In the mid 90s, when my mentor, Dr. Judy Bradford, tried to urge me into the LGBT health field, I asked her, "But what's different about our health?" It still makes me chuckle to think of it. "Almost everything" is the answer.
As I grew to learn, biology is only the beginning of health. The lion's share of our health is determined by our stressors, environment, social support, financial resources, access to care, etc. For us, many if not most of these health determinants are adversely affected by being a sexual and/or gender minority.
I did follow Judy's advice, getting a Ph.D. with a specialty in LGBT health, doing my dissertation on the thorny issues related to transgender health. But colleagues were few and far between. The 2003 witch hunts, where right-wing groups publicly attacked LGBT (and HIV) researchers, had left their mark. Much of the LGBT health research was very low-profile; some researchers even left the arena outright.
But times have changed. The U.S. Department of Health and Human Services has made great strides in addressing LGBT health disparities in recent years. They're promising to count us in a big survey, doing a lot more to train providers in LGBT issues, and, in a few instances, asking their regular grantees, "How will LGBT people be included in this program, too?"
Why is this important? Because we need to be counted on surveys. Researchers need to explore how their intervention works for LGBT people, too. We need to do a lot more work figuring out why we have such a profound smoking disparity. And why one out of every five LGBT nurses reports an unfriendly work environment. And how to combat the spike in LGBT mental health disorders that occurs when a state passes a ban on same-sex marriage. And how to change the reality that nearly one in five transgender people reports being turned away from medical care.
With an estimated $941-billion budget next year, HHS is not only the largest purchaser of care in the country; they are also the largest funder of research and prevention work. Basically, they're the most popular kid in school. So when they start to counter systemic LGBT health discrimination, it's a huge step that many providers and insurers will start to follow.
As one more example of this change, I recently found myself in Philadelphia attending, of all things, a White House Conference on LGBT Health.
As I looked around the room I marveled that there were hundreds in attendance. A decade ago most of the people working on LGBT health would fill a classroom, not an auditorium.
The day began with a series of panels and speeches by HHS officials detailing the advancements they've made. I'd heard most of them several times already. Am I happy about these changes? Absolutely. I truly respect the community members and allies putting in long hours to make every little change happen.
I also realize that most of the money HHS will spread around next year will still go out in ways that mask or ignore LGBT health disparities. We saw it in the $750 million in new funding that CDC distributed for wellness projects. States took their lead from funding announcements that ignored or downplayed LGBT disparities, doing very little to try to reach LGBT people with the new programs that were built. As I've told HHS Secretary Sebelius, that's not how we eliminate health disparities; that's how we risk creating new ones.
Even knowing this, as the day went on, it slowly dawned on me that I would remember this day forever. This event alone does wonders to send a flag hither and yon that LGBT health is no longer a fringe issue; it is an important consideration for the president, the White House, and Health and Human Services leadership. As I mingled with some longtime compatriots, we fell into silence. "I just can't believe it," said one as he hastily cleared his throat.
Perhaps Philadelphia Mayor Nutter put it most succinctly: "Ladies and gentleman, we are at the White House Conference on LGBT Health." We all cheered madly. Yes, this truly is a watershed moment.
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