In June of 2000, Bill Clinton designated the month of June as “Gay and Lesbian Pride Month” to commemorate the beginning of the Gay Liberation Movement during June of 1969. At that time, open homosexuality was prohibited and places of safety were often subjected to raids.
On June 28, 1969, a group of openly gay patrons at a gay bar called the Stonewall Inn in Greenwich Village, NY decided that they would no longer accept harassment by the police. Riots broke out, prompting law enforcement to send riot control officers in efforts to squelch the rebellion. For days after, protests were held at various places in New York as well as throughout the country.
More recently, former president Obama has been an advocate for gay rights, and in 2014 he signed an executive order that prohibits discrimination against federal employees and contractors on the basis of sexual orientation or gender identity. In June 2016, President Obama issued a proclamation calling for the elimination of prejudice “everywhere it exists and to celebrate the great diversity of the American people.”
Since 2010, the Rainbow Health Initiative in Minnesota has published an annual report called the “Voices of Health” about the wellness in the lesbian, bisexual, gay, transgender and queer (LBGTQ+) community (www.rainbowhealth.org/files). They designed this survey to gain insight into determinants of health that impact health outcomes in the LGBTQ+ population.
Determinants of health reflect the social factors, physical conditions of the environment where people live, individual behaviors, medical and behavioral health conditions, and access to health care that influence health status (healthypeople.gov). In 2016, over 2,200 LBGTQ+ Minnesotans completed their questionnaire about food security, homelessness, tobacco use, mental health and unwanted sexual contact.
In a review of their findings, social determinants of heath such as ability to afford food and housing were identified as barriers to quality health. Low access to nutritious food, as evidenced by skipping meals, cutting back and going hungry because of lack of finances, were identified by almost 30.8 percent of those surveyed.
Over 20 percent of participants indicated they had been homeless at least once or twice at some point in their lives, and 3.2 percent of respondents indicated that they were homeless at the time of the survey. The primary barriers attributed to securing housing were found to be unemployment and low wages.
Moreover, individual behaviors related to health included tobacco use, and though there has been a 4.5 percent decline in smoking in the LGBTQ+ population, 22 percent still report use. According to the Centers for Disease control, current rates of tobacco use nationally have also declined, but 15 percent of the general population report continued use of tobacco products.
Access to culturally responsive health care is particularly critical in the LBGTQ+ population due to the higher incidence of heart disease, asthma, certain cancers and osteoarthritis. Although the majority of responders indicated they have health insurance, African Americans are almost twice as likely to be uninsured (11.8 percent). Over one third of those questioned indicated they had not talked with their provider about sexual health in the last year.
The report also highlighted very high rates of mental health issues including depression (61 percent), post-traumatic stress disorder (45 percent), and anxiety (36 percent). The risk of suicide and suicide attempts in LGBTQ+ youth is alarming and up to four times the national average.
The high rate of sexual violence perpetrated in the LBGTQ+ population increases the prevalence of mental health issues, and 50-60 percent report being the victim of sexual violence, coercion or manipulation. It is clear that there are a number of health disparities in the LGBTQ community and a need for community education, support and inclusion.
These findings necessitate a change in how we approach health as it relates to the LGBTQ+ community. It is important to have a trusting relationship with a primary care provider who can promote wellness and prevention over the life span. Although political and social attitudes have shown some improvement, caution prevails, and up to 57 percent of LGBTQ+ who completed the questionnaires are not out with their provider.
NorthPoint Health and Wellness Center is working toward change. Leah Post-Radcliff leads To the Point, the family planning and sexual health program at NorthPoint, and is available to provide education and resources about LGBTQ+ health and wellness using a holistic approach. Services offered include:
- Birth control counseling and education
- STI counseling and education
- Pregnancy options counseling
- Free condoms and safer sex supplies (including lube!!)
- Community education programming
- Rapid HIV testing — no cost
- Dispense Plan B — ages 15+, no cost
- Family Planning Insurance coverage
- Vasectomy and tubal ligation education and scheduling
- Community outreach
- STI and pregnancy testing — no cost
For questions about your mental, physical and sexual health, contact your primary care physician, your behavioral health provider, and/or your local sexual health clinic.
Deirdre Annice Golden, Ph.D., LP, is director of behavioral health for NorthPoint Health and Wellness Center Behavioral Health Clinic, 1313 Penn Ave. N. She welcomes reader responses to Deirdre.Golden@co.hennepin.mn.us, or call 612-543-2705. Leah Post-Ratliff can be reached at 612-543-2604.