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Coleman-Chair-BP-7.jpgMedical advances, improved access to care, prevention initiatives, and our nation's aspiration of an AIDS-free generation are all good signs, but as a culture we will need to shift our perspective to stop the spread of HIV.

 
Over the last 30 years, where have we failed? We know that HIV is still mostly spread by sexual behavior. Yet, the disease is rather easily preventable through the use of condoms. Condoms are reasonably inexpensive, potentially readily available, easy to use, and highly effective in preventing HIV and other sexually transmitted infections (and unintended pregnancy). What a bargain! So, why are they not used more?


Behavioral HIV prevention strategies and interventions have tried to get people to reduce risky sexual behavior and promote condom use. While reasonably effective, there needs to be continuous implementation of these interventions, and they are costly. Investment in prevention strategies has always been difficult.


New strategies are overdue. In the United States, we continue to experience 50,000 new infections a year, with young people aged 13-29 accounting for 39% of all new HIV infections.* And, there are serious health disparities.  People of color, youth, and sexual minorities are much more likely to become infected than other groups. While 60% of new infections around the world are found in gay and bisexual men, only 2% of the global prevention budget is directed at this group. Also, transgender individuals are an overlooked population at major risk for HIV, due in large part to continued stigma and discrimination. This disparity in funding efforts represents the institutionalized stigmatization, heterosexism, and homophobia that exist in our cultures as well as in our public health systems. If we do not attend to this population as well as other marginalized populations such as sex workers and drug users, we will fail in our efforts to stop the spread of infections.


A fundamental problem remains. We remain a sexually dysfunctional culture. We live in a culture that is still uncomfortable talking about sex and sexuality in a mature and honest fashion. We continue to debate and hold back on providing comprehensive sexuality education. It is very clear that what distinguishes the United States from other developed countries in sexual health indicators is the existence of (or lack thereof) early and sustained comprehensive sexuality education. When kids are educated early they grow up to be more comfortable with talking about sexuality, more likely to be sexually responsible, and have lower rates of sexually transmitted infections and unintended pregnancies. They contribute to a cultural climate that is sexually healthy. That climate then insists on comprehensive sexuality education and thereby creates a cycle of healthiness. In the United States, we are still caught up in a negative and unhealthy vicious cycle. The goal of the Joycelyn Elders Chair in Sexual Health Education is to reverse this negative cycle.


As the current Chair in Sexual Health, I continue to push a sexual health agenda in HIV prevention. I believe in the need for a broad sexual health approach to stem the tide of the HIV epidemic. I envision an approach that goes beyond venereology and on an individual level

• emphasizes a positive and respectful approach to sexuality and sexual expression throughout the lifespan;

• acknowledges sexuality as a basic and fundamental aspect of our humanness and that the pursuit of sexual pleasure is natural and desirable;

• combats sexual coercion, shame, discrimination, and violence;

• promotes positive sexual identity and esteem;

• encourages honest communication and trust between partners;

• supports the possibility of having pleasurable, fulfilling, and satisfying sexual experiences;

• insists that individuals take responsibility of the consequences of their sexual choices and their impact on others; and

• optimizes reproductive capacity and choice

 

At the community level, it is achieved through

• access to developmentally appropriate, comprehensive, and scientifically accurate sexuality education;

• clinical and preventative sexual health services; and

• respect for individual differences and diversity and a lack of societal prejudice, stigma, and discrimination.

As the Chair in Sexual Health, I will continue to work with our faculty at the Program in Human Sexuality and with partners around the world to promote a sexually healthier culture - not only to address the sexual problems in the world -- but to advance the opportunity for everyone to lead sexually healthier lives which are pleasurable and satisfying.

Eli Coleman, PhD
Professor and Director
Chair in Sexual Health

 

New HIV Infections in the United States by Centers for Disease Control and Prevention

Momentum against reparative therapy

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Spitzer-BP.jpgIn recent months public momentum has been building against reparative therapy for individuals who are gay, lesbian, and bisexual. For more two decades organizations and associations that work with mental health professionals have been advising that sexual orientation change efforts are not likely to work and that these efforts may be harmful to patients.

Recently several incidents have brought this issue into the headlines. First, two leaders of organizations that have promoted reparative therapy have publically stated that sexual orientation change does not work, and they have apologized for the harm that their work may have caused to individuals: John Smid, former director of Love in Action,* October 2011 on Hardball with Chris Matthews and Alan Chambers, director of Exodus International, January 2012 at the Gay Christian Network conference. Since then Exodus International has shifted its stance on reparative therapy. In a blog post dated June 19, 2012, Chambers states that Exodus International is "no longer an organization that associates with or promotes therapeutic practices that focus on changing one's attraction." The organization states that they will now focus on helping individuals to reconcile their faith and same-sex attractions by not acting on those attractions.

In May 2012, the Archives of Sexual Behavior published a letter to the editor from Robert Spitzer, MD, retracting his study about the effectiveness of reparative therapy published by the journal in 2003.** In his letter Spitzer concluded, "I believe I owe the gay community an apology for my study making unproven claims of the efficacy of reparative therapy. I also apologize to any gay person who wasted time and energy undergoing some form of reparative therapy because they believed that I had proven that reparative therapy works with some 'highly motivated' individuals." Since 2003 Spitzer's study has been held up by organizations and even international governments as scientific proof that sexual orientation change is possible. Ironically, in 1973 Spitzer lead the efforts to remove homosexuality from the Diagnostic and Statistical Manual of Mental Disorders. Gabriel Arana, a writer for The American Prospect broke this story in April 2012 in his article "My So-Called Ex-Gay Life."

Currently the California Legislature is considering a bill that would make reparative therapy for individuals under the age of 18 illegal and require adults seeking conversion therapy to sign informed consent forms indicating that they understand the potential dangers, including depression and suicide, and that reparative therapy has no medical basis. The bill SB 1172 passed the House on May 30, 2012, and is now under active consideration in the Assembly. The bill states that

• Under no circumstances shall a mental health provider engage in sexual orientation change efforts with a patient under 18 years of age.

• Any sexual orientation change efforts attempted on a patient under 18 years of age by a mental health provider shall be considered unprofessional conduct and shall subject a mental health provider to discipline by the licensing entity for that mental health provider.

The bill's author Senator Ted Lieu said, "Under the guise of a California license, some therapists are taking advantage of vulnerable people by pushing dangerous sexual orientation-change efforts. These bogus efforts have led in some cases to patients later committing suicide, as well as severe mental and physical anguish. This is junk science and it must stop." Lieu went on to say, "Being lesbian or gay is not a disease or mental disorder for the same reason that being a heterosexual is not a disease or a mental disorder. The medical community is unanimous in stating that homosexuality is not a medical condition."

On May 17, 2012, the International Day Against Homophobia and Transphobia, the Pan American Health Organization released a statement outlining the dangers or reparative therapy, psychopathologization, and homophobia. The statement concludes, "A therapist who classifies non-heterosexual patients as 'deviant' not only offends them but also contributes to the aggravation of their problems. 'Reparative' or 'conversion therapies' have no medical indication and represent a severe threat to the health and human rights of the affected persons. They constitute unjustifiable practices that should be denounced and subject to adequate sanctions and penalties." The document makes recommendations of how homophobia and ill-treatment can be overcome through the efforts of governments, academic institutions, professional associations, media, and civil society organizations.

In 2009 the American Psychological Association issued a report based on two years of work that stated that sexual orientation change efforts can pose critical health risks to gay, lesbian, and bi-sexual patients and advised patients to avoid such treatments (see PHS Newsletter articles "APA warns against telling clients their sexual orientation can be changed," and Eli Coleman's "Letter from the Chair in Sexual Health September 2009").

*As of March 15, 2012, the organization Love in Action changed its name to Restoration Path.

**Spitzer, R. (2012). Spitzer Reassesses His 2003 Study of Reparative Therapy of Homosexuality. Archives of Sexual Behavior, 41 (4), 757. doi: 10.1007/s10508-012-9966-y

PHOTO:  Robert Spitzer, MD, Courtesy of Truth Wins Out, from Spitzer's video apology

 

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Letter from the Chair in Sexual Health

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Daniel-Zamudio-BP.jpgA Chilean gay man who was brutally beaten in a park in Santiago earlier this month succumbed to his injuries on March 27, 2012.  Prosecutors claim that 24-year-old Daniel  Zamudio was struck with bottles, rocks and other blunt objects before the attackers cut off part of his ear, carved swastikas into his chest, and burned other parts of his body with cigarettes.

The attack has sparked widespread outrage across Chile and throughout Latin America.
A few days after the attack, President Sebastián Piñera and Interior Minister Rodrigo Hinzpeter met with members of Zamudio's family and Movilh, a GLBT human rights advocacy organization.  Hinzpeter and the United Nations have urged Chilean lawmakers to pass a law that would ban discrimination based on sexual orientation, gender identity and expression.

Daniel Zamudio has become Latin America's Matthew Shepard.

What is tragic is that after 40 years of gay liberation, we still face homophobic attitudes that discriminate, stigmatize, and demoralize people based upon their sexual orientation.  In many countries scientific evidence has led to public policy changes and changes in public opinion, but obviously we have not gone far enough.

Thirty years ago, I wrote my most cited article "Developmental Stages of the Coming Out Process."  I wrote it to describe a new model of affirmation therapy as opposed to the outdated "illness model."  It showed how individuals could escape from shame and self-destruction through a process of affirming one's own sexual identity and developing meaningful relationships and integrating their sexual identity with their overall identity and integrating into society.

It was a helpful model then.  I am often struck by how relevant this article still is today.  Today the struggle for self-acceptance and acceptance by others has been made be easier, but true integration is still an issue.  Individuals, families, and communities continue to struggle around these issues.

Oh for the day that this article is irrelevant and meaningless.

Meanwhile, we need to continue to strive to make the world a more accepting place for diversity of sexual and gender identity.  Everyone's life is enriched by this acceptance.

There is obviously no place for the homophobic attitudes and hatred that apparently led to the death of Daniel Zamudio.  I do hope that like Matthew Shepard's death, that this horrible event will lead to greater public awareness, changes in public policy, and new hate crime laws that will help to foster a climate of tolerance, inclusion, and respect for diversity.

In Minnesota, we are struggling with the question of whether individuals who love someone of the same gender can be entitled to the full rights of citizenry - including the right to marry.  There is no scientific evidence which shows that this will have adverse effects on society; and in fact there is ample evidence that laws that assure rights to citizenry will result in better health for all.

We need to move to a more enlightened society based upon the best available science and the principles of democracy and justice.

Coleman, E. (1981/82). Developmental stages of the coming out process. Journal of Homosexuality, 7(2/3), 31-43. doi: 10.1300/J082v07n02_06

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Feminist Perspectives on the Psychology of Same Sex Marriages
Thursday, April 19, 2012
7:00 PM - 9:00 PM
Room 3-100 Mayo Memorial Building

Free and open to the public
Gender neutral restrooms will be available.

Lisa Diamond, Beverly Green, and Glenda Russell will discuss their research and clinical perspectives on marriage equality and the marriage amendment. All three speakers are nationally renowned researchers, authors, psychologists, and teachers. Their specialties are in GLBT concerns and they will speak about women's issues, sexual orientation, ethnic and cultural diversity, and feminism and marriage. Greene will focus on marriage equality as a wedge issue used to divide African Americans and LGBT people. Diamond will discuss areas of caution in the fight for marriage equality, specifically regarding the movement to position same sex couples as indistinguishable from heterosexual couples. Russell will discuss feminist views of marriage from the second wave in the 1970s to the present time. This event is being organized by the Minnesota Psychological Association, Minnesota Women in Psychology, GLBTA Programs Office, Program in Human Sexuality, and the Women's Center.

Beverly Greene, Ph.D., ABPP, St. John's University is Editor of "Education, Research, and Practice in Lesbian, Gay, Bisexual, and Transgendered Psychology" and "Ethnic and Cultural Diversity among Lesbian and Gay Men." Lisa Diamond, Ph.D. is Associate Professor of Psychology and Gender Studies, University of Utah and author of "Sexual Fluidity." Glenda Russell, Ph.D. is a psychologist practicing at the University of Colorado at Boulder.

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med-class-crop-2.jpgA study conducted at the Stanford School of Medicine confirms that a majority of American medical schools are lacking LGBT-related health curriculum in the classroom and in clinical training. The study findings were published on September 7, 2011, in the Journal of the American Medical Association.

The Stanford research team surveyed deans of medical schools in Canada and the United States.  Of the complete responses the group received (132 = 75%) they found that of the entire medical school curricula the median reported time dedicated to LGBT-related content was 5 hours.  Some schools reported dedicating no time to LGBT-related content in the classroom or the clinic.

At this time, most schools (128) teach student that when taking a patient's sexual history students should ask the question, "Do you have sex with men, women, or both?"  However, on a list of 16 LGBT-specific topics,* only 11 schools reported covering all 16 topics in their curricula.  The topics covered most frequently by schools are sexual orientation, HIV, and gender identity, and the topics covered least often by schools are genital reconstruction surgery, body image, and transitioning.

*LGBT specific curricula topics:  barriers to Care, body image, chronic disease risk, coming out, DSD/intersex, gender identity, HIV, LGBT, adolescents, mental health issues, safer sex, sexual orientation, SRS, STI, substance use, transitioning, unhealthy, and relationships/IPV

Obedin-Maliver, J., Goldsmith, E. S., Stewart, L., White, W., Tran, E., Brenman, S., . . . Lunn, M. R. (2011). Lesbian, Gay, Bisexual, and Transgender-Related Content in Undergraduate Medical Education. JAMA, 306(9), 971-977. doi: 10.1001/jama.2011.1255

Photo: PHS faculty teaching the human sexuality course at University of Minnesota Medical School

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LGBT-report-BP.jpgResearchers need to proactively engage lesbian, gay, bisexual, and transgender people in health studies and collect data on these populations to identify and better understand health conditions that affect them, says a new report from the Institute of Medicine (IOM).

The scarcity of research yields an incomplete picture of LGBT health status and needs, which is further fragmented by the tendency to treat sexual and gender minorities as a single homogeneous group, said the committee that wrote the report.

The historic report, The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, provides a thorough compilation of what is known about the health of each of these groups at different stages of life and outlines an agenda for the research and data collection necessary to form a fuller understanding.

"Based on a thorough review of the science, this report recommends a research agenda to better understand the characteristics of the LGBT population, assess their unique health needs, and to identify the factors that either compromise or promote their health and well-being," said Walter Bockting, PhD, IOM committee member and professor at the Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School. "The report recognizes that the LGBT population is diverse in terms of gender, age, race, and ethnicity, and calls for intervention research that addresses the needs of those with documented health inequities."

LGBT individuals make up a minority of the population, therefore researchers face challenges in recruiting sufficient numbers of these individuals in general population surveys to yield meaningful data. Stigma experienced by gender and sexual minorities can make them reluctant to disclose their orientation, worsening the problem. Moreover, it is difficult to synthesize data about these groups when studies and surveys use a variety of ways to define them.

Demographic data provides the foundation for understanding any population's status and needs, federally funded surveys should proactively collect data on sexual orientation and gender identity, just as they routinely gather information on race and ethnicity, the new report says. Information on patients' sexual orientation and gender identity also should be collected in electronic health records, provided that privacy concerns can be satisfactorily addressed, the committee said.

The National Institutes of Health should support the development of standardized measures of sexual orientation and gender identity for use in federal surveys and other means of data collection.

In addition, the National Institutes of Health should provide training opportunities in conducting research with LGBT populations. Training should engage researchers who are not specifically studying LGBT health issues as well as those who are. The agency also should use its policy on the inclusion of women and racial and ethnic minorities in clinical research as a model to encourage grant applicants to address how their proposed studies will include or exclude sexual and gender minorities.

Throughout his tenure at the University of Minnesota, Bockting has conducted research on the health disparities found among transgender people.

Bockting said, "This Report recognizes that we have much to learn about the health of this subgroup of the LGBT population, and calls for research to improve access to quality, evidence-based transgender care. The acknowledgment of this still largely invisible population and the attention the Report draws to their specific health needs is enormously validating and holds the promise of new initiatives to promote transgender health."

The study was sponsored by the National Institutes of Health. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

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Robert Garofalo MD, MPH, to speak at UMN

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Robert-Garofalo-MD-200x275.jpg"Advancing the Health of Lesbian, Gay, Bisexual, and Transgender Youth"

Robert Garofalo MD, MPH

Thursday, May 12, 2011, 4:30 PM

University of Minnesota

Mayo Memorial Auditorium

425 Delaware Street SE, Minneapolis, MN 55455

Free and open to the public. Allow for extra travel time to campus due to Central Corridor Light Rail construction.

On May 12, 2011, Robert Garofalo, MD, MPH, will discuss the process and findings of the recent Institutes of Medicine (IOM) Committee Report, The Health of Lesbian, Gay, Bisexual, and Transgender People. He will summarize and contextualize the state of the science as it exists for LGBT youth and, as suggested by the IOM, offer a paradigm for the next generation of academic work for this vulnerable population.

Dr. Garofalo is an associate professor of Pediatrics and Preventative Medicine at Northwestern University Fienberg School of Medicine. He is also an attending physician at Children's Memorial Hospital where he directs the Adolescent/Young Adult HIV Program. Dr. Garofalo is a national authority on LGBT health issues, adolescent sexuality, and HIV clinical care and prevention. He has been the principal investigator on five National Institute of Medicine (NIH) and two Centers for Disease Control and Prevention (CDC) funded research grants and serves as a co-investigator on three additional NIH-funded projects. He is the former past-President of the Gay and Lesbian Medical Association. In 2010, Dr. Garofalo served as a committee member for the National Academy of Sciences/Institute of Medicine Committee on Lesbian, Gay, Bisexual and Transgender Health Issues and Research Gaps and Opportunities.

Joycelyn-Elders-MD-BW200x226.jpgFormer US Surgeon General, Joycelyn Elders, MD, will attend the lecture as a discussant.

Please join us for the John Money Lecture in Pediatric Sexology hosted by the Program in Human SexualityDepartment of Family Medicine and Community Health, and the University of Minnesota Medical School.

Event co-sponsors

Boynton Health Service

Division of Pediatric Endocrinology, Department of Pediatrics

GLBTA Programs Office

Healthy Youth Development Prevention Research Center, Division of Adolescent Health and Medicine

Planned Parenthood Minnesota, North Dakota, South Dakota

School of Public Health

SHADE (Sexual Health Awareness and Disease Education)

Teenwise Minnesota

Transgender Commission

Youth and AIDS Projects, Division of Adolescent Health and Medicine


 

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Gay marriage now legal in Washington DC

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dc-bp.jpgOn March 3, 2010, same-sex marriage became legal in Washington DC. The district joins Connecticut, Iowa, Massachusetts, New Hampshire, and Vermont in granting marriage licenses to gay couples.

Many couples have requested licenses, some standing in line at the courthouse for hours. According to the Associated Press the courthouse spokeswoman Leah Gurowitz said that the 466 applications received from both gay and straight couples is much higher than the 50 or so applications normally received in a week.

On March 9, 2010, the Human Rights Campaign headquarter office in DC hosted some of the first wedding ceremonies.

Video of the first ceremonies on YouTube

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Hate crime protections have been expanded

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Shepard-Byrd-Act-BP.jpgOn October 28, 2009, President Obama signed the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act into law.  This act expands federal hate crime protection to include gender, sexual orientation, gender identity, and disability.

FBI data suggests that since 1991 there have been more than 118,000 hate crimes reported.  In 2007 more than 7,600 were reported, and in the last ten years there have been more than 12,000 reported hate crimes that were based on sexual orientation.

Obama affirmed the importance of this legislation in his remarks at a reception to celebrate the new act, "You understood that we must stand against crimes that are meant not only to break bones, but to break spirits -- not only to inflict harm, but to instill fear.  You understand that the rights afforded every citizen under our Constitution mean nothing if we do not protect those rights -- both from unjust laws and violent acts."  

View a video of the president's remarks

Read the full text of president's remarks.

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PAHO-BP.jpgOn July 12-14, 2009, the Pan American Health Organization (PAHO) held an expert consultation in Panama City, Panama, to develop concrete recommendations for a regional multi-component action plan to address health needs and demands of the men who have sex with men (MSM) population.  Eli Coleman PhD, on behalf of PHS, was invited to participate and facilitate part of the meeting.  In addition, PHS postdoctoral fellow, Cesar Gonzales, PhD, was also invited to share his expertise in HIV prevention among MSM and transgender populations.  The objective of the consultation was to analyze factors and situations associated with health problems, social hardship, and poor quality of living among gay and bisexual men, and other MSM in Latin America.  Participants proposed a set of urgently needed interventions to meet the sexual health needs of MSM, including prevention of HIV and other sexually transmitted infections.  Forty participants were invited from all regions of the Americas with particular emphasis on experts from Latin America and the Caribbean including UN agencies in charge of the MSM/sexual diversity; experts in provision of HIV/STI, sexual health, mental health or addiction services to MSM populations; and experts in development of health services for specific target populations.  In order to activate these strategies throughout Latin American and the Caribbean PAHO will outline consultation recommendations technical document that is forthcoming.

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Diaz-BP.jpgPsychologist, activist, and scholar, Armando Diaz, traveled from Mexico City to study at PHS.  Diaz is working on his PhD in sociology at El Colegio de Mexico.  Inspired by Cara a Cara (Face to Face) an HIV prevention training program for community advocates that was created by PHS and conducted in Mexico, Diaz developed the educational program Hombres, conciencia y encuentros (Men, Awareness, and Encounters).  Diaz's training is designed to reduce social and personal vulnerability among gay men and men who have sex with men in urban and rural communities throughout Mexico.  Through presentations, workshops, and small group discussions, trainers focus on sexual diversity, masculinity, history, human rights, HIV/AIDS prevention, and physical and emotional health.  Starting locally in Guadalajara, the program has expanded to reach individuals from many areas of Mexico.  The group is now working with the Sexual Citizenship Network from Jalisco, National Vigilance Council in Sexual Diversity and HIV/AIDS.

Diaz has come to understand the importance of sexual health education and sexual rights.  Although many of the young LGBTI in Mexico are more open about their sexual identity, and there is a growing culture presence with GLBT parades and public gathering places, advocates still have work to do to achieve full integration.  Through their research Diaz and his colleagues found that many individuals young and old are challenged in constructing intimate relationships and many young people do not fully understand the potential impact of HIV.

Diaz believes that an empowered individual has the opportunity to look beyond his own needs to the needs of his community.  Ideally, strengthening a person strengthens the family, the community, the nation, and ultimately, the world.  "The world has been broken through the mistakes of discrimination and injustice.  The social acceptance of sexual diversity will help to align communities and right this history," said Diaz.  It is Diaz's hope that with acceptance an individual can turn his focus to other social issues like homelessness, poverty, and the environment.

While at PHS Diaz spent time consulting with Eli Coleman, PhD, as well as spending some time at a St. Paul clinic (La Clinica) to better understand the options and needs surrounding sexual health and HIV/AIDS for Latinos.   He also made time to explore materials in the Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies.  He was excited to find books about the GLBT rights movement in Mexico that he has not been able to locate at home.  Diaz feels that connecting the present to the past is very powerful.  He said, "history shows millennia of violence and discrimination and when one transgender person decides to live as he feels, when one lesbian chooses to love who she loves, and when one gay man decides to assume himself these people are changing the world by breaking the power structure of history.  I am fortunate to work with these individuals and to witness the change."

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India decriminalizes homosexuality

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India-BP.jpgOn July 2, 2009, India's High Court decriminalized homosexuality by removing Section 377 of the Indian Penal Code.  The historic judgment reverses a nearly 150-year old law which brought about sentences ranging from fines to a 10-year term in jail.  In his conclusion, Chief Justice Dr. S Muralidhar wrote, "Where society can display inclusiveness and understanding, such persons can be assured of a life of dignity and nondiscrimination. . . . It cannot be forgotten that discrimination is antithesis of equality and that it is the recognition of equality which will foster the dignity of every individual."  August marked gay pride celebrations in India, and this year they celebrated legally.

PHOTO credit:  158 at NowPublic.com

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About this Archive

This page is an archive of recent entries in the Gay category.

Fellows is the previous category.

Gender Identity is the next category.

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