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Md. advocates should now focus on health care

A new fight and focus after marriage victory

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By LESLIE CALMAN & SUZANNE SCHLATTMAN

Two recent developments provide the opportunity for LGBT Marylanders to achieve equality.

The first is obvious: After a hard-fought battle and with the help of innumerable straight allies, marriage equality is now law of the land in Maryland. Although the federal Defense of Marriage Act continues to bar a number of benefits to married LGBT people, state-level benefits are now fully available.

This means that many more Marylanders will be able to qualify for health insurance coverage. What’s the connection? Many more people will be able to access health insurance through their spouses. And Maryland is ahead of the curve on implementing President Obama’s Affordable Care Act. The new insurance exchanges and reduced rates the ACA mandates are sure to expand coverage to more than 300,000 previously uninsured state residents — including many lesbian, gay, bisexual and transgender Marylanders.

To maximize the benefit of both of these major policy changes, it’s important for LGBT Marylanders to get informed and get engaged.

LGBT Marylanders are more likely than heterosexual people to be uninsured. LGBT people are more likely to be self-employed, to earn less or to work for employers who don’t offer health insurance. For an American woman, the best predictor of whether she has health insurance is if she is married — a status previously denied to LGBT women.

Marriage equality and the Affordable Care Act confront these inequities in many tangible ways that increase coverage, improve quality and help build a better system to ensure that all Marylanders can get the healthcare they need free from unnecessary administrative burden or prejudicial judgment.

First, for people with low incomes, the ACA makes health insurance available for free or at reduced rates. Individuals earning up to about $15,000 per year will be able to get free coverage through the expanded Medicaid program starting Jan. 1, 2014.

Other single Marylanders earning up to $44,680 can get tax credits to subsidize their coverage through our new Maryland Health Connection. Plans sold in the Connection will provide robust benefits at affordable rates by encouraging competition and making it easier for consumers to compare and shop for insurance.

Qualifying small businesses can also get tax credits of up to 35 percent of the business’ health care costs if they provide health insurance for their employees.

There are many other provisions in the law that can make it an even greater win for LGBT Marylanders. For example, the state will set a benchmark, or minimum standards of medical treatments to be guaranteed in the Maryland Health Connection. This is an opportunity to eliminate arbitrary exclusions based on sexual orientation and gender identity that currently create significant barriers to care, particularly for transgender people. There are a number of insurance plans that deny coverage for any services or medications related to sex transformation — and that can apply to denial of vital screenings, like mammograms or pap tests, for a person born female but has since become a transgender man.

The ACA also creates a unique opportunity to learn more about the different experiences of LGBT Marylanders in our healthcare system: how does the experience of being stigmatized affect health and access to health care? Are LGBT people less likely to get recommended cancer screenings? More likely to suffer stress? More likely to smoke?  Collecting data on sexual orientation and gender identity can be a way to better understand and address inequities and injustice in health and in our health care system that disproportionately affects LGBT patients.

Finally, the ACA also creates a Navigator program that can empower trusted service providers in the LGBT community to conduct education and enrollment work and ensure that state marketing efforts cater to LGBT people and direct them to brokers or community-based organizations that understand unique health care considerations in the community and help them find coverage that best suits their needs.

It is important for those advocates who were engaged in the successful campaign for marriage equality to now turn their attention and efforts to make sure that Maryland’s implementation of the Affordable Care Act goes as far as it possibly can to guarantee meaningful access to quality, affordable health care for LGBT Marylanders.

Leslie Calman is executive director of the Mautner Project. Suzanne Schlattman is community outreach and development director of the Maryland Health Care for All coalition.

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Health

UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for women’s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyone’s health is synonymous with protecting everyone’s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world — for everyone,” said Byanyima.

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Health

New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, the National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25 Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”

The study stated that trans women’s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to “survival sex work” and violence, which increases the risk of contracting HIV. 

The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”

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Health

A Whole New Perspective on Well-Being

The Mather’s team recognizes that everyone’s wellness journey is completely unique to their life experiences and influences.

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The Mather is incorporating biophilic design—a design approach to facilitate access to nature or things that replicate natural patterns.

It’s easy to spot the distinctive, elegant silhouette of The Mather, a Life Plan Community for those 62+ opening this spring in Tysons, Virginia. What is not apparent to the naked eye is The Mather’s unique wellness philosophy, which is literally built into the community. 

The Mather’s team recognizes that everyone’s wellness journey is completely unique to their life experiences and influences.

Nature is one of the important factors that contribute to well-being. So The Mather is incorporating biophilic design—a design approach to facilitate access to nature or things that replicate natural patterns. This can include interior spaces with sightlines to a garden, choosing natural wood and stone as interior materials, or incorporating fragrant flowers and plants indoors to spark memories and provide tactile opportunities such as gardening. 

Residents of The Mather will be able to select from plentiful amenities, programs, and other offerings to target their personal wellness goals and preferences.

“Providing biophilic design within interior settings connects residents to the natural world,” says Mary Leary, CEO and President of Mather, the organization behind The Mather. “Research shows that a connection to nature provides positive benefits to mental states and overall well-being. At The Mather, biophilic design is the intersection of buildings and programs with nature in an urban setting.”

“The Mather is attracting a diverse group of older adults,” says Mary. “As a result, we aim to incorporate wellness practices from around the world, including Wyda movement theory of the Celtic Druids, which helps people achieve harmony with nature and contentment through mindfulness.” This holistic regenerative approach is similar to Qi Gong and yoga, while born in a different part of the world. Mather Institute has a special focus on mindfulness to support older adults’ practice of present moment awareness, which can lead to increased overall well-being, compassion, and joy.

A very different example of a wellness offering at The Mather is the Gharieni Welnamis spa wave bed, which uses computer-controlled vibrational therapy and audio frequencies to train the brain to relax. “The bed increases mindfulness, concentration, and creativity—all of which support our mission of creating Ways to Age Well,SM” says Mary.

These and other personalized ways to wellness will ensure that residents of The Mather can choose from seemingly countless ways to focus on their well-being. In other words, the sky’s the limit!

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