Showing posts with label Health Care LGBTQ. Show all posts
Showing posts with label Health Care LGBTQ. Show all posts

March 19, 2020

LGBT Community Might Be At Greater Risk of COVID-19

More than 100 organizations sent an open letter to medical groups and the news media stating that LGBT people are at greater risk from the novel coronavirus due to other social and medical issues that affect the LGBT community. 
Scout, who goes by one name, is a bisexual and trans man who is the deputy director of the National LGBT Cancer Network. That organization took the initiative on drafting the letter, which was released March 11, and gathering co-signers.
Local organizations that signed the letter include Equality California, Horizons Foundation, National Center for Lesbian Rights, the San Francisco LGBT Community Center, and the Transgender Law Center.
The letter highlights three issues that may put LGBTs at greater risk during the COVID-19 epidemic: higher tobacco use than among the general population, higher rates of cancer and HIV-infection, and instances of discrimination on account of sexual orientation and gender identity (COVID-19 is the respiratory disease caused by the novel coronavirus.)
"We're really concerned because we know that whenever there's a health issue, the pre-loaded issues in our community create an issue for us," Scout, a Ph.D., said in a phone interview with the Bay Area Reporter March 16. "We have more social isolation, more smoking. But we know how to offset that. As coronavirus expands so fast, we wanted to let the public health community know we can take steps to avoid another health disparity."
Scout said that offsetting the effects of these risk factors involve keeping community organizations appraised of governmental decision-making. 
"We have a lot of community organizations we trust and a lot of government entities we don't trust — for good reason," Scout said. "The first step is for community organizations to connect with public health channels to get communicated information out."
He said that it was very helpful that the New York State Lesbian, Gay, Bisexual and Transgender Health & Human Services Network had the chance to speak with Governor Andrew M. Cuomo (D).
"Someone asked 'where will we go to get tested without anti-trans discrimination?' And the governor was able to say 'the state is doing the testing and you know we have strong protections, so call me at this number if anyone experiences it,'" Scout said. "That's the kind of support we need."
Officials from the California LGBTQ Health and Human Services Network did not respond to a B.A.R. request for comment at press time. 
The letter notes that COVID-19 is particularly harmful to smokers, and LGBTs have a 50% higher smoking rate than the general population, according to a 2017 study. LGBT seniors, like their heterosexual, cisgender counterparts, are at higher risk if they become infected with the novel coronavirus. 
One of the goals of the letter is, as it states, "ensuring that media coverage notes the particular vulnerabilities of any person with pre-existing respiratory illnesses, compromised immune systems or who uses tobacco products. While populations — like LGBTQ+ communities — can be at increased risk, it is important to note the overall state of health that contributes to any person's increased vulnerability to contracting COVID-19."
Scout noted that trans people often face discrimination in social environments and medicine is no exception. 
"We have a horrible history of access to care," he said. "There's not a trans person I know who has been openly welcomed in medical care throughout their whole life. Many of us are underemployed, making it harder to access health care."
Social distancing, which is being employed to deal with the crisis, may also have effects of its own.
"Other issues of comorbidity — suicide, depression — for all these reasons our lives are complicated with stigma and discrimination," Scout said.
But Scout is hopeful that from social distancing will emerge new ways for people to keep in touch.
"I think we're going to see new, really creative ideas on how to connect in the near future," Scout said. "But for now, every single person — especially those who struggle with depression — should remember how vital social connection is to our health.
"Use video chat, connect with a community center, connect online with people with shared hobbies. We have to find new ways to connect because that is more important to our health than any of us realize," he said.
HIV and coronavirus
As the B.A.R. previously reported, the amount that HIV-positive people are at a heightened risk of contracting or dying from COVID-19 depends on their level of immunosuppression.
"For an HIV patient who is on stable antiretroviral therapy and has a normal CD4 count, their risk may be slightly increased," Dr. Steve Pergam of the Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Research Center wrote in an email to the B.A.R. last week. "HIV is a different disease than it was years ago. For people who have a reconstituted immune system because of treatment, I think the risk is not going to be tremendously different."
Scout is the deputy director of the National LGBT Cancer Network. Photo: Courtesy LinkedIn
 Scout is the deputy director of the National LGBT Cancer Network. Photo: Courtesy LinkedIn  

Scout said that people with HIV may also suffer from other factors in their lives. 
"If you do not have your virus well-managed, get more motivation to get it well-managed," Scout said. "We don't know if people with an undetectable viral load have higher risk, but we obviously know there's too many people — we're not in a perfect world — with HIV and people with HIV sometimes have other factors in their lives, like addiction, poverty and racial discrimination. 
"All of our lives are a complicated algebra equation," he added.
To avoid COVID-19, the San Francisco Department of Public Health is advising people to wash their hands with soap and water for at least 20 seconds, avoid touching their faces, cover their coughs and sneezes, try alternatives to the handshake, and stay home if they are sick.
It is not recommended people wear face masks if they are not sick. The greatest risk is from droplets containing the coronavirus on surfaces.
People over 60, those with chronic medical conditions, and those with weakened immune systems are at particular risk if they contract the coronavirus. According to the Centers for Disease Control and Prevention, symptoms of COVID-19 include a fever, cough, and shortness of breath. More serious cases result in pneumonia.
(LGBTQ Agenda is an online column that appears weekly, usually on Tuesdays. Got a tip on queer news? Contact John Ferrannini at

November 7, 2019

HHS Broads The Field For Opt Outs Against LGBT in Health

             Image result for hhs health against lgbt
Drawing immediate and widespread condemnation, the Trump administration on November 1 proposed a new rule giving recipients of Department of Health and Human Services (HHS) funding — including adoption and foster care agencies — the ability to discriminate on the basis of sex, sexual orientation, gender identity, and religion.
The rule, which would unravel President Barack Obama’s 2016 rule banning recipients of HHS funding from discrimination, marks the latest development in a visible rightward shift at HHS under the Trump administration. The move came roughly six months after HHS unveiled a proposal that erased Obamacare rules protecting individuals on the basis of gender identity and sexual orientation and nine months after the agency granted taxpayer-funded foster care agencies in South Carolina with an exemption from HHS nondiscrimination rules.
The rule was unveiled on a Friday afternoon, but that didn’t stop LGBTQ groups, progressive religious organizations, advocates for seniors, and others from sounding alarms about the anticipated effects of the rule. Governor Andrew Cuomo of New York has vowed to challenge the rule in courts. 
If finalized, the rule would apply broadly, affecting foster care agencies, HIV prevention services, senior care offerings, and other recipients of federal funding from HHS. 
HHS claimed in a November 1 statement that the rule realigns the agency in accordance with the Constitution, federal statutes, and Supreme Court decisions. The administration contends that those precedents and laws prevent the government from infringing on religious freedom, but said nothing about the way in which the latest rule impacts LGBTQ Americans. 
The Coalition for Homeless Youth, which is dedicated to assisting runaway and homeless youth and consists of dozens of New York-based member organizations ranging from the Ali Forney Center to the Hetrick-Martin Institute, pointed to the high percentage of homeless LGBTQ youth as it blasted the most recent proposed rule.
“Today’s rule sent a clear message that this administration doesn’t care about [LGBT youth’s] well-being,” Jamie Powlovich, the coalition’s executive director, said. “This is not okay.”
Advocacy and Services for LGBT Elders (SAGE), an organization dedicated to serving the needs of queer seniors, noted in a written statement that the rule targets programs benefitting seniors and warned that “their access to their programs is at risk.”
“This latest announcement from the Trump administration is yet another salvo in the war the administration has conducted against the most basic rights of LGBT people,” SAGE said. “In this year that marks the 50th anniversary of the Stonewall uprising, enough is enough. The federal government should be championing non-discrimination protections, not advancing discrimina­tion.”
Mara Keisling, executive director of the National Center for Transgender Equality, described Trump’s move as “an abuse of taxpayer dollars” in the name of “empowering hatred and bigotry towards society’s most vulnerable members.”
“Stigma and prejudice are fueling a public health crisis among transgender people across the country, one that manifests itself as suicide, addiction, intimate partner violence, and HIV,” Keisling said. “Enabling providers of life-saving services to worsen these crises by rejecting transgender people is a moral crime and a severe abdication of HHS’s mission to preserve public health.”
ACT UP New York also voiced outrage, saying in a tweet that the rule “will disproportionately impact our queer, trans, and non-binary siblings and HIV and STI related initiatives. Shame on this administration for attempting to erase us.”
Like all other proposed rules, there will be a waiting period during which folks can submit feedback to the administration via comments. In the meantime, Cuomo, who called the move “heartless and dumb as it would deny countless children a loving family and a safe place to call home,” said in a tweet that he would take legal action against the administration, but did not elaborate upon his plans.
Expectedly, Trump’s proposal drew praise from religious leaders who hailed the move as a win for religious liberty. The United States Conference of Catholic Bishops unveiled a rosy statement commending the administration and griping about the Obama-era rule.
“To restrict faith-based organizati­ons’ work by infringing on religious freedom — as the 2016 rule threatened to do — is unfair and serves no one, especially the children in need of these services,” the group stated. “We welcome today’s proposed rule modifications and look forward to reviewing and commenting on them further.”
New Ways Ministry, a group dedicated to LGBTQ Catholics, specifically called out the bishops for their support of a proposal that New Ways said: “is not for the poor, but harshly against them.”
“This new rule, now in effect, will damage thousands and potentially millions of Americans lives,” New Ways Ministry’s associate director, Robert Shine, said in a written statement. “Children in need of foster or adoptive parents will be deprived of loving homes as their potential parents face discrimination. And some of society’s most vulnerable groups who already struggle, like youth experiencing homelessness, people living with HIV, and those seeking treatment for addiction, will have their sufferings compounded.”

October 16, 2019

In Boston An LGBTQ Gym Empowers The Community For Physical Health

Justice Williams with gym-goers and kettlebells at CORE in Brookline, Mass.
Robin Lubbock/WBUR

On a recent Sunday in a tiny gym just outside of Boston, physical trainer Justice Williams teaches Leo Morris a stretch called the Brettzel.
"Yasss," Williams shouts. "There you go. Elbows down."
"Jesus," Morris says, exhausted.
"Yass," Williams shouts again. "And hold. Very nice."
Morris, who is nonbinary and uses they/them pronouns, is among about 10 people working out who identify as gay, trans and/or queer.
This is "Queer Gym." It's one of a few workout spaces explicitly for LGBTQ folks that's cropped up in North America in recent years. Williams, who started this pop-up gym, says it's a place where people can work out if they're in the LGBTQ+ community and don't feel comfortable in regular gyms. He says going to a gym can be an awkward experience for many people, but that vulnerability is amplified when your body or mannerisms don't conform to people's interpretation of how you should be.
"[Gyms] are hyper-masculine, they're toxic, they're about an aesthetic," Williams says. "Being part of the LGBT community, I've observed and noticed that people don't feel comfortable in gyms today."
Morris, who Williams is teaching how to Brettzel stretch, recently had top surgery — which is an operation to remove breast tissue to reflect a person's gender expression.
"My body looks a little bit different than a lot of the other peoples' who are in the gym," they say.
Justice Williams talks Eddie Maisonet through a crawl to side kick.
Robin Lubbock/WBUR

And Morris says that causes some people to stare.
"When you're working out, you just want to focus on your workout. But when you know that other people are staring at you and then sometimes talking about you, it can be distracting," Morris says. "It can be demoralizing, you know when you're supposed to be pumping yourself up in the gym."
Eddie Maisonet, who is trans, says he wears sleeveless shirts when he works out and has also noticed people staring at the scars from his top surgery. But Maisonet says at Queer Gym, the visibility is only positive.
"Here, we're looking at each other, but we're so supportive," he says. "It's people trying to take pointers or make sure you're not hurting yourself as opposed to feeling like a spectacle."
Maisonet says other physical trainers he's worked with didn't know how to work with trans people. But Williams does.
"If I tell Justice, 'yo, this hurts', he'll give me a modification or tell me to take a break," Maisonet says. "So, I feel listened to and I feel a lot stronger, and that kind of confidence — there are not many places in my life where I can get that."
Creating confidence is why Williams says he became a personal trainer. Williams is trans, too. Ten years ago Williams needed to lose weight before taking testosterone, and couldn't find a personal trainer who understood his journey.
"And that forced me to learn on my own so that I could teach the proper way to work out, to be in my body, to polish my armor," Williams says.
And today, Williams' armor couldn't be shinier. Now, he's hoping to offer that protection to whoever comes to Queer Gym, a place he says honors queer people's existence. He says the ultimate goal is to arm people in his community with the confidence to navigate all gyms.
But until then, Williams says he'll try to keep Queer Gym around for as long as necessary. 

August 6, 2019

New Study Shows LGBT Cancer Survivors Receive Less Follow Up Care and Screening

                                      Image result for lgbt cancer survivors

New research shows the difficulties many LGBT people face, even after they beat cancer.

A study of more than 70,000 cancer survivors conducted by Boston University researchers shows that LGBT cancer survivors receive less access to follow-up care for preventing and detecting recurrences, and screening for long-term effects of cancer treatments than their heterosexual counterparts.
That can lead such sexual minorities, especially LGBT women, to suffer from poorer mental and physical health post-cancer in a country where there could be more than 1 million LGBT cancer survivors in need of care.

"There is a silent epidemic," says study author Uli Boehmer, an associate professor of community health sciences at the Boston University School of Public Health.

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The research adds to evidence suggesting the LGBT community faces discrimination and insensitivity in health care.

Boehmer notes that LGBT people, especially women, are more likely to have jobs that do not provide health insurance and also struggle more often to afford co-payments for follow-up visits.

Furthermore, the study highlights a significant lack of data collection about LGBT cancer survivors' experiences with medical care, suggesting doctors don't yet know the extent of the problem.

Boehmer, who has studied cancer in the LGBT community for more than 30 years, says the fight to bridge the knowledge gap remains frustrating.

"We don't even have data yet on the types of treatments they get or if they're being treated according to guidelines or not," says Boehmer. "We need to chip away at this big black hole where we know very little about what's going on."

August 4, 2019

Trump Obamare Changes Goes After The Health of Gay, Transgender in The US

LGBTQ rights have come a long way in the U.S. But the community still faces threats in the form of legalization, discrimination and even violence. Just the FAQs, USA TODAY

Trump's proposal would put LGBTQ lives at risk. The right to health cannot be obfuscated by the political or social beliefs of others. 

Katherine Archuleta , Opinion contributor

As a former director of the U.S. Office of Personnel Management under President Barack Obama, I oversaw the federal government’s 2-million-strong civilian workforce on everything from human resource policy to retirement benefits to health care. This included implementation of all regulations outlined in the Affordable Care Act, including Section 1557 which prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs or activities.
This section covers discrimination on the basis of gender identity, but the Trump-Pence White House has needlessly proposed a new regulation that would cruelly strip the ACA of specific protections for LGBTQ patients, specifically transgender people. This proposed regulation callously puts lives at risk, and it’s imperative the American people make their voices heard on why this it is dangerous and unacceptable.
On June 14, the Department of Health and Human Services (HHS) published a proposed regulation based on a court's outrageous claim that the ACA's protection against discrimination on the basis of gender identity is “likely unlawful.”  This initiated a 60-day public comment period that runs through Aug. 12. In a press release sent out by HHS, Roger Severino, the Director of the department's Office of Civil Rights, offered this ratonale: “When Congress prohibited sex discrimination, it did so according to the plain meaning of the term, and we are making our regulations conform.”

Denying care over personal beliefs 

This is a bad faith and incorrect view of “sex discrimination,” but it’s unsurprising coming from Mr. Severino. His long history of attacking the civil rights of LGBTQ people and women includes calling same-sex marriage part of a “radical” agenda, defending the abusive practice of so-called “conversion therapy, and espousing anti-choice opinions, even at the expense of an individual’s health care. He has said that being LGBTQ is “against your biology” and stated that sexual orientation, when compared to race, is an issue of “character.” 
This is not a person who prioritizes the health and safety of all Americans but, rather, consistently seeks to push his personal beliefs on the citizens who look to him for quality and safety in our their health care system.
Over the past two decades, federal courts have made it clear that sex discrimination under the Civil Rights Act of 1964 covers LGBTQ people due to discrimination based on sex stereotyping. Numerous federal agencies, including the Equal Employment Opportunity Commission, have reaffirmed this interpretation and incorporated it into their policies.
Simply put, there is longstanding precedent for ensuring LGBTQ people, particularly transgender people, are free from discrimination in health care spaces, which makes this administration’s attacks on the medical access of LGBTQ people all the more heinous.

Don't inflict harm on LGBTQ people

All medical access for all LGBTQ people and their loved ones is affected by this proposed regulation and the blanket "religious freedom" exemptions it would offer: a gay man who goes into the emergency room with a broken arm, a lesbian with cancer, a bisexual person with diabetes, a trans child getting immunizations prior to the start of the school year. This regulation goes against everything medical science has fought to make clear: that the right to health cannot be obfuscated by the political or social beliefs of others.
In a 2009 survey echoed in later studies, Lambda Legal found that 56% of lesbian, gay and bisexual people and 70% of transgender and gender non-conforming people reported experiencing discrimination by health care providers — including refusal of care, harsh language and physical roughness because of their sexual orientation or gender identity. In a free society that places human rights and life above personal beliefs and petty differences, that is unacceptable.
It is imperative the public submit comments urging the Trump-Pence White House and HHS to abandon this reckless proposed regulation that would inflict cruel and unnecessary harm on marginalized communities.
Katherine Archuleta is a founding partner at Dimension Strategies and was the director of the Office of Personnel Management under President Barack Obama. Follow her on Twitter: @Archuleta2012
You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to

June 4, 2019

As LGBT Boomers Grow Old

Image result for lgbt retirement
First retirenment home for LGBT in Sweeden

JoNel Aleccia and Melissa Bailey, The Washington Post

Two years ago, nursing professor Kim Acquaviva asked a group of home-care nurses whether they thought she was going to hell for being a lesbian. It's OK if you do, Acquaviva said, but is the afterlife within your scope of practice?

After Acquaviva's talk, an older nurse announced she would change how she treats LGBT people under her care. 

"I still think you're going to hell, but I'm going to stop telling patients that," the nurse told Acquaviva.
Acquaviva, a professor at George Washington University School of Nursing in Washington, raised the example at a panel hosted by Kaiser Health News on inclusive care for LGBT seniors. It was one of many examples of discrimination that these older adults may face as they seek medical care.

LGBT baby boomers, dubbed "the Stonewall Generation," came of age just as the 1969 New York uprising galvanized a push for gay rights. After living through an era of unprecedented social change, they're facing new challenges as they grow old.

"Fifty years after Stonewall, there's a new generation of LGBT elders who never thought they'd get an AARP card," said Nii-Quartelai-Quartey, AARP's senior adviser and national liaison on the issue who also participated in the panel.

By 2030, there will be an estimated 7 million LGBT people in the United States over 50. About 4.7 million of them will need elder care and services, according to SAGE, an advocacy group.
In a country where most elder care is left to family, many LGBT people are estranged from relatives and don't have that option. Turning to others for care - in assisted-living centers, nursing homes or hospice settings - makes them uniquely vulnerable.

"The fear of living in a situation where they can't advocate for their own care and safety is terrifying," said Hilary Meyer, chief enterprise and innovation officer for SAGE.

Three-quarters of LGBT people are worried about having adequate family or social supports, according to a nationally representative survey of AARP members released last year.
More than a third said they are concerned that they'll have to hide their identity to find suitable housing as they age. And at least 60 percent are concerned about neglect, harassment, and abuse, the survey showed.

Often, those fears are founded, according to results of a forthcoming survey of more than 850 hospice and palliative care providers about LGBT patients and family experiences.
"I think the information we've got is actually quite discouraging and quite concerning," said Gary Stein, a professor at the Wurzweiler School of Social Work at Yeshiva University who co-led the project.

Most providers surveyed said LGBT people received discriminatory care, he said. For transgender patients, two-thirds said that was true.

Caregivers reported hundreds of examples of disrespectful treatment, Stein said.
When LGBT couples would hold hands, staff "might roll their eyes, make faces at each other," he said. They often failed to consult the patients' partners, directing questions to biological family members instead.

In several instances, staff would "try to pray" to the patient or their family, Stein said.
Some LGBT patients were left in soiled diapers or rationed pain medication in a "punishing way" because of their sexual identity, he added.

"For transgender patients, there was lots of discomfort around what to call the person," Stein said. "A number of people said patients were called 'it' instead of a pronoun."
Twenty states have laws that specifically protect LGBT people against discrimination, but most don't, Stein noted. A recently enacted Trump administration "conscience rule" allows providers to decline to provide care that goes against their moral or spiritual beliefs. Advocates said the new rule could make it easier to discriminate against LGBT people.

Still, a growing number of senior housing and care sites are putting nondiscrimination policies in place and training personnel to provide LGBT-inclusive care.
The SAGE staff has trained more than 50,000 people at more than 300 sites nationwide, Meyer said. They learn best practices for asking questions that don't perpetuate stigma.

"It's even something as simple as asking somebody, a woman if her husband will be visiting," said Meyer, noting that the question forces the person to decide whether to announce her sexual identity. "Having to come out of the closet that way can be very challenging."

In a few high-profile instances, LGBT couples or individuals have sued providers for discrimination.
In 2016, Lambda Legal, a gay advocacy group, sued an Illinois senior residential facility for failing to protect Marsha Wetzel, 70, a disabled lesbian, from harassment and violence by other residents. The U.S. Court of Appeals for the 7th Circuit ruled that a landlord may be held liable under the Fair Housing Act for failing to protect a tenant from known discriminatory harassment by other tenants.
Karen Loewy, Wetzel's attorney, would say only that "the matter has been resolved," and Wetzel is now living at a Chicago-area facility.

Last summer, in Missouri, a married lesbian couple, Mary Walsh, 73, and Bev Nance, 69, sued a senior-living facility that denied their housing application. The Friendship Village assisted-living center cited a "cohabitation policy" that defines marriage as between one man and one woman as the reason.

A U.S. district judge dismissed the lawsuit in January, saying that their claims of discrimination were "based on sexual orientation rather than sex alone." The distinction is important because neither federal nor state laws explicitly prohibit discrimination based on sexual orientation. The lawsuit was stayed pending Supreme Court decisions that could affect the outcome.

In the meantime, the couple has remained in their single-family home, where Walsh has developed health problems, said their attorney, Julie Wilensky of the National Center for Lesbian Rights.
"They wanted to be planning in advance so that they would have stability when issues might come up in the future," Wilensky said.
Not every LGBT person will want to step forward in the way Wetzel, Walsh, and Nance have, Loewy, said.

"When you feel like you're being denied care . . . you may not want to be out there to wave the banner," she said.
Finding an LGBT-tolerant facility can be difficult. People are often bound by geography, and options are limited.

Still, LGBT people and their families can - and should - have candid conversations with potential caregivers before they make a choice, Loewy said.

One key question: Ask what kind of experience staff have working with LGBT people.
"If they say they haven't [treated any such patients], don't believe them," Loewy said. "You want to hear a really clear commitment to ensuring every resident of this facility is going to be treated with dignity."
- - -
This report was produced by Kaiser Health News, a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

July 24, 2018

Trump Wants Regulatory Changes to Make it More Difficult for LGBT to Obtain Medical Help

The Trump administration is considering regulatory changes that would worsen barriers many lesbian, gay, bisexual, and transgender (LGBT) people in the United States face in obtaining health care, Human Rights Watch said in a report released today. The US Department of Health and Human Services (HHS) should reconsider those changes, which would leave LGBT people more vulnerable to discrimination.

The 34-page report, “‘You Don’t Want Second Best’: Anti-LGBT Discrimination in US Health Care,” documents some of the obstacles that LGBT people face when seeking mental and physical health care services. Many LGBT people are unable to find services in their area, encounter discrimination or refusals of service in healthcare settings, or delay or forego care because of concerns of mistreatment.

“Discrimination puts LGBT people at heightened risk for a range of health issues, from depression and addiction to cancer and chronic conditions,” said Ryan Thoreson, an LGBT rights researcher at Human Rights Watch. “Instead of treating those disparities as a public health issue, HHS is developing politicized rules that will make them much worse.”

Two upcoming regulatory changes are likely to worsen these barriers, Human Rights Watch said. In January 2018, HHS issued a proposed rule that would broaden existing religious exemptions in health care law, giving sweeping discretion to insurers and providers to deny service to patients because of their moral or religious beliefs. In April 2018, the Trump administration announced plans to roll back a regulation that clarifies that federal law prohibits health care discrimination based on gender identity. If finalized, these changes would further undermine the limited antidiscrimination protections that currently exist for LGBT people.

Human Rights Watch interviewed 81 people for the report, including providers and individuals who said they had experienced discrimination in healthcare settings.

July 23, 2018 Report
“You Don’t Want Second Best”
Anti-LGBT Discrimination in US Health Care
Existing protections for LGBT people in health care are uneven. In 2016, the Obama administration issued a regulation clarifying that Section 1557 of the Affordable Care Act, which prohibits sex discrimination in health care, also prohibits discrimination against transgender people. Eight states and religious health care providers challenged the regulation in court, and the Trump administration has signaled it plans to roll it back.

Protections at the state level are lacking. As of July 2018, 37 states do not expressly ban health insurance discrimination based on sexual orientation or gender identity. New Jersey prohibits discrimination based on gender identity but not sexual orientation. In 10 US states, transition-related health care is expressly excluded from Medicaid coverage, limiting options for low-income transgender people.

LGBT people interviewed for the report described difficulty finding hormone replacement therapy, HIV prevention and treatment options, fertility and reproductive services, and even just welcoming primary care services. Judith N., a transgender woman in East Tennessee, said, “I spent years looking for access to therapy and hormones and I just couldn’t find it.”

Others described discriminatory treatment by providers. Trevor L., a gay man in Memphis, recalled an incident when he took an HIV test at his annual checkup in 2016: “and they sat down and started preaching to me – not biblical things, but saying, you know this is not appropriate, I can help you with counseling, and I was like, oh, thank you, I’ve been out for 20 years and I think I’m okay. It’s almost like they feel they have the right to tell you that it’s wrong.”

In addition to discrimination, many LGBT people are refused services outright because of their sexual orientation or gender identity. In a nationally representative survey conducted by the Center for American Progress in 2017, 8 percent of lesbian, gay, and bisexual respondents and 29 percent of transgender respondents reported that a healthcare provider had refused to see them because of their sexual orientation or gender identity in the past year. Interviewees described being denied counseling and therapy, refused fertility treatments, denied a checkup or other primary care services, and in one instance, told that a pediatrician’s religious beliefs precluded her from evaluating a same-sex couple’s 6-day-old child.

Both providers and LGBT people noted that concerns about discrimination and mistreatment led LGBT people to delay or forego care. A 2015 survey of almost 28,000 transgender people found that, in the year preceding the survey, 23 percent did not seek care they needed because of concern about mistreatment based on gender identity.

Many interviewees expressed concern that laws permitting providers to refuse service on moral or religious grounds would make care even harder to obtain. Persephone Webb, a transgender activist in Knoxville, Tennessee, said that “[i]t tells people who are prone to being bigoted to be a little braver, and a little braver. And we see through this – we know this is an attack on LGBT people.”

Instead of finalizing the proposed changes, HHS should preserve antidiscrimination protections and withdraw sweeping exemptions that put patients at risk, Human Rights Watch said. Lawmakers at the state and federal level should prohibit discrimination in health care on the basis of sexual orientation and gender identity and should repeal exemptions that allow providers to refuse to serve patients because of their sexual orientation or gender identity.

“When LGBT people seek medical care, the oath to do no harm too often gives way to judgment and discrimination,” Thoreson said. “Lawmakers need to make clear that patients come first, regardless of their sexual orientation or gender identity.”

March 20, 2018

LGBT Inclusive Hospice Care

Cover of
Cover of "LGBTQ-Inclusive Hospice and Palliative Care "
Discrimination against LGBT people is unacceptable in any instance. But it is particularly unforgiveable when encountered in a hospice or palliative care environment.
When an LGBT person has a serious or life-limiting illness and seeks palliative care or hospice care, they run the risk of isolation and marginalization at the precise time when they most need support. LGBT family members of straight patients seeking hospice care are also vulnerable.
A 2016 survey quoted in The Atlantic article “LGBT Seniors Are Being Pushed Back Into the Closet” by David R. Wheeler,” found that LGBT seniors were frequently mistreated by care-center staff. Abuse  included cases of verbal and physical harassment and refusal of basic services. Some respondents reported being prayed for and warned they might ‘go to hell’ for their sexual orientation or gender identity.” Stripped of any sense of comfort while facing a serious illness some find their situation all the more excruciating. LGBT adults who’ve already experienced a lifetime of discrimination may be particularly vulnerable as they seek out care.
When seeking LGBT-inclusive hospice and palliative care for ourselves or a loved one, it is critically important to know what to look for. In the handbook for hospice and palliative care professionals, LGBTQ-Inclusive Hospice and Palliative Care by Kimberly D. Acquaviva (Harrington Park Press) offers guidelines that translate easily into advice for those seeking palliative and end-of-life care. It is the Book of the Year for Palliative Care and Hospice category from the American Journal of Nursing.
Beyond sensitivity training in caring for LGBT patients, the handbook reiterates the broader tenet of never assuming anything about patients, family members, colleagues, or employees. Never assume the gender a person identifies as or the pronouns they want used to refer to themselves. Never make assumptions about how a person wants to be addressed, never assume that an LGBT person’s family either rejects or embraces theim and never assume anything regarding spirituality.
The handbook discusses how to conduct an inclusive “intake interview” and how to understand complex family dynamics. It offers guidance on topics that may not be as obvious, but are equally critical, such as whether or not an LGBT healthcare professional should disclose their gender identity and/or sexual orientation in an effort to bond with the patient. Professionals need to be mindful of not inadvertently “outing” patients whose sex anatomy and gender identity do not match by using their preferred gender pronouns, and making sure patients’ wishes are legally protected with a healthcare power of attorney.
For those searching for a hospice or palliative care organization, one of the most important things to look for is a prominently displayed, LGBT-inclusive, nondiscrimination statement.
The statement should, at minimum, include the phrases “gender identity” and “sexual orientation,” in addition to the other phrases that commonly appear in nondiscrimination statements. The statement should appear on the organization’s website homepage — not buried on some other page and be included in any printed marketing materials.
Type the terms “LGBT,” LGBTQ,” “gay,” “lesbian,” “bisexual,” “transgender,” “discrimination,” “gender identity,”  gender expression,” or “sexual orientation” into any search boxes embedded on the organization’s homepage. It should yield a link to the nondiscrimination statement.
In order for a hospice or palliative care employees also feel safe, comfortable, and valued. Look at the organization’s non-discrimination statement to make sure it protects LGBT employees. Also, look for staff diversity that don’t appear awkward, forced, or worse, stock photos of crayon-box lineups. Ads in LGBT newspapers and websites, an information booth at a local LGBT Pride festival, and availability of an LGBT bereavement group is ideal.
There’s an easy way to assess how inclusive a hospice or palliative care program really is: If you visit the program’s offices just look for gender-neutral bathrooms. A willingness to address the needs of ALL people by installing gender-neutral bathrooms is a pretty good indication of its commitment to LGBT inclusivity.
LGBTQ-Inclusive Hospice and Palliative Care is published by Harrington Park Press, and distributed by Columbia University Press.

It is adamfoxie's 10th🦊Anniversay. 10 years witnessing the world and bringing you a pieace whcih is ussually not getting its due coverage.

January 19, 2018

Trump"s Conscience Law Will Allow Medical Personnel from Attending to Gays


 No abortions for you hnoey but you can have the cross of Christ and his love for people like me

Health care workers who want to refuse to treat patients because of religious or moral beliefs will have a new defender in the Trump administration.

The top civil rights official at the Department of Health and Human Services is creating the Division of Conscience and Religious Freedom to protect doctors, nurses and other health care workers who refuse to take part in procedures like abortion or treat certain people because of moral or religious objections.

"Never forget that religious freedom is a primary freedom, that it is a civil right that deserves enforcement and respect," said Roger Severino, the director of HHS's Office for Civil Rights, at a ceremony to announce the new division.

The establishment of the division reverses an Obama-era policy that barred health care workers from refusing to treat transgender individuals or people who have had or are seeking abortions.

That Obama rule was challenged in court by the Franciscan Alliance, a Christian health care organization in Texas, and a judge in 2016 blocked enforcement as the case played out in court.

The new division appears to be primarily aimed at preventing health care workers from participating in abortion services that go against their religious beliefs. The division cites a 2011 federal regulation guiding the enforcement of conscience protections that mentions abortion more than 30 times.
Louise Melling, deputy legal director at the American Civil Liberties Union, said those conscience objections could expand to allow health workers to refuse some services to gay, lesbian and transgender people.

"This administration has taken a very expansive view of religious liberty," she said in an interview. "It understands religious liberty to override antidiscrimination principles."

HHS makes clear that it won't allow gender discrimination that is banned by federal law. The question, according to Melling, is whether the administration includes gender identity and sexual orientation in the definition of gender.

She says there are many examples of health workers refusing care on religious grounds, including a nurse who didn't want to provide post-operative care to a woman who had an abortion, a pediatrician who declined to see a child because his parents were lesbians and a fertility doctor who didn't want to provide services to a lesbian couple.

Acting HHS Secretary Eric Hargan said Thursday that is the point.

"For too long too many of these health care practitioners have been bullied and discriminated against because of their religious beliefs and moral conviction," he said.

The government, he said, has "hounded religious hospitals and the men and women who staff them, forcing them to provide and refer for services that violate their consciences."

The new division won't have to wait to get to work. A pediatric nurse at the Winnebago County Health Department in Illinois filed a complaint with HHS on Tuesday because she objects to her employer requiring that she be trained to make referrals to providers of abortion services or to help woman get abortion drugs, according to the Rockford Register Star.

This isn't the first time in the Trump administration that HHS's Office of Civil Rights has moved to protect people with moral or religious objections to some kinds of health care. In October, the agency allowed employers to refuse to pay for birth control coverage.

"Health providers should have the ability to live their religious beliefs without fear of workplace discrimination," said Sen. James Lankford, R-Okla., in a statement.

Lankford has long advocated for such protections and has sponsored a bill called the Conscience Protection Act to codify the rules.

HHS head Roger Semerino (Former Director, DeVos Center for Religion and Civil Society, Institute for Family, Community, and Opportunity)

The media spends a lot of time tracking Donald Trump’s every move and chasing down members of Congress, but much of governing happens in these bland halls. Under Trump, HHS may see more changes than any other agency, in part because the president’s predecessor left his biggest mark here. As Congress stalls on passing a new health-care bill, the Trump administration can still fight Obamacare with revised regulations, rejiggered budgets, and lackluster enforcement. 

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