Health
Md. advocates should now focus on health care
A new fight and focus after marriage victory
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.
Health
MISTR announces it’s now prescribing DoxyPE
MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTR’s telehealth platform to receive DoxyPEP online for free, according to a release from the company.
With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.
“Despite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,” said Tristan Schukraft, CEO and founder of MISTR. “I’m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.”
An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV.
MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.
Health
UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary
UN agency urges global action to protect human rights
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.
Health
New CDC report finds transgender women at higher risk for HIV
More than 1,600 people in seven cities surveyed
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.”
Blade Summer Kickoff Party returns to Rehoboth
Andy Cohen coming to D.C.
Want to dance for a good cause?
Calendar: May 3-9
Brittney Griner considered suicide in Russian prison
HHS reverses Trump-era anti-LGBTQ rule
4th Circuit rules gender identity is a protected characteristic
Pride season has begun
PHOTOS: Capital Pride Pageant
