Research has previously demonstrated that ballot initiatives to ban same-sex marriage create psychological stress for the gay community, and new analysis from a massive National Institutes of Health study has confirmed the same effect. Around 2004, NIH began conducting interviews for a massive mental health survey, then followed up with the same participants a year later. In the 13 states that approved constitutional amendments banning same-sex marriage that year, there was a sharp increase in psychological disorders among people who identified as gay, lesbian or bisexual, according to Columbia University psychologist Mark Hatzenbuehler:

“Lesbian, gay and bisexual individuals who lived in the states that banned same sex marriage experienced a significant increase in psychiatric disorders,” Hatzenbuehler says.

“There was a 37 percent increase in mood disorders,” he says, “a 42 percent increase in alcohol-use disorders, and — I think really strikingly — a 248 percent increase in generalized anxiety disorders.”

To put those numbers in perspective, although Hatzenbuehler did find more than a doubling in the rate of anxiety disorders in states that eventually banned gay marriage, in absolute numbers he found that anxiety disorders went from being reported among 2.7 percent to 9.4 percent of gay, lesbian and bisexual people.

The effect was unique to members of the gay community and unique to those states, not occurring among LGB people in states that didn’t have ballot measures that year. Hatzenbuehler attributes the psychological stress to negative media portrayals, anti-gay graffiti, a general loss of safety, and a feeling of directly targeted for discrimination.

Conservatives regularly claim that there are “health consequences” associated with being gay, but they rarely admit that it’s their rhetoric and tactics that are responsible.

 

AARP strives to serve the interests of all people over the age of 50, and that includes members of the LGBT community. The organization has a webpage dedicated to AARP Pride, with resources related to issues like marriage equality’s legal benefits, nondiscrimination protections in nursing homes, and unique health concerns like HIV. Because of AARP’s inclusiveness, the American Family Association is specifically targeting the retirement group for contributing money to the “homosexual agenda.” AFA Executive Vice President Buddy Smith offered this warning:

SMITH: When you reach the age of a person like myself and you begin to get information from the AARP saying that they will represent you and your values and standards, you’d better be careful. This group is a very, very powerful Washington lobby, and you just may be very surprised and disappointed to see those things that they are promoting and those things they are opposing.

Be very careful that you know what your fees are going for because the AARP is not on your side. If you are a Christian and believe in Biblical values, you can pretty much count on the fact that everything that you are in favor of, the AARP is opposing.

LGBT older adults face many unique challenges, especially in regards to their very economic well-being. Because of discrimination and alienation throughout their lifetime, as well as their inability to claim partner benefits like Social Security, LGBT older adults are much more likely to be living in isolation and poverty. It makes perfect sense that AARP would recognize that a segment of its constituency experiences particularly troubling circumstances and could use additional support. Conservatives, like AFA’s own Bryan Fischer, have long claimed that gay men die early because of HIV and other supposed consequences of “homosexual behavior,” so perhaps Smith thinks AARP should be a straights-only organization because he believes it already is.

If AARP is supporting the “homosexual agenda,” then that agenda is merely survival.

The U.S. Preventive Services Task Force (USPSTF) has issued new recommendations on who should be routinely screened for HIV infection. Previously, USPSTF released recommendations that only high-risk individuals should be screened for HIV. Specifically, it concluded that “the benefit of screening adolescents and adults without risk factors for HIV is too small relative to potential harms to justify a general recommendation.” In November, the USPSTF issued draft recommendations that all adolescents and adults, regardless of high-risk, should be routinely screened for HIV infection. As of yesterday, those draft recommendations became final. In a statement issued yesterday, USPSTF issued a final recommendation officially proposing that all individuals ages 15–65 should be screened for HIV infection, including pregnant women who are unaware of their HIV status.

According to the CDC, nearly 1.2 million Americans are now living with HIV, and approximately 20 to 25 percent are unaware of their positive status. Each year, about 50,000 people become infected with HIV. The USPSTF now recommends that people ages 15-65 should be tested at least once in their life, with more frequent screenings for higher-risk individuals, including men who have sex with men (MSM), individuals engaging in unprotected sex, or sharing needles with a HIV-infected person.

This much-needed change has three significant benefits:

• First, USPSTF’s recommendation could reduce the spread of HIV infections across the country. People who are screened will receive an earlier diagnosis, and can start medical treatment and lessen spreading HIV to others. Recommending the screening of all adults — ages 15-65 — will help to not isolate those who are “high-risk,” by instead focusing on everyone to promote healthier and longer lives.

• Second, recommending that adults ages 15-65 receive routine HIV screening could reduce stigma and discrimination of those who may be infected. According to Ban Ki-Moon, Secretary-General of the United Nations, “Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so … Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world.” Stigma prevents many individuals from receiving HIV testing and preventative care, and this new recommendation from high-risk to adolescents and adults will likely be beneficial.

• Third, under the Affordable Care Act, insurers must cover preventive services recommended by the USPSTF without copay, co-insurance, or deductible — this means that many individuals will now have more affordable access to HIV screenings.

The new USPSTF recommendation is a major advancement in public health, and will help thousands of American take control of their health by becoming aware of their HIV status.

Preston Mitchum is a Policy Analyst with LGBT Progress.

Texas Attorney General Greg Abbott (R) has issued new guidance stating that domestic partnerships are unconstitutional under the Texas state Constitution’s amendment banning marriage for same-sex couples. However, his decision does contain a certain nuance that would still allow for same-sex couples to receive their partners’ health benefits. Abbott points out that recognizing relationships “similar” to marriage — like domestic partnerships — is unconstitutional, but, citing a lawmaker’s remarks when Texas passed its marriage amendment, he explains that the health benefits themselves are:

Representative Chisum’s statement simply explains that article I, section 32 does not, in his view, address whether a political subdivision may provide health benefits to the unmarried partner of an employee. The constitutional provision does, however, explicitly prohibit a political subdivision from creating or recognizing a legal status identical or similar to marriage. The political subdivisions you ask about have not simply provided health benefits to the partners of their employees. Instead, they have elected to create a domestic partnership status that is similar to marriage. Further, they have recognized that status by making it the sole basis on which health benefits may be conferred on the domestic partners of employees.

This presents a challenging space for employers who wish to recognize same-sex couples. The primary criterion that Abbott explains is problematic to domestic partnerships is that the requirement for their recognition is too similar to marriage, including that applicants must attest that they are not married and have no undissolved relational conflicts. Hypothetically, municipalities could offer employees the opportunity to designate a single beneficiary without requiring such qualifications for recognition and thus not violate the constitution at all.

Of course, Abbott’s opinion is nonbinding, and thus nothing is preventing domestic partnerships from continuing — only a court responding to a legal challenge could invalidate them. Currently, Dallas County and the cities of Austin, Dallas, El Paso, Fort Worth, and San Antonio, as well as Pflugerville School District, all offer domestic partnerships. Pflugerville was undoubtedly the specific target for the request for Abbott’s guidance, but district officials say the December decision to offer the benefits was simply a business decision by the insurance committee that does not cost the district or the taxpayers.

Last week, the Vermont Department of Financial Regulation, Division of Insurance issued a bulletin clarifying key protections for transgender Vermonters in health insurance. The bulletin clarifies that Vermont law prohibits gender identity discrimination in health coverage, including through the use of exclusions limiting benefits for medically necessary services provided to transgender people.

The bulletin prohibits health insurers doing business in Vermont from unfairly excluding coverage for the care that transgender people need. The bulletin specifically states that:

• Medical necessity remains the fundamental standard of care and legal requirement for treatment provided to transgender people.
• Insurers cannot exclude coverage for medically necessary health care services for transgender people, including transition-related surgeries and other care provided for gender dysphoria and related conditions.
• Plans offered through Vermont’s Health Benefits Exchange are covered by the bulletin.

The bulletin also recognizes that the Affordable Care Act prohibits discrimination on the basis of gender identity in any health program receiving federal funds or by an entity established under the ACA, including Health Insurance Marketplaces.

Vermont joins a growing number of states, Including California, Colorado, Oregon, and the District of Columbia, in recognizing that removing unfair discrimination from health insurance does not raise costs, and is invaluable in helping transgender people lead healthy and authentic lives. Similar antidiscrimination policies are supported by expert medical bodies who say that the care provided to transgender people, including transition-related health care, is medically necessary for many patients.

Read the full bulletin and the FAQ.

 

Andrew Cray is a Policy Analyst for LGBT Progress.

The Philadelphia City Council passed a groundbreaking new bill advancing LGBT equality today with a sweeping 14-3 vote. Here are a few of the bill’s provisions:

• Businesses that offer employee health plans that include same-sex partners will receive a tax credit incentive.
• The city’s health care plan can not discriminate against non-union transgender city employees.
• There is also now a Transgender Health Tax Credit to allow companies to cover healthcare needs specific to people who are transgender.
• City buildings are now required to provide gender-neutral restrooms.
• The city’s nondiscrimination law now protects sexual orientation and gender identity, including public accommodations.

These simple changes will ensure that LGBT people have equal access to health services and the other benefits offered by the city. The comprehensive bill and the support it received will serve as a valuable role model for other cities to enact similar protections.

 

Today the Office of Minority Health at the Department of Health and Human Services released the new National Standards for Culturally and Linguistically Appropriate Services (CLAS). The new CLAS Standards, which have been under development for several years, are a groundbreaking response to increasing awareness of the factors that frequently prevent diverse populations such as the LGBT community from getting the health care that they need.

The Office of Minority Health established the original CLAS Standards in 2001 as a framework for advancing health equity, improving care quality, and eliminating health care disparities. The new standards go beyond this original framework by creating a blueprint for health care providers to implement culturally and linguistically appropriate services in order to help all patients achieve better health and health care.

Cultural competency is a major concern for LGBT people in health care settings across the U.S. Earlier this year in Missouri, for example, Roger Gorley was arrested and forcibly removed from his husband’s bedside when the hospital refused to recognize them as a family. And in a 2010 incident that is unfortunately not unique for transgender people, Erin Vaught was ridiculed as “it” and refused treatment for a lung condition at a hospital in Indiana after hospital personnel learned she was a transgender woman.

Following the example of initiatives such as the LGBT-inclusive nondiscrimination requirements from The Joint Commission, the new CLAS standards fully incorporate the concerns of LGBT people into the framework of culturally and linguistically appropriate care.

The implementation blueprint for the standards emphasizes that discrimination based on factors such as sexual orientation, gender identity, and gender expression impedes the provision of quality care and services. It calls on facilities and providers to provide all individuals with assurances that disrespect or discrimination of any kind is not tolerated.

Further, to help avoid expensive and dangerous conflicts related to cultural misunderstandings between providers and their patients, the blueprint encourages facilities and health care providers to undertake regular trainings on the needs of patients from different cultural backgrounds, including LGBT people.

The blueprint also underscores that demographic data, including data on sexual orientation and gender identity, are vital to the effective practice of cultural competency. They note that though LGBT data collection is not yet as standardized as other demographic data collection, the Department of Health and Human Services is developing a national data progression plan on sexual orientation and gender identity data and that the CLAS Standards implementation blueprint will be updated to reflect advances in this process.

Finally, the standards will have important ramifications for LGBT inclusion in other national health initiatives, such as the provision of culturally competent services by navigators and health insurance marketplaces under the Affordable Care Act. And with the growing understanding that very few health care professionals receive adequate preparation for working with LGBT patients, it is likely that the new CLAS Standards will help remind medical and other health professions schools of their responsibility for ensuring that health care providers are equipped to offer the highest quality of care to all their patients, including LGBT people.

As Tawara Goode, the director of the National Center for Cultural Competence at Georgetown University, summarized at this morning’s event marking the release of the new CLAS Standards, “some people think cultural competency is a workshop, and that they already took it.” But as she reminded the audience, cultural competency isn’t that simple — it is an ongoing processes of changing the culture in our health care system at every level in order to understand and respect the complex backgrounds of all patients.

Our guest blogger is Kellan Baker, Associate Director of LGBT Progress.

During a floor speech on Wednesday, Iowa state Sen. Dennis Guth (R) made a wide range of inflammatory and offensive remarks about LGBT Americans. Among other things, Guth claimed that homosexuality breeds mental health problems like depression, shortens people’s life spans, presents public health risks to straight Americans — including Guth’s family — and even contributes to the downfall of civilizations.

Radio Iowa chronicled Guth’s diatribe:

Guth said there are “numerous” health and mental problems associated with homosexuality that “ultimately” shorten the lives of gays and lesbians.

“There are health risks that my family incurs because of the increase of sexually transmitted infections that this lifestyle invites. For example, there are more and more medical tests required before giving blood or giving birth,” Guth said.

Guth said “many civilizations have fallen” because the traditional family was not protected and he argued the homosexual lifestyle “is a lie.”

“If I saw someone going the wrong way on a one-way street, I would make every effort to stop and redirect them,” Guth said. “Simply put, it saves lives to have honest communication not only about the sexually transmitted diseases that shorten lifespans, but also about the deep loneliness that accompanies a life based on youth, beauty and sex.”

You can listen to Guth’s entire speech here.

As Guth’s fellow Sen. Matt McCoy (D) pointed out after the speech, Guth’s accusations are ignorant and based on talking points from hard-right Christian and social conservative groups, not science. In fact, increasing acceptance of LGBT communities decreases societal stigma surrounding homosexuality and consequently improves LGBT Americans’ mental health; Guth’s family would be equally at risk for sexually transmitted infections from straight people if they don’t use safe sex practices; and both the medical community and lawmakers from both parties agree that barriers to LGBT Americans donating blood and organs is an outdated relic not supported by any actual public health risks.

Universities across the country have LGBT Resource Centers to provide support services and programming that help create a safer and more inclusive learning environment for LGBT students, but Texas conservatives are taking aim at these facilities. Wednesday night, the Texas A&M University Student Senate voted 35-28 to pass what was renamed the “Religious Funding Exemption Bill,” which allows students to  opt-out of paying the portion of their student fees that goes toward the campus GLBT Resource Center — about $2 — if they have religious objections.

Apparently, the bill was expanded at the last minute so that it didn’t simply target the GLBT Resource Center, but the impracticality remains. After all, as an editorial in the student newspaper The Battalion points out today, a student could make an argument to “morally oppose” any campus service. University officials, who have final approval over any budget changes, explained that students are disallowed from paying the University Advancement Fee. Moreover, Student Body President John Claybrook has not decided if he might veto the bill, though he did win his position running against the bill’s sponsor, Thomas McNutt. Given that it passed with a narrower vote than was expected, it may not have the support to override such a veto.

Though it’s unclear this student-led attack on LGBT Aggies is enforceable, the state legislature is considering a broader change that very well could. Texas Rep. Bill Zedler (R) has filed an amendment to the state’s appropriations bill to cut funding for public universities that have “Gender and Sexuality Centers and Related Student Centers.” The amendment offensively claims that the centers promote behaviors that have a high risk for disease:

An institution of higher education may not use money appropriated to the institution under this Act, or any property or facility of the institution funded by appropriations under this Act, to support, promote, or encourage any behavior that would lead to high risk behavior for AIDS, HIV, Hepatitis B, or any sexually transmitted disease.

Many LGBT resource centers work directly with campus health services to promote safe sex practices and overall sexual health for all students — even those who aren’t LGBT. Zedler is simply implying that anything gay is therefore unhealthy, a stigmatizing stereotype not based on reality. Rep. Wayne Christian (R) attempted a similar measure blocking support for LGBT services in 2011, but Democratic opposition forced him to withdraw it. Texas lawmakers are considering several other bills this term that target schools for supporting LGBT students and employees.

There is one glimmer of good news for LGBT students in Texas. While A&M’s student government was busy voting for a religious right to discriminate, the University of Houston’s student government unanimously passed a resolution opposing Zedler’s amendment.