Tag Archives: transgender health

HIV and AIDS among Youth and Young Adults

Youth and young adults between the ages of 13 and 24 in the United States are among the highest risk groups of being infected with HIV. The CDC reports that the greatest number of new HIV infections within this age group are among gay and bisexual males, with African-American and Latino males who have sex with other men being at even greater risk.

Why is this population increasingly at risk? There are a myriad of reasons, including a lack of sexual education and information promoting abstinence and delaying initial sexual encounters. These groups are also among the highest populations suffering from substance abuse, homelessness, and sexually transmitted infections.

HIV and AIDS among Youth and Young AdultsLooking at global numbers, a young person becomes HIV-positive every 30 seconds. Studies have shown that the majority of youth and young adults in the U.S. are not afraid of contracting HIV, which equates to low testing rates and low rates of condom use. While there are an increasing number of HIV and AIDS awareness promotion programs, youth advocacy, and health counseling, the data translates to a dire need for greater outreach efforts.

The best way to prevent infection with HIV is abstinence. Secondly, reducing the number of sexual partners, avoiding unprotected sexual encounters, and being tested regularly are the most important steps you can take to prevent infection or spreading the virus. More than half of the percentage of youth infected with HIV/AIDS were not aware that they had the virus.

While many young adults are not concerned with contracting HIV, a large number are still in denial of the increasing risk of contracting and spreading the virus. Even if you think you are not at risk, it is recommended that you get tested regularly. Speak to a professional today, there are a number free test sites available as well as youth programs and counseling services .

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Seeking LGBTQ Healthcare in the United States

The healthcare system in the United States today is difficult to navigate at best, and Byzantine at worst. Unfortunately, the latter end of the spectrum is usually what LGBTQ couples seeking health coverage have to deal with. From the overwhelming amount of paperwork, to the alienation of having to “prove” a relationship via notary public, or some otherwise asinine bureaucratic document, to the very real threat of being terminated simply for coming out in the workplace (yes, it’s still perfectly legal to fire someone for being gay in 29 states), finding the proper health coverage as an LGBTQ couple can be nothing short of harrowing.

The system is so deeply flawed on such a macroeconomic scale, that many members of the LTBTQ community simply do not apply for health coverage, even when it’s made readily available. Hesitancy with regards to being open in a clinical setting about sexual orientation and gender identity lends to the growing number of LGBTQ persons opting out of regular treatment. In order to avoid this type of mismanagement, or neglect, several resources are available to the growing LGBTQ community.

Seeking LGBTQ Healthcare in the United StatesHealth Professionals Advancing LGBT Equality, formerly known as The Gay & Lesbian Medical Association, or GLMA, is an invaluable resource for the LGBTQ community at large. No registration is required, and any member of the community can simply log onto the website and search for a reputable LGBTQ-friendly healthcare provider.

The Strong Families Movement is another informative resource for LGBTQ families beginning the journey towards comprehensive health coverage. The link listed within this article is an instruction manual regarding where to start, what questions to ask, and how to determine which healthcare provider is right for your family.

What about those members of the LGBTQ community making an attempt to navigate the healthcare system on their own? The organization Out For Health not only tells the inexperienced where to begin, but contains an easy-to-access healthcare provider directory through the link above.

For those newly out, and ready to take charge of their health, following the simple tips and tricks in this list are necessary for finding a healthcare provider that provides a safe space, conducive to healing.

Seeking Interventions for Transgender Sex Workers at Risk of HIV

A key population at risk for HIV within the worldwide epidemic response has been overlooked, according to a new study: transgender sex workers, along with their clients, have been missing from HIV national surveillance and program interventions. One reason could be that their gender is often misclassified.

The study “HIV risk and preventive interventions in transgender women sex workers,” published in July in The Lancet, took a look at the knowledge gaps regarding transgender women and prevention interventions.

According to the study, when a legally authorized gender or gender appropriate identification is absent, it can heighten the discrimination a transgender person may face, restricting their access to adequate healthcare, education, employment, and voting rights. The combination of discrimination and stigma restricts their economic opportunities. Some transgender women have turned to sex work as a result to fund a livelihood that includes fees for gender-affirming hormones, injections, and surgeries so they appear more feminine and can increase their earning power. Transgender sex workers also receive community support from their peers and gender validation from their male clients.

Seeking Interventions for Transgender Sex Workers at Risk of HIV Sex work puts them in greater harm. The study indicates:

  • These women face an increased exposure to violence, reduced rates of condom use and increased risk of sexual transmitted infection.
  • Transgender women detained or imprisoned in connection with sex work are often placed in male facilities which places them at sexual risk and drug injection.
  • They are reported to participate in high levels of drug use and the use is often associated with sex with their partners and clients.
  • Many transgender women have faced stigma and discrimination in medical settings. Also, their costly surgical interventions are not always covered. As a result, some transgender women will needle-share or use contaminated needles for hormone or silicone injections.
  • When achieving feminization, erectile dysfunction can occur and interfere with correct condom use.
  • The new vaginal lining of transgender women can be subject to micro tears due to mechanical and physiological factors.

HIV is primarily transmitted in transgender women through condomless intercourse with male partners, the study says. It also shows that these women might be more likely to engage in condomless receptive anal intercourse with stable partners than with clients as a way of expressing intimacy. However, this sexual activity has been linked to higher rates of substance misuse, low self-esteem and self-efficacy. Few transgender women ask about the sexual status of their stable partners.

7 Ways to Improve Healthcare for the Transgender Patient

Many healthcare workers lack the training to deal with the unique issues the transgender community faces. While others disapprove of the lifestyle of the LGBT community for one reason or another. This can compromise the patients’ care.

That’s according to a new study in LGBT Health that discusses the issues the transgender patient faces and measures that can be taken by providers to improve care.

7 Ways to Improve Healthcare for the Transgender PatientThe transgender population struggles with social stigmas and rejection, and this experience has compounded in some medical settings, according to the study. The lack of cultural competency and knowledgeable physicians interferes with the patients’ ability to receive compassionate, knowledgeable and nonjudgmental healthcare.  Awkward doctor-patient interactions occur because many physicians lack training in transgender healthcare issues, such as how to approach the gender identity of the patient.

This is a problem because more than 7,000 transgender patients postpone medical care due to the discrimination they face, according to the National Transgender Discrimination Survey.  This group is at an increased risk for HIV infection and its related illnesses like depression, anxiety, suicide and substance abuse.

Healthcare facilities and workers at these organizations can take steps to improving transgender care by conducting an education campaign. Here are some ideas on how to start:

  1. Schedule a series of lectures from healthcare workers with specific training in transgender healthcare.
  2. Hold consumer panels with transgender individuals.
  3. Conduct cultural-sensitivity trainings.
  4. Make resources about transgender healthcare available to workers whether online or via printed materials.
  5. Post LGBT-friendly signs and welcome information at the facility and on the organization’s websites.
  6. Signal in your publications that your physicians are comfortable with transgender patients and knowledgeable about their unique care.
  7. Review office documents and update them accordingly to respectfully address the complex issue of gender identity, such as providing gender-neutral or transgender-inclusive terminology.

The cultural sensitivity provided at your healthcare facility can minimize barriers so transgender patients receive the care that they need. The study believes it will help prevent further health complications, build rapport within the transgender community and diminish healthcare delays.

Victories for Transgender Healthcare Rights

Victories for Transgender Healthcare RightsNew policy changes on the federal and state level are allowing more healthcare coverage for the transgender community.

In May, the Obama administration got rid of a 33-year old ban on Medicare coverage for gender reassignment surgery.  The government ban was put in place when the surgeries were considered experimental, but the Department of Health and Human Services pointed to recent medical studies showing that the exclusion of coverage wasn’t necessary. In fact, the American Medical Association and the American Psychological Association consider the surgery safe for those who suffer from gender dysphoria, which is a condition where a person is intensely uncomfortable with their birth’s sex.

The ruling doesn’t provide a guarantee that the surgeries are covered; instead, it allows individuals to demonstrate the need for the surgery like other medical treatments. The greater significance of this ruling is it now opens up more opportunities for transgender individuals. According to the Washington Post, private insurance plans tend to follow Medicare on what’s considered a medical necessary treatment.

On the state level, Massachusetts became the third state to make changes to its health care insurance to allow transgender related services full access to health care treatments. This includes gender reassignment surgery. The administration of Governor Deval Patrick also stopped private insurers from denying coverage.

Massachusetts joins California, Colorado, Connecticut, Oregon and Vermont in acknowledging and mandating transition care for transgender individuals as a significant part of medical coverage.

Earlier this year, the mayor of the nation’s capital clarified a policy that went into effect in 2013 in an attempt to help prevent residents from paying high out-of-pocket expenses for medically necessary treatment. Mayor Vincent Gray told health insurance providers in the District of Columbia that they must cover treatment for those diagnosed with gender dysphoria
such as gender reassignment surgeries.

The Public Employees Benefits Board Has Transgender Covered

The Public Employees Benefits Board Has Transgender CoveredTransgender individuals can face a number of complicated, unique health issues. They also have many mental grievances as statistics show a higher suicide rate than the general population. Being a minority, people of that identify as transgender have seen some hard times paying their medical expenses. The Public Employees Benefits Board of Washington state unanimously voted to end gender discrimination for coverage. Plans will be available for them covering office visits, hormonal therapy and psychological care as soon as January 2015.

The problem was brought to light months ago by advocates. Gender dysphoria issues are expensive to treat and most insurance policies today do not cover them. PEBB members state adding transgender individuals could potentially raise policies by $1.

The Public Employees Benefits Board Has Transgender CoveredPEBB also voted against raising insurance premiums. The Uniform Medical Plan currently covers 60% of the states employees, and rates are expected to go up $5 to $84 a month for a single policy while full family coverage will rise $14 for a $241 monthly charge.Sadly, not all are in favor of this reform. Executive Leader of the Washington Federation of State Employees, Greg Devereux, voted against it. “This is a tough one for me. I think providers and others should also take a hit in that regard“, claims Devereux.

“Providing the full range of services to transgender individuals is literally a matter of life and death. PEBB’s decision sends a clear message to transgender individuals that they matter, and paves the way for other employers to follow suit”, said Seth Kirby, board president of Pride Foundation. This reform is a great move for equal rights, and experts predict many may actually move to Washington from out-of-state so they may get coverage.

Transgender Children: Making the Change Early

Transgender Children: Making the Change EarlyWhile not a common issue, growing up feeling like your body is the wrong gender is a struggle. About 700,000 people in the U.S., or 0.3% of the population identify as transgender in 2014. This often translates into stress for individuals and families because society has rigid guidelines for how it identifies an individual’s gender. In a shocking 2013 study, 41 percent of 6,400 transgender respondents claimed to have attempted suicide. Becoming who we feel we are is a very important journey; one seven-year-old A.J. (who’s name has been changed for privacy concerns) would go on much sooner than the average person.

A.J. was originally born a boy, but not long after A.J. turned 3, things started to changed. At the time, he wanted longer hair. Mother, Debi, claimed A.J. “screamed and fought when I got out the clippers and got one cut down the side … there were tears… like torture.” He did not feel comfortable in his clothes, frequently telling his parents he wanted to wear dresses and jewelery. The victim of constant harassment, A.J. said “When I first, in the fourth grade, cut my hair they called me he-she.”

At 4 years old, A.J.’s parents took her to their pediatrician, who declared the then boy’s gender identity did not align with her then body. While much happier now, her (A.J.) parents expressed great difficulty with the transition. Many of A.J.’s childhood friends have been distanced. Her parents have transferred her to a new school and guarded her transgender status with secrecy; something they plan to continue to do, fearing the discrimination their daughter could face.

A.J.’s story is truly a testimony of the power of love and family. Her family are not only Southern Baptists, they are also Republican and generally do not support things like transitional surgery/therapy. A.J.’s mother says they are in no way pushing a liberal agenda, and was quoted stating, “There is a profound difference between wanting to be something in imaginary play and in declaring who you are insistently, consistently and persistently. Those are three markers that set transgender children apart, and my daughter displayed all of them.”

Of transgenderism, A.J.’s dad said, “It’s not something we asked for. It’s not something we wanted. It just happened. My thought process all along is I would rather have a happy, healthy little girl than a suicidal, dead son.”

Transition Care Covered: Maryland Insures Transgender Employees

Sailor Holobaugh, left, and his attorney Jer Welter
Sailor Holobaugh, left, and his attorney Jer Welter

Maryland’s state-provided health insurance plans now offers coverage for hormone therapy, gender reassignment surgery, and other transition-related medical issues for state employees. The result of legal negotiations in 31 year old Sailor Holobaugh’s discrimination case, the state approved reimbursement of Holobaugh’s prior transition-related medical costs and is shifting to a new standard for all employee health-care policies. Holobaugh remarked, “This is basically a fabulous shift in policy.”

This makes Maryland the third state to provide transgender individuals such coverage, following the path paved by Oregon and California. Holobaugh paid over $6,000 for a bilateral mastectomy as part of his transition. He claimed he was denied reimbursement by insurance provider Care First Blue Cross Blue Shield because of state-provided policy restrictions. In November of 2012, Holobaugh took the case to court, ultimately leading to state-wide reforms.

“Maryland has moved one step closer to achieving full equality and justice for transgender Marylanders. We celebrate this development, and look forward to a time when these discriminatory exclusions are removed from all public and private health insurance policies.” stated Aaron Merki, the executive director for Free State Legal, a nonprofit organization that represents lesbian, gay, bisexual and transgender clients in Maryland.

Holobaugh added, “It’s pretty exciting. I think this will affect a large number of people, especially now that children can stay on their parents’ plan until age 26 under the Affordable Care Act.”

The new coverage policy will extend to all state employees, retirees and dependents. It will cover mental health services, hormone therapy and surgeries tied to gender transition. The state is unsure how much these changes will cost. Also, there is currently no statement on retroactive reimbursement but Jer Welter, a managing attorney from Free State Legal, recommends transgender individuals to seek legal consultation, as it may very well be a possibility.

 

AIDS Convention Attacks Homophobic Laws

20th International AIDS Conference (AIDS 2014)

Campaigners at the World AIDS Conference in Melbourne, Australia shed light on anti-gay laws in countries across the world that they believe are promoting the spread of the disease. The issue boils down to a divide between pro-gay western countries and poorer countries with persistent anti-gay laws. Chair of the conference and co-discoverer of the virus, Nobel laureate Francoise Barre-Sinoussi, brought more attention to this global pandemic on Sunday; paying particular attention to minorities that hold a disproportionate burden due to the previously mentioned laws.

Nobel laureate Francoise Barre-Sinoussi speaking at the World AIDS Conference
Nobel laureate Francoise Barre-Sinoussi speaking at the World AIDS Conference

“The cruel reality is that in every region of the world, stigma and discrimination continue to be the main barriers to effective access to health,” Barre-Sinoussi said. “We need again to shout out loud that we will not stand idly by when governments, in violation of all human rights principles, are enforcing monstrous laws that only marginalize populations that are already the most vulnerable in society.”

A report issued by the U.N. agency UNAIDS declared 79 countries have criminalized same-sex relations, and seven of these countries issue the death sentence for any display of homosexuality. One of the major issues is the silence generated by jailing homosexuals; that is, it is impossible for them to get tested or recieve treatment while incarcerated. Furthermore, AIDS can unconsciously spread through the institution if those infected are unaware of their status. Therefore these countries are not only robbing homosexuals of equal rights, they are sentencing them to their death.

Human rights activist Kirby Michaels noted in a speech that western countries are growing tired of the large amount of funds they are donating in combating AIDS; about half of the $19 billion (USD) provided to fight AIDS in developing countries. “Someone must tell those who will not act the practical facts of life in our world,” questioned Kirby. “They cannot expect taxpayers in other countries to shell out, indefinitely, huge funds for antiretroviral drugs if they simply refuse to reform their own laws and policies to help their own citizens.”

France’s head of their National Agency for AIDS Reasearch (ANRS), Jean-Francios Delfraissey questioned the medical consequences if funding slowed. “I’m a doctor, so my reflex is to think that these countries need antiretrovirals like everyone, and we should not be punishing patients in the hope of getting a government to shift its position. However, the Fund is not just a bank, it’s a moral entity,” he said. “It can set general lines (for disbursement), so funding can be conditional.”

The argument many advocates made was aimed at changing anti-homosexual law, and raising AIDS awareness. There are is a substantial amount of money being spent to institutionalize people based on their sexuality which could easily be reverted to a number of programs that could benefit these countries’ economies or national health. Russia for example, has passed a legislation banning the distribution of any information regarding a gay sexual orientation. Not only does this force anyone homosexual into hiding, but it deturs them from seeking medical treatment if they get sick. This anti-humane thinking needs to change, and hopefully the effects of this campaign will bring just that.

 

Mississippi’s First LGBT Healthcare Center

Mississippi’s First LGBT Healthcare CenterLast year My Brother’s Keeper, Inc., a nonprofit organization hoping to reach out to an under-served population in the state, opened Mississippi’s first LGBT healthcare center. On February 7, 2013, the Open Arms Healthcare Center opened its doors. The results of their work was presented at the American Public Health Association (APHA)’s meeting last November in Boston. The nonprofit worked closely with their sponsors Jackson Black Pride, an organization that holds an event in Jackson every year in order to spread awareness of the LGBT community in that city, said My Brother’s Keeper, Inc. CEO  June Gipson, PhD.

The organization gathered patient’s data, accumulating it for two years in order to get a better look at their specific healthcare needs. There isn’t a lot of medical data out there specifically geared to the LGBT community. The healthcare center’s clinical quality assurance manager Shemeka Hamlin-Palmer, PhD said, “They wanted to go somewhere where they felt no one would disclose their information. They wanted more health prevention. They wanted more individualized care than just for the entire LGBT population.”

State health professionals who were already connected to the nonprofit were called up and asked to volunteer their time. Counselors, nurses, and doctors were available to give clinical care services and preventative care. Becoming a Healthy You is the center’s own preventative program. Monday through Friday, patients can come in for different blood screenings for blood-sugar level, glucose level, and sexually transmitted diseases. The clinical services are available Saturdays from 8 A.M. to 1 P.M. One general practitioner, two infectious disease doctors, a registered nurse, a women’s health nurse practitioner, and two phlebotomists are available for services. Gibson said many of the center’s patients are uninsured, while others receive Medicaid or Medicare.

In an interview with The Nation’s Health Gibson said, “The services are on a sliding scale. You have your lab work. We fund raise to be able to pay for their labs. And we have other organizations to fund raise for us to do lab work.”

Transportation services, a referral service, a food pantry and clothing are also available. For the transgender community, the center provides aid in getting hormones. They also offer counseling services. Gibson said, “We’re making sure they have prescriptions that meet their needs and lab work to check their hormone levels to make sure they’re on pace with their health.”

215 patients have attended since the center’s opening day. Between 30 and 40 people come for the preventative program, and 15 to 20 are there each Saturday.