The US Supreme Court and the Future of Sexual and Gender Minority Health

2021 ◽  
pp. e1-e3
Author(s):  
Michael Liu ◽  
Jack L. Turban ◽  
Kenneth H. Mayer

Over the past decade, the United States has made substantial progress in advancing the rights of sexual and gender minority (SGM) people. In 2015, the Supreme Court of the United States (SCOTUS) decision in Obergefell v. Hodges provided same-sex couples the fundamental right to marry across the United States.1 In 2020, the landmark Bostock v. Clayton County decision extended the interpretation of “on the basis of sex” under title VII of the 1964 Civil Rights Act to prohibit workplace discrimination on the basis of sexual orientation and gender identity.2 This sweeping decision sets the precedent that other sex-based antidiscrimination laws should be interpreted to include SGM people. However, explicit and broad protections based on sexual orientation and gender identity are not common features of federal laws, and existing SGM protections remain tenuous, as they rely on judicial interpretation. With recent shifts in the composition of SCOTUS, there is the increasing possibility that the hard-earned protections for SGM people in the United States will be reversed through recently argued and upcoming cases. Based on the available empirical evidence, we are concerned about the possible physical and mental health sequelae. (Am J Public Health. Published online ahead of print May 20, 2021: e1–e3. https://doi.org/10.2105/AJPH.2021.306302 )

LGBT Health ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 279-282 ◽  
Author(s):  
Gregory Phillips II ◽  
Dylan Felt ◽  
Megan M. Ruprecht ◽  
Xinzi Wang ◽  
Jiayi Xu ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252539
Author(s):  
Travis Salway ◽  
Stephen Juwono ◽  
Ben Klassen ◽  
Olivier Ferlatte ◽  
Aidan Ablona ◽  
...  

Background “Conversion therapy” practices (CTP) are organized and sustained efforts to avoid the adoption of non-heterosexual sexual orientations and/or of gender identities not assigned at birth. Few data are available to inform the contemporary prevalence of CTP. The aim of this study is to quantify the prevalence of CTP among Canadian sexual and gender minority men, including details regarding the setting, age of initiation, and duration of CTP exposure. Methods Sexual and gender minority men, including transmen and non-binary individuals, aged ≥ 15, living in Canada were recruited via social media and networking applications and websites, November 2019—February 2020. Participants provided demographic data and detailed information about their experiences with CTP. Results 21% of respondents (N = 9,214) indicated that they or any person with authority (e.g., parent, caregiver) ever tried to change their sexual orientation or gender identity, and 10% had experienced CTP. CTP experience was highest among non-binary (20%) and transgender respondents (19%), those aged 15–19 years (13%), immigrants (15%), and racial/ethnic minorities (11–22%, with variability by identity). Among the n = 910 participants who experienced CTP, most experienced CTP in religious/faith-based settings (67%) or licensed healthcare provider offices (20%). 72% of those who experienced CTP first attended before the age of 20 years, 24% attended for one year or longer, and 31% attended more than five sessions. Interpretation CTP remains prevalent in Canada and is most prevalent among younger cohorts, transgender people, immigrants, and racial/ethnic minorities. Legislation, policy, and education are needed that target both religious and healthcare settings.


LGBT Health ◽  
2021 ◽  
Author(s):  
Ana María del Río-González ◽  
Maria Cecilia Zea ◽  
Jennifer Flórez-Donado ◽  
Prince Torres-Salazar ◽  
Daniela Abello-Luque ◽  
...  

Author(s):  
Christy Mallory ◽  
Brad Sears

LGBT people in the United States continue to experience discrimination because of their sexual orientation and gender identity, despite increasing acceptance of LGBT people and legal recognition of marriage for same-sex couples nationwide. This ongoing discrimination can lead to under- and unemployment, resulting in socioeconomic disparities for LGBT people. In addition, empirical research has linked LGBT health disparities, including disparities in health-related risk factors, to experiences of stigma and discrimination. Currently, federal statutes in the United States do not prohibit discrimination based on sexual orientation or gender identity in employment, housing, or public accommodations, leaving regulation in this area primarily to state and local governments. This creates a limited and uneven patchwork of protections from discrimination against LGBT people across the country. Despite public support for LGBT-inclusive non-discrimination laws across the country, in 28 states there are no statewide statutory protections for LGBT people in employment, housing, or public accommodations. To date, only 20 states and the District of Columbia have enacted comprehensive non-discrimination statutes that expressly prohibit discrimination based on both sexual orientation and gender identity in all three of these areas. One additional state has statutes that prohibit sexual orientation discrimination, but not gender identity discrimination, in these areas. One other state prohibits discrimination based on sexual orientation and gender identity in employment and housing, but not in public accommodations. In states without statutes that prohibit discrimination based on sexual orientation and/or gender identity, there are other policies that afford LGBT people at least some limited protections from discrimination. In some of these states, state executive branch officials have expanded non-discrimination protections for LGBT people under their executive or agency powers. For example, in three states, state government agencies have expanded broad protections from sexual orientation or gender identity discrimination through administrative regulations. And, in 12 states without statutes prohibiting discrimination against LGBT people, governors have issued executive orders that protect state government employees (and sometimes employees of state government contractors) from discrimination based on sexual orientation and gender identity. In addition, local government ordinances provide another source of protection from discrimination; however, these laws are generally unenforceable in court and provide much more limited remedies than statewide non-discrimination statutes. In recent years, lawmakers have increasingly attempted to limit the reach of state and local non-discrimination laws, which can leave LGBT people vulnerable to discrimination. For example, some states have passed laws allowing religiously motivated discrimination and others have passed laws prohibiting local governments from enacting their own non-discrimination ordinances that are broader than state non-discrimination laws. While most of these bills have not passed, the recent increase in the introduction of these measures suggests that state legislatures will continue to consider rolling back non-discrimination protections for LGBT people in the coming years. Continued efforts are required at both the state and federal levels to ensure that LGBT people are fully protected from discrimination based on their sexual orientation and gender identity throughout the United States, including federal legislation and statewide bills in over half the states.


2020 ◽  
pp. 074355842093322
Author(s):  
Christopher J. Ceccolini ◽  
V. Paul Poteat ◽  
Jerel P. Calzo ◽  
Hirokazu Yoshikawa ◽  
Kasey Meyer

Research among sexual and gender minority (SGM) youth has suggested associations between Gender-Sexuality Alliance (GSA) involvement and better health. Emergent research has similarly demonstrated associations between family support and general well-being among SGM youth. However, the trait of bravery has received little attention in this literature, despite its relevance for youth in marginalized positions. We examined the association between level of GSA involvement, family support, and bravery among GSA members ( n = 295; Mage = 16.07), and whether those associations differed based on sexual orientation or gender identity. We then conducted one-on-one interviews with SGM youth ( n = 10), to understand how they understood bravery and experienced support in both GSA and family contexts. Greater GSA involvement significantly predicted greater bravery for all youth, whereas greater family support predicted greater bravery only for heterosexual youth. No significant moderation was found for gender minority youth. Our qualitative findings clarified how SGM youth conceptualized bravery and how they experienced it within their GSA and family settings. GSAs were associated with more frequent displays of explicit support for SGM identity, while families were perceived as providing less explicit support.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050092
Author(s):  
Victoria J McGowan ◽  
Hayley J Lowther ◽  
Catherine Meads

ObjectiveTo systematically review all published and unpublished evidence on the impact of the COVID-19 pandemic on the health and well-being of UK sexual and gender minority (LGBT+; lesbian, gay, bisexual, transgender, non-binary, intersex and queer) people.MethodsAny relevant studies with or without comparator were included, with outcomes of: COVID-19 incidence, hospitalisation rates, illness severity, death rates, other health and well-being. Six databases (platforms) were searched—CINAHL Plus (Ovid), Cochrane Central (Cochrane Library), Medline (Ovid), Embase (Ovid), Science Citation Index (Web of Science) and Scopus between 2019 and 2020 in December 2020, using synonyms for sexual and gender minorities and COVID-19 search terms. Data extraction and quality assessment (using the relevant Joanna Briggs checklist) were in duplicate with differences resolved through discussion. Results were tabulated and synthesis was through narrative description.ResultsNo published research was found on any outcomes. Eleven grey literature reports found to be of low quality were included, mostly conducted by small LGBT+ charities. Only four had heterosexual/cisgender comparators. Mental health and well-being, health behaviours, safety, social connectedness and access to routine healthcare all showed poorer or worse outcomes than comparators.ConclusionsLack of research gives significant concern, given pre-existing health inequities. Social and structural factors may have contributed to poorer outcomes (mental health, well-being and access to healthcare). Paucity of evidence is driven by lack of routinely collected sexual orientation and gender identity data, possibly resulting from institutional homophobia/transphobia which needs to be addressed. Men are more at risk of serious illness from COVID-19 than women, so using data from trans women and men might have started to answer questions around whether higher rates were due to sex hormone or chromosomal effects. Routine data collection on sexual orientation and gender identity is required to examine the extent to which COVID-19 is widening pre-existing health inequalities.PROSPERO registration numberCRD42020224304.


2021 ◽  
pp. e1-e5
Author(s):  
Anthony N. Almazan ◽  
Dana King ◽  
Chris Grasso ◽  
Sean Cahill ◽  
Micah Lattanner ◽  
...  

Objectives. To examine the relationship between city-level structural stigma pertaining to sexual orientation and gender identity (SOGI) and completeness of patient SOGI data collection at US federally qualified health centers (FQHCs). Methods. We used the Human Rights Campaign’s Municipal Equality Index to quantify city-level structural stigma against sexual and gender minority people in 506 US cities across 49 states. We ascertained the completeness of SOGI data collection at FQHCs from the 2018 Uniform Data System, which describes FQHC patient demographics and service utilization. We included FQHCs in cities captured by the structural stigma index in multinomial generalized linear mixed models to examine the relationship between city-level structural stigma and SOGI data completeness. Results. FQHCs in cities with more protective sexual orientation nondiscrimination policies reported more complete patient sexual orientation data (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.2, 2.1). This association was also found for gender identity nondiscrimination policies and gender identity data collection (AOR = 1.7; 95% CI = 1.3, 2.2). Conclusions. Municipal sexual and gender minority nondiscrimination laws are associated with social and municipal environments that facilitate patient SOGI data collection. (Am J Public Health. Published online ahead of print September 9, 2021:e1–e5. https://doi.org/10.2105/AJPH.2021.306414 )


2020 ◽  
Vol 16 (6) ◽  
pp. 309-316
Author(s):  
Gwendolyn P. Quinn ◽  
Ash B. Alpert ◽  
Megan Sutter ◽  
Matthew B. Schabath

Sexual and gender minority (SGM) individuals encompass a broad spectrum of sexual orientations and gender identities. Although SGM is a research term, this population is often known as lesbian, gay, bisexual, transgender, queer (LGBTQ). Typically, LGB refers to sexual orientation, T refers to gender identity, and Q may refer to either. Although each group is distinct, they share the common bond of experiencing health disparities that may be caused, in part, by stigma and discrimination, as well as by the oncology provider’s lack of knowledge and, therefore, lack of comfort in treating this population. One challenge in improving the quality of care for SGM patients with cancer is the lack of collection of sexual orientation and gender identity (SOGI) data in the medical record. Furthermore, national studies suggest that many oncologists are unsure of what to do with this information, even when it is collected, and some are uncertain as to why they would need to know the SOGI of their patients. This clinical review offers insight into the health disparities experienced by SGM individuals and strategies for improving the clinical encounter and creating a welcoming environment.


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