilia Dunham, Network Program Associate

by Emilia Dunham

Program Associate, Reporting from Creating Change on “Beyond Lawrence V. Texas”

Sodomy: you may know it’s been decriminalized for the past 8 years, but across the country many LGBT people are still unnecessarily criminalized. Though it’s not technically a crime to be LGBT, LGBT people are disproportionately affected by random offenses like loitering and prostitution (real or perceived). Frankly it was humbling to realize how easy it was someone’s life to be completely ruined by reasons nearly out of their control, how privileged I am, and how many of us no idea how many issues affect our whole community.

You might not be surprised that laws in Louisianna are particularly bias against LGBT people (40% of all cases). The laws are so asinine and extreme that two charges of prostitution could land you on the sex offender list for life! With the offense you have to send postcards to pretty much everyone imaginable. The worst part is that they put a huge orange stamp on your ID so that everyone who sees it knows you are on the sex offender list. Can you imagine how terrible that would make your life?

You’d think New York City would be better, but unfortunately in some precints, 100% of all loitering offenses involve LGBT people. Even fare evasion charges are largely against LGBTQ poor people. NY laws also enforce that trying to talk with strangers, loitering and even carrying condoms indicate an intent to prostitute which is enough to be arrested. As a result, many sex workers and homeless LGBTQ refuse to take condoms despite understanding of health concerns.

So what does this have to do with health? Folks who are dispropriately targetted by these crimes have a very difficult time accessing health insurance through any sort of public aid because of their charges. Additionally, it’s incredibly difficult and often impossible to clear their records, placing a barrier to jobs with health insurance. Thus, when we think about health disparities in our communities and issues of access to care, we should be thinking of  the broader picture. We should do more to include those communities that are most affected by this profiling in our public health research, advocacy, work: low-socio-economic, trans women, feminine gay men and gender non-conforming people. Clearly when folks are refusing to carry condoms because of policy, we should be focusing on deeper avenues of public health work.

February 5, 2011 Posted by | Creating Change, Creating Change 2011, Uncategorized | 2 Comments

Designing a Survey Using Data to Gain Protections for LGBT People

Emilia Dunham, Network Program Associate

by Emilia Dunham

Program Associate

Reporting on Creating Change

This morning I attended a workshop on what has become an important but broken record in our community: LGBT data collection with Cristy Mallory, Jody Herman, and Masen Davis. 

They discussed some of the best practices for developing and including questions on sexual orientation and gender identity. You may be familiar with recommendations of the Sexual Minority Assessment Research Team (SMART) for instance.

In this workshops the presentors discussed the survey process in the form of questions to ask your research team when planning surveys:

  1. what is the goal?
  2. who is the target?
  3. what resources are available?
  4. how will you reach people? (what is your promotion strategy?)
  5. how to get high response rate? (incentive: start with money; next is community based appeal)
  6. how do you design your survey and what questions do you ask? (consider existing surveys, define terms, do not use jargon, add “don’t know/refused to answer”)
  7. how will you collect and analyze the data? (clean data to remove non-target)
  8. how will you write-up and distribute the results?
  9. how will you utilize the results to achieve original goal? (to advocate, improve programs, etc)

California Case Study

Masen Davis of the Transgender Law Center discussed their study of trans Californians. The strategy was to use existing strong networks, effectivelymade practical use of staff time and volunteers, incentives and many other means. Fortunately the results of the survey was very successful as it can show what’s needed for other surveys and more importantly it gives you data you need. For instance it showed that among CA trans people, there are significant issues of homelessness, income gaps, health disparities, etc.

The need for data may be familiar to most of us: It’s hard to show proof of discrimination, unemployment, health disparities without data, even when that is known in communities. The end goal being that data can be used to access funding from government.

The California State Trans Study Report is a great example of what can be done to successfully achieve research, data and policy goals.

February 4, 2011 Posted by | Creating Change, Creating Change 2011, Uncategorized | 2 Comments

Welcome from Minneapolis (Creating Change)

Emilia Dunham, Network Program Associate

by Emilia Dunham

Network Program Associate

Due to another blizzard (just business as usual at this point), I safely flew a day earlier to Minneapolis, MN for Creating Change and arrived mid-day.

With my activities starting tomorrow I just wanted to write a “Welcome from Minneapolis” and introduce some of the exciting things I have the opportunity to be involved with this jam-packed, amazing week.

For this conference I have the honor of representing two fabulous organizations. I of course will be representing The Network, and you will be seeing updates from me throughout the week about workshops and other activities we are involved in.

I also have the distinction of serving as the Chair of NYAC’s Youth Kicks! Committee and will be attending Creating Change with the other committee members. Youth Kicks (or YK!) is a committee of 10 youth/young adults chosen through an application process, working together toward developing a social marketing campaign to lessen the effects of smoking in the LGBTQ Youth community. I am proud to be part of such a talented group of people from across the country who have the potential to make a real difference.

Many of the YK! members will be at Creating Change, and while we are still in beginning stages, this will be the first time many of us will meet. While here, we will be working on a photo campaign to start some awareness raising and connecting folks with us. Come find us at Creating Change (bios and pics are here) or take part wherever you are. We’ll soon have some social media sites starting up.


Be sure to keep up on our blog. We have some fabulous blogging scholars who will be posting frequently on workshops and the conference in general that you’ll want to track. Visit our blog, watch our social media for updates or click our Creating Change 2011 link with all blog entries for this Conference.

Please join me in welcoming our special guest bloggers Dean Anderson, Megan Lee and former staff person Sasha Kaufmann!! You’ll hear from them soon.

February 1, 2011 Posted by | Creating Change, Creating Change 2011, social media, Uncategorized | 2 Comments

FDA’s Center for Tobacco Products Tweet Up Tomorrow #tobaccofreetweetup

The FDA’s Center for Tobacco Products is hosting a Tweet Up tomorrow. I am sure most you might have a couple questions around FDA Regulations of Tobacco. From trying to understand what it truly means, to finding ways to get involved here here is an opportunity to get some of your questions asked!

Below is communication sent directly from FDA’s Center for Tobacco Products:

Let’s Tweet Up!

We are planning a Tweet Up (#tobaccofreetweetup) with and on Twitter at 11am this Friday, January 7, 2011 to discuss cessation and the Tobacco Control Act.

We hope you and your stakeholders will join us for the Tweet Up and will use our resources!  You can send us your questions ahead of time on Twitter, @FDATobacco with the hashtag #tobaccofreetweetup, or via email at  We will answer your questions during the event via our Twitter profile, @FDATobacco.  We will do our very best to answer all questions submitted during the hour long “Tweet Up” session. However, we may not be able to get to them all.  Learn more at .

We appreciate your help spreading the word.  Below are some suggested tweets that you can share on your twitter profiles to help promote the Tweet Up and our resources:

  • New Year, new you! Let’s tweet up in 2011. Stay tuned for details. #tobaccofreetweetup. Visit  Please RT.
  • Get info on the #tobaccofreetweetup on 1/7 at 11am. Send questions to @FDAtobacco & learn about resources to use in 2011
  • Join FDA & for the #tobaccofreetweetup 1/7 at 11am.  Send @FDAtobacco your questions

January 6, 2011 Posted by | Uncategorized | Leave a comment

Sharing Our Lessons 4: From Queer Youth to Public Health Leader


by Emilia Dunham

We are pleased to announce the release of our 4th edition of our Sharing our Lessons series:

From Queer Youth to Public Health Leader. A Case Study of Engaging and Mentoring LGBT Youth into Tobacco Control Leadership.”

Interview by Steering Committee member Kitty Jerome of Steering Committee member Ernesto Dominguez

With our Sharing our Lessons series we hope to highlight activities happening in the field of LGBT tobacco control and share the stories and voices of those fighting the good fight against big tobacco. We will be mailing out copies of this new document to our mailing list, if you would like a hard copy and are not on our mailing list please email us.

The document is available online on our resource library as well.

December 21, 2010 Posted by | Uncategorized | Leave a comment


by Emilia Dunham

With the help of Scout, I performed a policy review on the draft framework for the THE NATIONAL PREVENTION AND HEALTH PROMOTION STRATEGY.

This draft was developed as the result of a September 15, 2010 meeting that the Surgeon General convened of the National Prevention and Health Promotion Council (the Council). They agreed on the framework for the National Prevention and Health Promotion Strategy (National Prevention Strategy) which includes the Vision, Goals, and Strategic Directions. The Council will use the framework to guide development of the National Prevention Strategy.

The National Prevention Strategy represents a historic opportunity to bring prevention and wellness to the forefront of our national conversation on health. A focus on prevention will offer an opportunity to not only improve the health of Americans, but also help to reduce health care costs and improve quality of care. By concentrating on the underlying drivers of chronic diseases, we will help to shift the nation from today’s “sick-care” system to a “health care” system that encourages health and well-being, while maintaining state-of-the-art medicine.

To view the draft we reviewed, see their PDF online.

A copy of our review is available on our website.

Comments We Submitted (also available on our website)

1. What are your general suggestions on the development of the National Prevention and Health Promotion Strategy (National Prevention Strategy)

The National Prevention Strategy strongly addresses health equity within its Strategic Directions and guiding principles.  These directions effectively address preventative causes of death and disability by developing actions to counteract these factors.  However, we have a number of recommendations to ensure specific inclusion of disproportionately at-risk populations such as the LGBT population.

2. What are your thoughts on the following elements of the Draft Framework:

Vision/Goals: We recommend defining the term “community” to extend beyond geography as many social/community networks transcend the geographical boundaries that necessarily constrain state and local governments.  If the definition of community is limited to geography, key social networks may be shortchanged from exerting the influence that can mobilize their constituencies.

3. What recommendations should be included in the National Prevention Strategy to advance the Draft Strategic Directions?

  • Recommendation 1: In the second paragraph under “Additional Information on the Framework,” in reference to “a number of conditions that disproportionately affect certain sub‐populations (e.g., racial/ethnic groups, specific age groups, gender)” add “sexual orientation” and “gender identity,” and consider replacing “gender” with “sex” for clarity.
  • Recommendation 2: Within the “Draft Strategic Direction” Table, Strategic Direction: “Address Specific Populations’ Needs to Eliminate Health Disparities,” provide examples of health disparity measures such as “LGBT” and “Socio-Economic Status” on the Example Program of “Electronic health records to collect/analyze data on health disparities measures.”
  • Recommendation 3: Within the “Draft Strategic Direction” Table, on the fifth Strategic Direction: “Healthy Physical and Social Environment,” consider adding “work”, “socialize” and “go to school” (i.e. Most Americans do not live, work, socialize or attend schoolin communities that optimize healthy behaviors).  This addition connotes that health disparities are experienced via membership in a broader definition of communities, not limited to geography.  An example program could be in promoting clean indoor air at workplaces, clubs and community centers.
  • Recommendation 4: The Draft Table’s sixth “Strategic Direction: High Impact, Quality Clinical Preventive Services” rationale “Half of Americans do not receive recommended preventative care” could be expanded to add “and that figure increases for many populations experiencing health disparities.”  A further Example Program of that Strategic goal could be: “Provide cultural competency for providers to sensitively and appropriately treat at-risks populations (e.g. LGBT, low-SES, racial/ethnic minorities, persons with disabilities, elderly).”
  • Recommendation 5: The Draft Table’s seventh “Strategic Direction: Injury-Free Living” may consider that some populations (e.g. LGBT, racial/ethnic minorities, religious minorities) suffer from bias-related violence not always enforced or protected within the criminal justice system.
  • Recommendation 6: For the Draft Table’s eighth “Strategic Direction: Mental and Emotional Wellbeing,” an additional Example Program could include “Ensure inclusion of vulnerable populations traditionally marginalized from/within mental health services (e.g. LGBT).”
  • Recommendation 7: In the Draft Table’s tenth “Strategic Direction: Tobacco-Free Living” an Example Program could include “Address populations affected by tobacco health disparities (e.g. LGBT, low-SES, racial/ethnic minorities) through culturally tailored counter-marketing and quit programs.”

4. Do you have suggestions for how the National Prevention Council can work with state, local, tribal governments, non-profit, or private partners to promote prevention and wellness?

Research has increasingly shown that social change is hugely facilitated by two factors: environmental norms and social networks (as discussed in the books Connected and Switched).  Thus we make two suggestions for working with local governments. A. Emphasize policy/environmental changes such as building bike lanes, clean air legislation, and passing non-discrimination laws protecting LGBT youth in schools from harassment. B. Encourage governments to partner with community nexus organizations that can be change leaders for wellness in social networks, such as community based organizations for disparity populations (e.g. LGBT equality groups, African American churches, immigrant rights groups).

Additionally, we respectfully suggest that the National Prevention Council consider how to work with community nexus groups that engage social/community networks that transcend the geographical boundaries that necessarily constrain state and local governments.  If resources, information, and partnerships continue to remain entrenched in geographically bounded organizations, key social networks may be shortchanged from exerting the influence that can mobilize their constituencies.  The Prevention Council should seriously consider working with national community-based organizations as well as the local governmental agencies.

We also request that the National Prevention Council encourage all government and agency partners to include traditionally excluded and/or underserved populations experiencing health disparities within their programs, goals, funding announcements, and research.

5. What prior federal prevention and health promotion efforts could serve as a model for the National Prevention Council?

The integration of community leaders through Ryan White Planning Councils was one model that showed great promise in creating a bidirectional flow of information and innovation, from federal to local level and vice versa.  Lessons from this can be used to create an even more successful wellness community council that engages disparate community leaders at a local level.  This community group can generate ideas for local innovation, then flow successful innovations to the national level for further study and replication.

December 7, 2010 Posted by | Uncategorized | 2 Comments

Healthy People 2020 Launch Report on Webinar

by Emilia Dunham

reporting on the Healthy People 2020 Launch webinar, hosted in DC on December 2nd, 2020.

With over 5,000 people registered to view this webinar, this event marks the release of the Nation’s health promotion and disease prevention objectives for the decade. Despite some technical difficulties @lgbttobacco, @scoutout and HP 2020’s own twitter feed @gohealthypeople have updates on the presentation.

HHS Assistant Secretary for Health, Dr. Howard Koh introduced the presentation with some opening words on their 30 year commitment to a healthy future. Dr. Jonathan Fielding provided an overview of HP 2020’s framework and process, including short- and long-term implementation efforts in “Recommendations for Implementing Healthy People 2020.”

Fortunately, we have Scout on the ground reporting who participated in the launch event as well as asking questions. He asked the important question of whether organizations serving LGBTs will be added to federal Requests for Funding Announcements (RFAs) such as the Communities Putting Prevention to Work (CPPW) grants. HHS Assistant Secretary for Health, Dr. Howard Koh responded by saying they are looking at data collection options to expand into LGBT, low Socio-Economic Status (SES) and geography. Dr. Koh also mentioned the cross-HHS LGBT Task Force they convened (there are some folks on here who can help make some real changes.) He also talked about how they were trying to formally expand the definition of disparity populations to include LGBT, people of low socioeconomic status, and people with disabilities. They discussed the cycle of social determinants as pictured in the diagram here in how it affects so many areas that LGBT people are so acquainted with.

At the end, as means to symbolically and literally build community, attendees were asked to meet one another. As a particular impressive moment, the Surgeon General Benjamin personally thanked the Network for its advocacy on behalf of the LGBT communities. The picture at the bottom shows Scout with another one of our supporters, Director of the shop responsible for Healthy People 2020, HHS Office of Disease Prevention and Health Promotion’s Rear Admiral Penny Slade-Sawyer.

Can you see how LGBT is on the cover?

To keep up on announcements, changes and other news about HP 2020, they have a linkedin profile.

They can be followed on twitter, which also has updates on the event from earlier today (many have been retweeted at @lgbttobacco)

Of course, their website has boatloads of information on it.

We have the documents online:

Healthy People 2020 Bisexual People’s Heatlh Fact Sheet

Healthy People 2020 Gay Men’s Health Fact Sheet

Healthy People 2020 Transgender People Health Fact Sheet

Healthy People 2020 Lesbian People’s Fact Sheet

Healthy People 2020 Healthy Companion Document

Have questions? Email or ask us at

Scout and Rear Admiral Penny Slade-Sawyer

December 2, 2010 Posted by | Uncategorized | 1 Comment

LGBT Surveillance: Next Steps for the Federal Government Summary

On Monday, November 22nd, we held a BrownBag Webinar called “LGBT Surveillance: Next Steps for the Federal Government.” The call focused on a discussion on federal opportunities for LGBT data to be considered for inclusion in national surveillance (surveys).

The crux of the conversation’s goal was to gather Lessons Learned from stories that callers shared on gathering LGBT data on the state level. In our highest attended BrownBag, participants shared their strategies for LGBT inclusion as well as barriers that have come up in that process. Scout introduced the call by requesting stories on state LGBT data implementation that can be used to help the federal government in whether/how they would include LGBT data questions on national surveys.

Among the reasons LGBT data has been left off national surveys, several myths circulate on why exclusion continues. For instance, surveyors fear higher refusal rates, break-off rates and confusion from respondents taking these surveys.

Current National Surveillance Efforts:

o       Despite failed efforts to include GLBT questions on the national Census, researchers are studying same-sex partner data gathered from the survey.

o       DHHS is including LGBT health measures on their major health survey (National Health Institute Survey : NHIS) but that is still within the works.

o       The National Adult Tobacco Survey includes multiple questions on LGBT as a singular question.

o       CDC sponsored survey on LGBT data in the United States in “Sexual behavior and selected health measures: Men and women 15–44 years of age

o       A group of researchers and advocates are working on a document for how gender identity questions can be added to national surveys (i.e. education, health.)

State Experiences

  • New York: City Health Department in NYC had a strong experience with adding sexual orientation and gender identity

o       Unexpected positive outcome: Mainstream scientists are excited about looking at LGBT data because they care about health disparities showing that LGBT data collection is not just a minority issue.

o       Positive Outcome: Multiple surveys point to LGBT data

  • California: California Health Interview Survey (CHIS) has included sexual orientation (not gender identity)

o       Barrier and Solution: When respondents are confused, the protocol is to reinforce the need for complete understanding of demographics/disparate populations and that no one is forced to answer the question.

  • Illinois – YRBS – does not include LGB, but Chicago does include a question asking folks “Which best describes you ‘gay’, ‘bisexual’, ‘lesbian’, ‘not sure”
  • New Mexico – NM has made a lot of progress in adding LGBT measure

o       Strides: “Sexual orientation” was added to both the Adult Tobacco Survey (ATS) in 2003 and the Behavioral Risk Factor Surveillance System (BRFS) in 2005.  Since 2009, both surveys added a question including “transgender”.

o       Barriers and Solutions:

  • A few participants questioned why LGB was asked, but confusion why that was added was explained.
  • In early years, there was confusion from 65+ year old individuals about LGB questions, so NM limited how many seniors received that question as many responded with “I don’t know.”
  • Lack of youth data is a major gap that needs to be filled. Since 2005, advocates and researchers have been proposing that “sexual attraction” to be added to the Youth Risk Behavior Surveillance System (YRBS) as no LGBT questions are currently asked on this major survey for youth.

o       Positive Outcome: NM APHA data paper from 2003-2009 showed refusal rates of sexual orientation question in BRFSS to only be .8- 1.8% which compares with refusal rates for other categories like 4.1-4.5% on household income.

  • Ohio – Led focus LGBT focus groups with reports on what was asked as well as transcripts for the groups. Another report is here.

o       Barrier: There weren’t enough respondents

Resources on LGBT data collection and best practices

Next Steps:

  • Please send emails or comment here with experiences of “Lessons Learned” at
  • We are looking for folks who have information on who has adult tobacco, YRBS, BRFFS, Quitlines
  • Another call continuing discussion will be announced.
  • A separate call on program data may be useful for folks who are looking for assistance on including LGBT data themselves.

November 29, 2010 Posted by | Presentations, social media, Uncategorized | , , | Leave a comment

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