Category Archives: Health Issues

REPORT: Consequences Of ‘Fiscal Showdown’ Could Be Disastrous For LGBT Americans


If Congress fails to act during the lame-duck session, a series of onerous automatic federal spending cuts and tax hikes will go into effect on January 2, 2013. Failure to reach a compromise in this budget battle would be a painful pill to swallow for all Americans. But for LGBT people, failure to reach an agreement on the fiscal showdown would have particularly dire consequences.

If Congress fails to act, automatic across-the-board spending cuts will take effect under a process known as “sequestration.” Today a report released today by the Center for American Progress, the National Gay and Lesbian Task Force, and a coalition of 23 national LGBT organizations highlights how across-the-board cuts under sequestration would reduce key federal programs and services that support the health, wellness, and livelihood of LGBT Americans and their families. For example,

  • Sequestration would hurt LGBT workers. Sequestration would threaten the employment security of LGBT workers (who continue to experience high rates of bias on the job) because federal agencies such as the Equal Employment Opportunity Commission would have fewer resources to investigate claims of employment discrimination.
  • Sequestration would compromise LGBT health. Cuts under sequestration would compromise the health of LGBT Americans by blocking LGBT seniors’ access to Medicare, reducing programmatic funding to health centers designed to serve the LGBT population, and impeding suicide prevention efforts aimed at helping LGBT Americans.
  • Sequestration would harm LGBT youth. Sequestration would threaten federal agencies with the removal of critical resources used to prevent bullying and school violence against LGBT youth.
  • Sequestration would exacerbate LGBT homelessness and housing discrimination. Across-the-board cuts under sequestration would limit the government’s capacity to address the high rates of homelessness among LGBT youth and to combat housing discrimination against LGBT renters, tenants, and potential homeowners.
  • Sequestration would threaten the basic safety of LGBT Americans. Sequestration would restrict available resources designed to address the disproportionate levels of abuse, harassment, and violent crime committed against LGBT individuals.

While the CAP/Task Force report only touches on how these wholesale cuts impact LGBT Americans, failure to reach a deal on the fiscal showdown also means that tax breaks for lower-income and middle class families will expire. This means most families would face a higher tax burden if Congress fails to act. This would be particularly devastating to LGBT families who on average report lower incomes than families headed by different-sex couples. These families cannot foot a higher tax bill, especially when so many of them are already on tenuous economic footing.

In the remaining days of the 112th Congress, it is imperative that our lawmakers act swiftly to protect LGBT Americans from the severe sequestration consequences to federal programs that both directly and indirectly support them and their families. This means a combination of spending cuts that inflict minimal economic harm on American families along with modest tax increases on the wealthiest two percent of Americans. Only through this combination of cuts and revenue can we put our country back on stable financial footing.

To achieve this, however, congressional Republicans must abandon their quest to hold ordinary citizens hostage in order to protect tax cuts for the wealthiest Americans. For all Americans—gay or straight, transgender or not—preventing millionaires and billionaires from paying their fair share at the expense of the middle-class is not in the best interest of the country.

Congress has a little over one month to broker a compromise. For all Americans – including those that are LGBT – the clock is ticking.


LGBT People of Color Need More Than Health Insurance

The health care debate is still raging across the country, and ensuring that it moves forward so that all Americans have access to affordable and high-quality health insurance is a critical first step. But acquiring and keeping health insurance coverage is only half the battle for millions of Americans.


New research from the Center for American Progress, for example, shows that lesbian, gay, bisexual and transgender (LGBT) people have health care needs and challenges that are starkly different from the rest of the population. The research also shows that racial and ethnic minorities who are lesbian, gay or bisexual face some of the greatest health care challenges in our country.


For example, lesbian and bisexual black women are the least likely to have had a mammogram in the past two years. Only 35 percent of these women have had mammograms recently, compared to nearly 70 percent of heterosexual African-American, Asian or Pacific Islander, or white women. One out of every five lesbian/gay/bisexual African-American adults has diabetes. Straight African-American and straight, lesbian, gay or bisexual Asian or Pacific Islander, Latino, and white adults are much less likely to have diabetes—fewer than 8 percent of these populations have been diagnosed with the disease.


Mental health needs are also a concern. For example, lesbian/gay/bisexual Asian or Pacific Islander adults are more likely than other groups to report experiencing psychological distress. Lesbian/gay/bisexual Latinos are similarly much more likely than all other racial or ethnic groups—gay or straight—to report problems with alcohol abuse and addiction.



Data on the general transgender population is notoriously sparse and anecdotal—information on transgender racial and ethnic minorities is even more so. But based on what we do know, people in this population face the largest obstacles to finding and affording high-quality and highly competent health care.


The odds are slim that doctors, nurses and other health care providers are aware of the health realities their LGBT patients of color face and are able to effectively treat them. Ulrike Boehmer’s review of 3.8 million citations of articles in the National Library of Medicine published between 1980 and 1999 found that just 3,800, or 0.1 percent, are related to LGBT issues. And 85 percent of the articles failed to include any mention of the racial or ethnic background of the individuals studied.


A clear first step to improve health treatment for LGBT racial and ethnic minorities is building the medical community’s knowledge of their unique needs. Unfortunately, no national government health survey regularly asks about a person’s sexual orientation or gender identity. The federal government already collects health data based on race and ethnicity, and adding questions on sexual orientation and gender identity would provide researchers with this much-needed information to better identify the health care needs of LGBT people of color. In turn, advocates could then fight for programs and funding that better and more competently serve this population. Medical schools and other institutions could also incorporate this information into their curricula and training programs to prepare future practitioners to treat and care for these patients.


Over time, this approach will reduce the disparities between LGBT people of color and other populations, and the federal government should take the lead in tackling this problem. The U.S. Department of Health and Human Services should particularly establish a dedicated Office of LGBT Health. Data collection should be a priority for this office, which must ensure that any federally funded health study that collects demographic information on categories such as age, sex, race, ethnicity, primary language or socioeconomic status must also include questions about sexual orientation and gender identity.


Insurance coverage is a vital health care reform issue, but it is not the only factor that prevents people from quality care in the United States. Our nation’s health care system needs to do a much better job treating the real needs of all its patients, and that includes LGBT people who are racial and ethnic minorities.


Jeff Krehely is the director of LGBT research at the Center for American Progress.

Health Disparities Faced By the Transgender Community

Ten Things Transgender Persons Should discuss with Their Healthcare Care Provider

1. Access to Healthcare

It is not easy to find a healthcare provider who knows how to treat transgender people. Sometimes it is difficult to find someone who will agree to treat you. Some providers may feel that there is something wrong with you because you are a transgender person. They are not correct, of course. They may not understand that you have always been this way. Even if you do find someone who will treat you, your insurance may not pay for the treatment. Ask your provider if your costs will be covered by your insurance. If they will not, ask if they will reduce your bill so you can pay.


2. Health History

Its important for you to be able to trust your healthcare provider. Tell them about the medicines you have taken and the surgeries you may have had. If your provider knows what has happened with you in the past, he or she will be better able to give you the best treatment today.


3. Hormones

Talk with your provider about hormone treatment. If you are starting hormones for the first time, ask about the things you need to watch out for while taking these medicines. If you are a transgender woman, ask about estrogen and blood clots, swelling, high or low blood pressure and high blood sugar. If you are a transgender man, ask about the blood tests you will need to be sure your testosterone dose is safe. Be sure and take only the hormones prescribed by your provider.


4. Cardiovascular Health

Transgender persons may be at increased risk for heart attack or stroke, not only from hormone use but from cigarette smoking, overweight, high blood pressure and diabetes. Transgender women may fear that their provider may make them stop estrogen if they develop heart trouble, and so they may not report feelings such as chest pain or trouble breathing. Be sure to tell your provider if you do have these feelings.


5. Cancer

It is very rare to develop cancer due to hormone treatment, but your provider will evaluate you for this possibility when he or she sees you for check-ups. Your provider will also check for possible cancer of your sex organs, if they have not been removed. Again this is very rare but it should be checked along with the rest of your physical examination.


6. Sexually Transmitted Diseases and Safe Sex

Transgender people, particularly young transgender people, may be engaging in sexual activity. Just like anyone else, transgender people may get a sexually transmitted disease. It is very important to practice safe sex, so you will not become infected with HIV or other sexually transmitted diseases. Ask your provider about safe sex practices.


7. Alcohol and Tobacco

Transgender persons who drink alcohol may drink too much and risk damage to the liver or other organs. Too much alcohol may also cause a person to treat themselves or other people badly, or to drive unsafely. Alcohol and hormones may be more dangerous when taken together. Many transgender people smoke cigarettes. This increases their risk of heart and lung disease, especially in persons taking hormones. Transgender persons who care about their health should not smoke, and they should drink only small amounts, if at all.


8. Depression

It is very easy for transgender persons to become sad and depressed. If our families or friends don’t want to see us anymore, it is a very depressing time. Even after transition, depression can still be a problem. When someone is depressed, they cannot be happy no matter what they are doing. Depressed persons may make bad choices and may harm themselves. Please talk with your provider or your therapist about your feelings and tell him or her if you feel sad or depressed. Many good treatments are available for depression.


9. Injectable Silicone

Some transgender women want to look feminine and beautiful without having to wait for the effects of estrogen. They expect injections of silicone to give them “instant curves.” The silicone, sold at “pumping parties” by non-medical persons, may move around in the tissues and cause ugly scars years later. It is usually not medical grade, may be contaminated and is often injected using a shared needle. You can get hepatitis or HIV through shared needles. Silicone is dangerous and should not be used.


10. Fitness (Diet & Exercise)

Many transgender people are overweight and do not exercise. It is hard to make time for exercise if you have to work long hours. A healthy diet and a frequent exercise routine are just as important for transgender persons as for anyone else. If you are planning to have surgery, your surgeon will want to be sure you are in good physical condition to do well during and after surgery. Try to eat a healthy diet and try to exercise for at least 20 minutes three times a week.


Author: Rebecca A. Allison, MD. Board of Directors, Gay and Lesbian Medical Association. Revised May 2012