With all the media coverage lately around Gay Pride events, as well as around marriage equality, it is ironic that so little is really known about the lives and health needs of lesbian, gay, bisexual and transgender (LGBT) people. This lack of specific information on the LGBT community is not just an academic problem; policymakers, especially those in government, demand real numbers to document the existence of problems. This is particularly true in these tough economic times, as funders, government officials and state agencies rightly demand efficient programs that are targeted like laser beams on specific, documented problems. In this context as with so many things, knowledge equals power: the power to allocate resources and work to fix these problems.
At the national level, researchers have estimated that LGBT people lag behind on seven of the ten targets set by the U.S. government to improve health nationally, called Healthy People 2010. In New York City, we know that LGBT lag behind on at least six of NYC's health goals, called Take Care New York. However, most states do not measure sexual orientation on their health surveys, and none have consistently measured gender identity.
As researchers and advocates, we are working to change that. In our recent work funded by the New York State Department of Health interviewing 60 experts in health and human services and surveying 3,500 LGBT New Yorkers about their health and human service needs, we have found some striking disparities between their experiences and those of non-LGBT people. Empire State Pride Agenda has just this week published these findings in a report entitled "LGBT Health and Human Service Needs in New York State."
For example, fourteen percent of all LGBT people, including one-third of transgender New Yorkers, are or have been homeless at one time--and we know that people who are homeless also lack other basic services. As one service provider who works with youth told us, "Housing is health care." Youth and adults who are homeless frequently cannot access health services at all. Youth who are transgender are particularly vulnerable. Another provider working with LGBT youth in upstate New York told us about a young boy who loved to sew and decorate. The social services in the county where he lived sent him to another county, rather than deal with gendered behavior that they found troubling. As the LGBT youth provider told us "What he needs is a sewing machine, not to be shipped off to a different county."
Another serious gap we found in LGBT health services was in culturally competent care. Even when LGBT people have access to health care--and many do not--it may not serve their needs. As one lesbian participant said, "I would love to go to an LGBT-friendly doctor, but I don't know where to find one. . . It seems to be a very common problem." 40% of LGBT people say there are not enough health professionals who are adequately trained and competent to deliver health care to LGBT people. 27% fear that if medical personnel found out that they are LGBT that they would be treated differently. This can result in people not giving their doctor the information he or she needs to provide effective case, or in LGBT people avoiding medical care at all.
Finally, violence against LGBT people continues to be a significant problem. Thirteen percent of LGBT people said that they had been physically or sexually assaulted because they were LGBT and only about a quarter of those who had been hit, punched or kicked in a homophobic assault had reported it to the police.
In many cases, sexual orientation and gender identity are excluded from existing data collection efforts, with the latest high profile example probably being the refusal of the U.S. Census to allow same-sex couples legally married in states that perform those marriages from identifying as such. Policymakers must support efforts to collect data on LGBT people to ensure that our health care system is serving everyone, like the New York State Department of Health did in funding this needs assessment. We know there are disparities. Without continuing data, we cannot understand and improve the lives of LGBT people, particularly the most vulnerable, such as youth, seniors, transgender people, people of color, and those in poverty. It is simply wrong for LGBT New Yorkers--or anyone else-- to be put into a Catch 22 where issues will not be addressed because there is a lack of data, but policymakers are squeamish or otherwise unwilling to ingrate us into their data gathering efforts. This lack of data leaves our community invisible and policymakers unable to propose good solutions to create a healthy community for all.
Visit www.prideagenda.org to read the whole report and learn more about LGBT health needs.
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