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LGBTQIA disparities amid COVID-19

Pandemic has disproportionately impacted vulnerable groups

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COVID-19 vaccine, gay news, Washington Blade

The COVID-19 pandemic has highlighted the importance of meeting the needs of diverse communities and minorities when facing emergencies such as COVID-19. But more importantly, it highlighted their vulnerability, since they are considered much more prone populations. COVID-19 has made it even more evident the disproportionate burden vulnerable populations bear and the weakness of our health system.

Minorities who are members of racial/ethnic groups are disproportionately affected and often exposed to higher illness rates and have substantially higher mortality and morbidity rates than the general population. For example, people vulnerable to HIV infection usually belong to socially, economically disadvantaged and discriminated groups. The Human Rights Campaign presented an investigative report on how the community faces unique challenges due to their economic situations and access to healthcare. According to HRC, LGBTQIA Americans are more likely than the general population to live in poverty and lack access to adequate health care, paid sick leave and basic needs during the pandemic. The Centers for Disease Control and Prevention states in one of its reports that the LGBTQIA community experiences stigma and discrimination in their lives that “… can increase vulnerabilities to illness and limit the means to achieving optimal health and well-being…” For example, discrimination and violence against LGBTQIA persons have been associated with high rates of psychiatric disorders, substance abuse, suicide and have long-lasting effects on the individuals. Furthermore, LGBTQIA mental health and personal safety are also affected when they go through the process of personal, family and social acceptance of their sexual orientation, gender identity and gender expression.

According to the Williams Institute, the leading research center on rights based on sexual orientation and gender identity, one in 10 LGBTQIA people is unemployed and more likely to live in poverty than heterosexual people, so they cannot always pay for proper medical care or preventive health measures. Also, approximately one in five LGBTQ + adults in the United States (22 percent) lives below the poverty line, compared to an estimated 16 percent poverty rate among heterosexuals. This data is much worse when we look closely at the trans population with 29 percent and LGBTQIA Latinos with 45 percent. These disparities are even more evident when we see that 17 percent of LGBTQIA adults do not have any medical health coverage compared to the 12 percent of the heterosexual population. That 17 percent increases with the LGBTQIA Black adults with 23 percent, trans adults with 22 percent, and trans Black adults with 32 percent who do not have any health coverage, compared to 12 percent of the heterosexual population that does not possess health coverage. The Office of Disease Prevention and Health Promotion statistics reflect that the LGBTQIA community is more likely to attempt suicide, be overweight or obese, have mental health problems, and less likely to receive cancer treatment.

According to several health organizations led by the National LGBT Cancer Network, the LGBTQIA population still faces great social and economic disparities compared to the heterosexual community, so they are more likely to get infected by COVID-19. The report summarizes how COVID-19 negatively affects the lives and livelihoods of the LGBTQIA community at disproportionate levels. The older generations of LGBTQIA encounter additional health barriers in the face of COVID-19 due to isolation, discrimination in the provision of services, and the lack of competent social services. The LGBTQIA community uses tobacco at rates that are 50 percent higher than the general population, and COVID-19 is a respiratory illness that has proven particularly harmful to smokers. In addition, the LGBTQIA population has higher rates of HIV and cancer, which means a more significant number may have compromised immune systems, leaving us more vulnerable to COVID-19 infections. LGBTQIA communities also face additional risks related to conditions that are often associated with complications from COVID-19. One in five LGBTQIA adults aged 50 and above has diabetes, a factor that raises the risk of complications for individuals diagnosed with COVID-19.

A Kaiser Family Foundation research finds that a larger share of LGBTQIA adults has experienced COVID-19 era job loss than heterosexuals adults (56 percent vs. 44 percent). Furthermore, the limited anti-discrimination protections from the LGBTQIA community also make them more vulnerable to joblessness due to an economic downturn resulting from COVID-19’s spread. Since February 2020, 56 percent of LGBTQIA people report that they or another adult in their household have lost a job, been placed on furloughs, or had their income or hours reduced because of the coronavirus outbreak, compared to 44 percent of non-LGBTQIA people.

In addition, recent data show that LGBTQIA respondents were more likely than non-LGBTQIA respondents to be laid off (12.4 percent vs. 7.8 percent) or furloughed from their jobs (14.1 percent vs. 9.7 percent), report problems affording essential household goods (23.5 percent vs. 16.8 percent), and report having problems paying their rent or mortgage (19.9 percent v. 11.7 percent). The research also shows that three-fourths of LGBTQIA people (74 percent) say worry and stress from the pandemic have had a negative impact on their mental health, compared to 49 percent of those, not LGBTQIA. A recent study from the William Institute also found that LGBTQIA people of color were twice as likely as white non-LGBTQIA people to test positive for COVID-19. According to the Williams Institute, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) represented a direct benefit for the LGBTQIA community amid the pandemic. However, LGBT people have still experienced the COVID-19 pandemic differently than heterosexuals, including being harder hit in some areas. The challenges presented by COVID-19 have exacerbated the stigma and discrimination to access to healthcare, social services, and basic legal protections for the LGBTQIA community. It is not the first time the LGBTQIA confronts the stigma and discrimination amid a pandemic. Since the HIV/AIDS pandemic from the 80s until now, the LGBTQIA community has developed an extraordinary resilience over decades, and pushing back against stigma and making claims for basic human dignity and equality

The World Health Organization recognizes that “vulnerable and marginalized groups in societies often have to bear an excessive share of health problems and are less likely to enjoy the right to health…” For this reason, the WHO recognizes the need for more aggressive regulations and laws that promote equality in services for these vulnerable groups to eliminate those current statutes that aggravate marginalization and hinder gradually, and even more so, access to health services, prevention, and care. National policies and state regulations must address the needs of LGBTQIA populations, with particular attention to black LGBTQIA and the absence of standardized protections against discrimination by healthcare providers. Although there have been substantial advances for the LGBTQIA population over the last decade, legal protections remain uneven, including those jurisdictions that do not expressly prohibit discrimination based on sexual orientation, gender identity, or/and gender expression. Eliminating LGBTQIA health disparities and enhancing efforts to improve their health are necessary to reduce disparities and increase longevity. Furthermore, under the context of COVID-19, researchers have found that the intersection of race with sexual orientation and gender identity is essential to understand pandemic’s impact. For example, data collection efforts related to COVID-19 must immediately add sexual orientation and gender identity questions. Collecting sexual orientation and gender identity data will improve knowledge about disparities from sexual minorities, enhance cultural competence among health providers, help implement anti-bullying policies, and reduce suicide and homelessness among youth, among others.

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Queer kids are not brainwashed

Trans children are real transgender people, not trend chasers

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In some conversations with progressive friends, my peers, despite their proclaimed liberal attitudes, voice concern over the fact that children can experiment with gender and sexuality. They say things like “kids are too young to question their gender…that seems dangerous” or “a lot of children are just following gender trends and are not actually trans.” Other friends state that they don’t believe that transgender children should have access to hormone blockers. 

All of these statements are bogus and harmful. Many people who question gender fluidity in children don’t realize that they themselves have been brainwashed into thinking, from a young age, that being cisgender and straight is the norm. It should not be the norm. In fact, queerness is ever more common now among Gen Z’ers, and this is because the youth of today are feeling more and more comfortable opening up about their different sexuality and gender from an early age. 

Being able to safely come out as trans or gay in high school is an extremely healthy process and greatly improves the mental health of kids who would otherwise struggle. In red states, and conservative high school districts, this kind of coming out is still difficult, and might even be banned in the future, if Republicans continue with their cruel agenda. But there is hope in progressive cities like Portland and New York, where students feel free to question cishet and straight standards. 

Much research points to the fact that trans children are who they say they are: real transgender people, and not trend chasers. Kristina Olson, a psychologist at the University of Washington, started running a long-term study on trans youth in 2013. Olson eventually amassed a group of more than 85 trans kids. Olson kept in touch with both the children and their parents over the years. Her team ultimately found that an overwhelming, vast majority of the children stayed consistent with the gender nonconforming identity they chose in childhood. In other words, these trans children were correct about their gender identity from a young age. The notion that children pick up trans identities as a “fad,” or are wrong about them, is outdated. 

We already know that Republicans are dangerous to trans children, and have already prevented them from receiving health care or playing sports in many red states. But what we need to stop is dialogue from progressive voices that discourages gender fluidity in youth. These statements from otherwise liberal leaning people are contradictory to the very values that Democrats stand for. 

Isaac Amend (he/him/his) is a trans man and young professional in the D.C. area. He was featured on National Geographic’s ‘Gender Revolution’ in 2017 as a student at Yale University. Amend is also on the board of the LGBT Democrats of Virginia. Find him on Instagram @isaacamend.

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A rare misstep for the amazing Nancy Pelosi

Taiwan trip a distraction amid good news for Democrats

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House Speaker Nancy Pelosi leads a U.S. delegation in Taiwan. (Photo via Speaker Nancy Pelosi's official Twitter)

I have always supported House Speaker Nancy Pelosi and continue to do so. She is an amazing woman. She has championed women’s rights, LGBTQ rights, the rights of all minorities, and the rights of people with disabilities. She has worked hard to make our country a better and more equal place for all.

So seeing the repercussions of her trip to Taiwan playing out, with even the South Korean president avoiding a meeting with her, she must now realize the visit may have been ill timed. Speaker Pelosi is a smart woman and politician. I assume her insistence on the trip may have been a response to some promises she made to the Chinese community in her district and around the nation. She has always been a strong supporter of human rights and has criticized the Chinese government in the past. She recently tweeted, “28 years ago, we traveled to Tiananmen Square to honor the courage & sacrifice of the students, workers & ordinary citizens who stood for the dignity & human rights that all people deserve. To this day, we remain committed to sharing their story with the world. #Tiananmen30.” 

The question some are asking is did this trip do anything for the people of Taiwan or could it potentially hurt the people there and here if China decides to restrict trade and begin new sanctions?

As the Washington Post reported, “The visit lasted barely 19 hours. But Nancy Pelosi’s contentious trip to Taiwan was a defining moment in the increasingly bitter rivalry between China and the United States. A fuller picture of the Chinese response will emerge over the coming weeks and months, and there are already signs it will encompass greater economic as well as military coercion. Whatever the final shape of Beijing’s retaliation, Pelosi’s visit heralds a new phase in China’s efforts to control Taiwan’s fate — and those measures are likely to increase the risk of conflict with U.S. forces in the western Pacific.” The New York Times said,  “Ms. Pelosi’s visit was ill timed” and called it “provocative.”

I would never question the speaker’s commitment to the human rights of the Chinese people. But at this time, as the third in line to the presidency, there may have been some unintended ramifications from what she did and what the implications could be. I think the very unusual may have occurred, and the speaker may not have considered everything. The trip was likely spurred on by her knowledge this is likely to be her last year as speaker and this was the last time she could arrange for such a trip having the clout she does. I think Speaker Pelosi may be thinking about what she did and if it was worth adding this to the international problems the White House is now facing.

We are living in interesting and difficult times. With the help of Speaker Pelosi for the first time in a while the Biden administration and Democrats are having an incredible run of successes here at home. Passing the first gun control bill in decades, the infrastructure bill, the chips bill, and now the Senate has passed the “Inflation Reduction Act of 2022” as a reconciliation package. The nation added 528,000 new jobs in July and unemployment is at the lowest it has been, matching pre-pandemic times, at 3.5%. Gas prices are steadily going down and inflation has likely peaked. Then there is the vote on the abortion amendment in Kansas, which the pro-choice side won by nearly 60/40 in a landslide definitely not predicted in that very red state. So, poking the Chinese at this time, generating negative headlines, doesn’t make much sense. I hope it will be only a blip in time.

This week we will see Pelosi do what she does best. She will move the House of Representatives to pass impactful legislation. She will keep her small Democratic majority together to pass the ‘Deficit Reduction Act of 2022’ and send it on to the president to sign. In 2018, she cut a deal to become Speaker for two more terms. That time is now coming to an end. If the Democrats manage to hold the House of Representative much of the credit must go to her. Should she then actually leave the speakership, the next speaker will have the unenviable task of trying to fill those four-inch stiletto heels. 

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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Monkeypox is a gay thing — we must say it

Will there be stigma, judgments, and homophobia? Of course

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The mainstream media and public health officials are being so damn careful not to label monkeypox “a gay disease” that they’re doing a disservice to the gay men who most need important information about the outbreak – while misleading everybody else.

In a July 28 New York Times story of the excruciating symptoms and lack of care available for those with monkeypox in that city, the sexuality of the men profiled isn’t referenced until 11 paragraphs into the story, and even then it refers to them as “men who have sex with men,” which is technically correct but dodgy. Moreover, the article, which supposedly addresses barriers to care, ignores the fact that gay men routinely experience apathy and even judgment from health providers.

Other media stories, and statements from the Centers for Disease Control and Prevention, have mentioned monkeypox cases in the context of “the LGBT community.” Really? Should lesbians be lining up for a monkeypox vaccine, whenever the heck they become widely available? This is happening to gay men. Say it.

Journalist Benjamin Ryan, in his excellent Washington Post opinion piece, draws a hard line between attempts not to unnecessarily stigmatize gay men and the importance of telling the truth about monkeypox, writing that “public health officials cannot be expected to police the public’s reactions to epidemiological facts.”

Ryan lays out those facts plainly:

Here is what we can discern from data collected about monkeypox so far: This viral outbreak isn’t just mostly occurring among men who have sex with men. The confirmed cases, at least to date, have consistently almost entirely occurred among this demographic, which accounts for 96 percent or more of diagnoses where data are available.

Per capita, the few monkeypox cases in women and children remain minuscule compared with the rate among gay and bisexual men. Of course, substantial transmission could always occur among such other groups. But researchers at the WHO and elsewhere have speculated that the monkeypox reproduction rate will likely remain significantly lower in such demographics — meaning the virus will more likely hit transmission dead ends among them than among gay and bisexual men.

An uncomfortable truth, one documented in peer-reviewed papers, is that sexual behaviors and networks specific to gay and bisexual men have long made them more likely to acquire various sexually transmitted infections compared with heterosexual people. This includes not only HIV, but also syphilis, gonorrhea, chlamydia, hepatitis B and sexually transmitted hepatitis C.

Global public health experts agree that skin-to-skin contact in the context of sexual activity between men has been the principal driver of the monkeypox outbreak, at least thus far.

Such experts have also asserted that the risk of monkeypox to the broader population not having multiple sex partners remains low — even “very low.” This is hopeful news, and the wider public deserves to be reassured accordingly. Assuaging fears of contagion will help fight unhelpful hysteria and prevent gay and bisexual men from being subjected to even greater stigma should they be painted as culprits of the spread of virus to others.

Monkeypox didn’t begin with gay men, that much is true. As Yale infectious disease expert Gregg Gonsalves explained to the New York Times, “This is not a gay disease; it has been circulating in West and Central Africa for many years… What likely happened, in this case, is that somebody who had monkeypox had a lesion and showed up at a gay rave in Europe, and it spread to those in that social and sexual network.”

Whatever the origins, we’re now dealing with an outbreak almost entirely limited to gay men in the United States and Europe. And that is worth saying explicitly.

Why? Because identifying those at risk and getting information to them is a basic public health strategy for containing an outbreak. Gay men are getting monkeypox and suffering greatly. When gay men understand the threat, we are more likely to take precautions, get vaccinated, or be informed about treatment.

Will there be stigma and judgements and homophobia? Of course. And we’ll have to deal with that. But that doesn’t mean we bury crucial facts in vague, evasive messaging.

Monkeypox is a gay thing. That’s the truth.

Mark S. King is an award-winning blogger, author, speaker, and HIV/AIDS activist who has been involved in HIV causes since testing positive in 1985.

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