BACK TO PHS NEWSLETTER


Katie Spencer, PhD, assistant professor, is the new coordinator of Transgender Health Services at PHS. Spencer is eager to continue to bring the program in line with current best practices in transgender care, increase operational transparency, and deepen community collaborations.

Spencer believes that, "In recent years there has been a huge and welcomed shift in health care for transgender and gender nonconforming individuals. Across the nation and locally more physicians and mental health providers are being trained to provide quality care for transgender and gender nonconforming patients, which increases access for trans clients. Part of our role is to continue to engage in cutting-edge research, training, and clinical service to break down barriers to competent care for trans clients. We have also seen a ground swell in community organizations that provide support to individuals across the gender spectrum. It is an exciting time to be in transgender health care, with multiple opportunities for collaboration, capacity building, and expanding the framework of how we provide trans clients the best holistic health care."

Over the last month Spencer has started to systematically incorporate the recommendations from the revised Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People as well as science-based research on trans health into the operations of the Center for Sexual Health. This process includes updating staff and patient materials as well as clinical procedures. She is also meeting with community organizations, community health care providers, and colleagues in the region to discuss possible collaborations and partnerships. Spencer will be reviving a community advisory board to focus on the Transgender Health Services program. Spencer's longer-term goals include developing a patient peer mentor program, revamping the group therapy model, and creating a community support space for patients and families that would include a library or resource materials on health, legal, and social support issues.

Spencer believes in empowering patients to have more say in their own and their community's care, revising our model of care to reflect patient-centered, patient-informed, and collaborative models of care, consistent with feedback from trans health care advocates and research on best outcomes for patient care. Spencer said, "My goal is to build on our successes in developing innovative research and public policy in the area of transgender health and incorporate these principles into a strong and cohesive framework that supports all aspects of our work in clinical care, new research, and community advocacy."

In addition to her clinical work, Spencer works with multiple community organizations working to educate about LGBT healthcare issues and primarily transgender healthcare. She works with the Minnesota Trans Youth Support Network on the Community Hormone Access Project, partnering with community advocates and trans youth to develop community based hormone protocols for transgender care, in hopes to increase access to competent care and hormone provision for trans youth. She recently participated in the development of a theatre educational project for high schools on transgender youth issues. Spencer provides training, education, and consultation on sexual health and transgender issues, and has worked with the Family Tree Clinic, Face to Face Health and Counseling Services, Fairview Clinics, the University of North Dakota, and the Minneapolis Veterans Administration. Spencer often speaks about the intersections of LGBT rights and impact on wellbeing, and recently presented a First Friday Forum for the Minnesota Psychological Association on the psychological research on same sex marriage.

Spencer received her MA and PhD in counseling psychology from the University of Missouri-Columbia. She received her BA in women's studies and psychology from the University of Wisconsin-Madison. Her internship was completed at the University of Illinois-Chicago Counseling Center, and she was a postdoctoral fellow at PHS. She has a strong interest social justice, and education and training of therapists and medical providers in sexual health and transgender health care competency. Her primary clinical practice is working with transgender and gender non-conforming, adolescents, and adults, women's sexual health, and LGBT sexual health and wellbeing. She co-facilitates several groups, including the gender exploration group for youth and their families, the women's sexual health group, and transgender adult interpersonal groups. She has experience working with compulsive sexual behavior and general sexual dysfunction concerns. Her research and clinical interests focus on cultural competency in working with LGB and transgender populations, LGBT sexual health, sex therapy with LGBT couples, trans youth, and feminist embodied approaches to sexual health.

Spencer became coordinator of Transgender Health Services in October 2012, when the former coordinator Walter Bockting, PhD, joined the Initiative for LGBT Health a new program at the New York Psychiatric Institute and the Columbia University.

BACK TO PHS NEWSLETTER

BACK TO PHS NEWSLETTER

 

PHS joined Exposed Brick Theatre to create the new play based on the stories, experiences, and perspectives of transgender and gender non-conforming youth. Nearly 180 people attended the premiere performance of Trans/formation: Addressing Gender Issues in School at the Pillsbury House Theatre. After the production, the audience enjoyed a lively discussion with the cast, writers, and director about the themes of the play and their experience working on the project.

The aims of the project are to validate transgender and gender non-conforming youth experiences through performance, to educate peers, parents, families, friends, and educators about the experiences of transgender and gender non-conforming youth, and to encourage dialogues around gender issues, advocacy, and ally support for adolescents.

The performance on May 4, 2012, was the first step in a larger process. The next steps will be for the playwrights Anton Jones, Suzy Messerole, and Aamera Siddiqui to make final edits to the script and for PHS psychologists Katie Spencer, PhD, and Dianne Berg, PhD, to finalize the educational materials on the themes of the play. The play script and educational materials will then be made available for high school groups to download and perform at their schools, amplifying the impact of this project.

PHS and Exposed Brick would like to thank Stacey Mills and Sam Heins for their donation that made this project possible. We would also like to thank all of the people that helped to create this piece including the youth we interviewed, the advisory board whose thoughtful and creative feedback lifted the play to a whole new level, the youth who read the early drafts and whose honest feedback led us in the right direction. The youth performers are outstanding and their commitment to the piece has been amazing.

PHOTO: credit David Hannigan

 

BACK TO PHS NEWSLETTER

 

BACK TO PHS NEWSLETTER

PHS has joined Exposed Brick Theatre to create a new play Trans/formation: Addressing Gender Issues in School based on the stories, experiences, and perspectives of transgender and gender non-conforming youth.  Dianne Berg, PhD, and Katie Spencer, PhD, are working with playwrights Anton Jones, Suzy Messerole, Aamera Siddiqui, and a community advisory group to develop the production and educational materials.  The aims of the project are to validate transgender youth experiences through performance, to educate peers, parents, families, friends, and educators about the experiences of transgender youth, and to encourage dialogues around gender issues, advocacy, and ally support for adolescents.
"In working with trans youth, it is integral to reach them in the settings they are in daily, it is not enough to intervene in the therapy office, but you also have to reach out to the classroom, to families, and to the community," said Spencer.  "This is a big step for PHS to put funding behind a community educative initiative like this, and I can tell you, from the community work I have been doing, people are really responding to it and they see it as a positive thing!"

The play production will be premiered on May 4, 2012, at the Pillsbury House Theatre in Minneapolis.  The play will also be performed at a Twin Cities high school.  Ultimately the play script and educational materials will be available for high school groups to download and perform at their schools. 

Messerole said that one of the individuals interviewed for the play shared that during his junior year of high school the gay straight alliance at his school brought in a speaker who was transgender.  The student shared with Messerole that it was the first time he had ever seen another transgender person and it was a very powerful experience.  Messerole added, "We all need to know that we are not alone, we all need to know that there are others who have similar stories. One of the most powerful things about theatre is its ability to hold up a mirror and see one's self reflected on stage. It's very validating to see someone one stage who 'gets you' in a way that is complex and nuanced."

Exposed Brick has worked extensively with area schools, creating over 30 Stand In It with Me performances since 2006.  Stand In It With Me performances are custom created for each school, based on interviews with students and teachers.  The performances fuel dialogue on issues of racism, gender discrimination, sexual orientation, classism, immigration, and more.

PHS and Exposed Brick are grateful to Stacey Mills and Sam Heins for their donation that made this project possible.  We would also like to thank all of the people that helped to create this piece including the youth we interviewed, the advisory board whose thoughtful and creative feedback lifted the play to a whole new level, the youth who read the early drafts and whose honest feedback led us in the right direction.  The youth performers are outstanding and their commitment to the piece has been amazing.

Community Advisory Board Members
Claire Avitable, director, 20% Theater Company
Katie Burgess, director, Trans Youth Support Network
Andrea Jenkins, trans activist, performer, poet
Moe Lionel, performer, Naked Stages Performer
Anthony Neumann, performer, director, Naked Eye
Ethan Turcotte, arts administrator, Kulture Klub Collaborative

Trans/formation: Addressing Gender Issues in School
By Anton Jones, Suzy Messerole, and Aamera Siddiqui

Friday, May 4, 2012 at 7 PM
Pillsbury House Theatre, 3501 Chicago Avenue South, Minneapolis, MN 55407

Parking: Free parking is available in the Pillsbury House lot next to Full Cycle, just south of 35th on the east side of the street.  Free street parking is also available on 35th and all other surrounding neighborhood streets.

Free and open to the public.  To reserve a seat, please RSVP to Jenae Batt at jenae@umn.edu or 612-625-1331.

BACK TO PHS NEWSLETTER

BACK TO PHS NEWSLETTER

Walter Bockting, PhD, was appointed to the American Psychological Association (APA) Task Force on Guidelines for Psychological Practice with Transgender and Gender Non-conforming Clients.  

Earlier, Bockting also served on the APA Task Force on Gender Identity and Gender Variance that released a report in 2008 that made several recommendations, including the recommendation to develop practice guidelines.  The new guidelines will help psychologists and students develop cultural competence for working with transgender clients and their families.

The group had their first face-to-face meeting February 10-12, 2012, in Atlanta, GA.  Bockting described the meeting as very productive.  He said, "Our task came into focus when we heard from individuals from the Atlanta transgender community about what is important to them and the challenges they have faced in their interactions with psychologists.  These guidelines are long overdue."  Once the guidelines are published, the next step will be to develop training for psychologists and students to develop their competence in treating transgender individual with respect and sensitivity.

The task force is a joint effort between Division 44 and the American Psychological Association Committee on Lesbian, Gay, Bisexual, and Transgender Concerns.  Group members include lore m .dickey (co-chair), Anneliese A. Singh (co-chair), Walter Bockting, Sand Chang, Kelly Ducheny, Laura Edwards-Leeper, Randall Ehrbar (PHS postdoctoral fellowship alumnus), Max Fuhrmann, Michael Hendricks, and Ellen Magalhaes.

In January 2012 the APA published practice guidelines in several areas, including revised "Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients."

BACK TO PHS NEWSLETTER

BACK TO PHS NEWSLETTER

Eli Coleman, PhD, and Walter Bockting, PhD, joined a meeting convened by the Pan American Health Organization / World Health Organization (PAHO / WHO) from December 19 to 21, 2011.  PAHO gathered representatives of the health sector, academia, and civil society organizations to discuss a series of recommendations for health services on how to address the needs and demands of transgender people in the region of the Americas.

The conclusions of this meeting will become part of a reference document addressing the main problems affecting access to and utilization of health services for and by transgender people. In addition, a plan for the development of a comprehensive strategy for health care provision for this population throughout the region will be designed. Both documents will subsequently form the basis for sub-regional consultations to be held in 2012.

The participants of the meeting, which was held at the headquarters of PAHO/WHO in Washington D.C., decided to adopt the term "trans" to refer to a population whose members are characterized by a variety of gender identities and expressions that differ from their sex assigned at birth. This population faces a number of problems in accessing health services in the countries of the region, many of which are a result of stigma, a lack of appropriate medical protocols and a lack of information on how to deal with certain social situations.

"Trans people have traditionally been stigmatized, marginalized, abused, discriminated against, and even subject to physical and emotional violence. These and other expressions of transphobia have to be considered factors that negatively impact health," said Dr. Gina Tambini, Area Manager of Family and Community Health. "In order for the health sector to be able to adequately respond to the needs of trans persons, we must create and implement policies of non-discrimination, rely on qualified personnel, and ensure that there are environments of respect and quality of care. The presence and active participation of trans persons was a fundamental and indispensable contribution to the success of the meeting.

Trans people as a group have greater vulnerability and exposure to such health problems as HIV, syphilis, gonorrhea, hepatitis, and genital herpes, which create special demands on health services. But in addition, health care providers need to be sensitive to issues of gender identity related to this group.

"The needs, problems, and demands of trans people cannot be defined externally, but must be expressed by them themselves," said Dr. Tambini.

At the PAHO meeting, participants discussed terminology, definitions, and descriptions of this population, as well as epidemiological profiles and health initiatives that have been carried out in the Americas. In addition to reviewing and discussing the content of the reference document, the meeting was intended to promote a multisectoral and multidisciplinary vision on the provision of services, including prevention.

PAHO was established in 1902 and is the world's oldest public health organization. PAHO works with all countries in the Americas to improve the health and quality of life of people of the Americas and serves as the Regional Office for the Americas of WHO.

BACK TO PHS NEWSLETTER

BACK TO PHS NEWSLETTER

The PHS research project All Gender Health is now recruiting participants to assist in the evaluation of a transgender health promotion program.  This is the culmination of a multi-year project funded by the National Institutes for Health (NIH) to look at the health and well-being of transgender people and their partners.  This is one of the first projects to look at the community as a whole, surveying people across the gender spectrum, and targeting health promotion to those who need it most.  All Gender Health will be enrolling participants through May 24, 2012.

All Gender Health is a web-based research project examining the effectiveness of an online activity-based sexual health intervention.  Previous phases of the All Gender Health project involved qualitative and quantitative data gathered from a national sample of the transgender population as well as the male partners of transgender people, which informed the development of the current and final phase.  This final phase is the evaluation of a website comprised of 22 different topics in 8 different modules developed by community members across the country.  Designed to meet users where they are, www.allgenderhealth.org allows each participant to identify goals around topics such as identity, community, resilience, , dating and relationships, and sexual health negotiation. Users then craft a plan toward those objectives in a simple, individualized way.

Over the past few years, a research team led by Walter Bockting, PhD, has worked closely with software engineers to custom build a research and intervention platform for this project.  Project coordinator, Chris Hoefer, describes the intervention as, "What used to be an all-weekend, two-day seminar with high level presentations and smaller group discussions has now been transformed into an interactive web-based experience that anyone anywhere can visit at their leisure in the comfort of their own home.  You only need access to a computer and the internet and you can draw on the knowledge and experiences of a broad collection of educators, entertainers, physicians, therapists, advocates, and community members."

Hoefer sees access as a huge advantage to the online format of health promotion.  Another advantage is the ability to upload new content and intervention modules as new knowledge becomes available. 

As with all things web-based, unforeseen challenges arose as study participants worked through the project. This means that Hoefer and his team must occasionally act as technology support when users find themselves using incompatible web browsers, video players and device hardware. "A unique challenge to a project like this is the rapid change in technology," says Hoefer. "Some of the elements built just a few years ago have already needed updates and the hardware being used to access it is obviously different. Nobody even knew what an iPad was when we began this process. But that's one of the inspiring  questions: how can we use these tools to bring sexual health information to people where they're able to absorb it?"

Findings from this study will be used to develop further online interventions to promote the health and well-being of transgender people and their partners.

The All Gender Health research team includes Walter Bockting, PhD (principal investigator), Eli Coleman, PhD, Jamie Feldman, MD, PhD, Cesar Gonzalez, PhD, Stephanie Hengst, Chris Hoefer (project coordinator), Keith Horvath, PhD (epidemiology), Michael Miner, PhD, Bean Robinson, PhD, , Rebecca Swinburne Romine, PhD, and David Valentine, PhD (anthropology).

BACK TO PHS NEWSLETTER

Back to PHS Newsletter

The World Professional Association for Transgender Health (WPATH) released a newly-revised edition of the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (SOC), on September 25, 2011, at the WPATH conference in Atlanta. This is the seventh version of the SOC.  The original SOC were published in 1979.  Previous revisions occurred in 1980, 1981, 1990, 1998 and 2001.

The SOC is considered the standard document of reference on caring for the transsexual, transgender, and gender nonconforming population. The newly-revised SOC will help health professionals better understand how they can offer the most effective care to these individuals.  The SOC focuses on primary care, gynecologic and urologic care, reproductive options, voice and communication therapy, mental health services and hormonal and surgical treatment.

"The latest 2011 revisions to the SOC realize that transgender, transsexual, and gender nonconforming people have unique health care needs to promote their overall health and well-being, and that those needs extend beyond hormonal treatment and surgical intervention," said SOC Committee Chair, Eli Coleman, PhD, Professor and Director at Program in Human Sexuality, University of Minnesota. 

"The previous versions of the SOC were always perceived to be about the things that a trans person must do to satisfy clinicians, this version is much more clear about every aspect of what clinicians ought to do in order to properly serve their clients. That is a truly radical reversal . . . one that serves both parties very well," said Christine Burns, SOC International Advisory Committee Member.

More than any other version, 2011 revisions also recognize that gender nonconformity in and of itself is not a disorder and that many people live comfortable lives without having to seek therapy or medical interventions for gender confusion or unhappiness.

This version provides more detailed clinical guidelines to address the health care needs of children, adolescents, and adults with gender dysphoria who need assistance with psychological, hormonal, or surgical care. 

In addition to clearly articulating the collaborative relationship needed between transsexual, transgender, and gender nonconforming individuals and health care providers, the new, 2011 revisions provide for new ways of thinking about cultural relativity and culture competence. 

The document includes a call to advocacy for professionals to promote public policies and legal reforms that promote tolerance and equity for gender and sexual diversity.  This document recognizes that well-being is not obtained through quality health care alone but a social climate that eliminates of prejudice, discrimination, and stigma and promotes a positive and tolerant society that embraces sexual and gender diversity.

WPATH, formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity disorders.  As an international multidisciplinary professional Association the mission of WPATH is to promote evidence based care, education, research, advocacy, public policy and respect in transgender health.

The World Professional Association for Transgender Health. (2011). Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, 7th Version.  Retrieved from http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf

Back to PHS Newsletter
 

Back to PHS Newsletter

A 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

Back to PHS Newsletter

Back to PHS Newsletter

Walter Bockting, PhD, participated in International Partnership for Advancing Transgender Health seminar in Salzburg, Austria, on October 2 - 8, 2011.

The meeting launched a multi-year partnership with international organizations including TIG (lead organization) and Labrys (supporting partner) in Kyrgyzstan, RED TRANS in Peru, Gender DynamiX in South Africa, and The Open Society Public Health Program and the Center of Excellence for Transgender Health at the University of California.

The group aims to establish and implement culturally appropriate guidelines on transgender health care. Ultimately, groups plan to cultivate trained networks of medical care providers who can offer high quality transgender health care and who will participate in the dissemination of best practices regionally.

Back to PHS Newsletter

Back to PHS Newsletter

October 20 - 22, 2011, Eli Coleman, PhD, and Joycelyn Elders, MD, presented at the VIII Congreso Nacional de Educación Sexual y Sexología organized by the Federación Mexicana de Educación Sexual y Sexología, A.C. (FEMESS) in Chiapas, Mexico.

More than 800 individuals attended the conference, including 150 people form the academic sector and health organization and 54 civil servants from the Ambulatory Centers of Prevention and Attention in AIDS and STI (Centros Ambulatorios de Prevención y Atención en SIDA e ITS or CAPACITS).

In a post-conference statement made by FEMESS, the organization thanked the government and university of the state of Chiapas for supporting the conference.  The organization also commended the government for its commitment to reach the United Nations Millennium Development Goals.  The organization also reiterated its support of the 2008 Inter-ministerial Declaration which was adopted by all health and education ministries in Latin American and the Caribbean which advocated for comprehensive sexuality education starting in pre-school to stem the tide of the HIV pandemic.  

FEMESS restated its goal to depathologize transsexualism as a mental disorder.  The organization reaffirms the need for gender expression to be recognized as a fundamental human right of free expression.  Further the group called on mental health professionals to support this position and join in the goal.

Videos from the conference:

Eli Coleman & Youth's Sexual Health in the 21st Century: Get involved!

Joycelyn Elders & Youth's Sexual Health in the 21st Century: Education, Empowerment & Resources

Photo: Joycelyn Elders, MD, Eli Coleman, PhD, with FEMESS conference organizers

Back to PHS Newsletter

Back to PHS Newsletter

August 1 - 5, 2011, Jae Sevelius, PhD, visited PHS to meet with one of her project advisors, Walter Bockting, PhD, and to learn about our transgender research and transgender health clinic.

Bockting is working with Sevelius on her NIH/NIMH-funded K-Award project to assess HIV risk behaviors and protective factors among transgender women of color to develop a culturally specific HIV prevention intervention for this high-risk, underserved population. 

The current focus of her K research is examining how the need for gender affirmation (a psychosocial dimension that refers to transgender women's desire for validation and support of their gender identity and expression) interacts with access to gender affirmation (their access to this type of validation and support) to promote or protect against risky health behaviors.  Sevelius is in year 3 of a 5-year grant.

Sevelius presented her research project to PHS faculty and staff.  She said, "I am passionate about promoting health and wellness within transgender communities. That certainly includes addressing health disparities, such as the egregious rates of HIV among transgender women of color, but also includes bringing resources to trans communities to support overall sexual health, mental health, holistic well-being, and spirituality."

She added, "One of the most rewarding aspects of my work so far has been witnessing the direct impact of the sexual health promotion intervention that I am developing for transgender women of color." Sevelius and two research assistants, Danielle Castro and Angel Ventura, conducted a pilot study of the intervention this year.  Sevelius said that she was, "astounded by the intensity of the positive response we got from participants. It is a peer-led intervention so I was just an observer, but there were many moments that I was brought to tears by what I witnessed during the course of these small-group sessions. The participants shared so much of themselves, supported one another through difficult disclosures, and struggled together to find connection and love through the traumas they have faced and continue to face in an ongoing way, even in a place that is as reputedly liberal as San Francisco. The participants were so grateful for the opportunity to come together in that way and learn from each other and the wonderful facilitators."

Sevelius is an advocate for systematic change for the wellness of the transgender community. She is hopeful that an increased visibility for the community will lead to an increased commitment to address the severe inequities and systemic transphobia that are pervasive. Sevelius said, "Unfortunately, I think we still have a long way to go here in the US in that we still do not collect trans-inclusive data that provides us with the essential big picture perspective that would allow us to really frame the issues accurately.  Health care providers are not adequately educated about the needs of trans people, and violence and discrimination are absolutely rampant. We need to start by acknowledging the existence of trans people on a national level by capturing their unique circumstances and needs in a systematic way."

Sevelius is an Assistant Professor with the Center for AIDS Prevention Studies (CAPS) in the Department of Medicine at the University of California San Francisco, and Co-Principal Investigator of the Center of Excellence for Transgender Health, which promotes increased access to culturally competent health care for transgender people through research, training, and advocacy. With funding from the California HIV/AIDS Research Program, building on work of the Transitions Project and in collaboration with API Wellness' TRANS:THRIVE program, Sevelius is also working to adapt and evaluate the evidence-based HIV prevention intervention SISTA (Sisters Informing Sisters about Topics on AIDS) for transgender women of color.  Another CHRP-funded project of Sevelius' is a qualitative investigation of the barriers to HIV treatment engagement and adherence among transgender women living with HIV. 

Back to PHS Newsletter

 

BACK TO PHS NEWSLETTER

Researchers 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.

BACK TO PHS NEWSLETTER